Oral Contraceptive Pill

More than 60 million women worldwide are currently using oral contraceptive. By now, because it is more than 40 years old, most known that the pill’s combination of synthetic oestrogen and progesterone hormones stops ovulation, making it an extremely effective birth control. It also regulates and alleviates many unpleasant symptoms of menstrual cycles.

The pill has undergone major changes since it first became available in North America in 1957. Back then doctors and patients had to grapple with the side effects of early oral contraceptive. First generation pills contained 5000 micrograms of oestrogen-more than 250 times the amount used in today’s lower dose pills. Over the years, as researchers continued to search for the balance of hormones that was enough to prevent pregnancy, the amount of oestrogen dropped to 150, then 100. Then 50 micrograms per pill.

Now many oral contraceptive pill on the market contained between 20 to 35 micrograms of oestrogen. In Europe a 15 micrograms pill is available. Side effects that plagued early pill users such as spotting, weight gain and breast tenderness tend to be minimal.

Newer pill also contain progestin that causes fewer side effects than their predecessors. And one addition to the pill family, Yasmin, introduced in 2001, uses synthetic progesterone like compound that helps reduce water retention, and may lead to some weight loss or at least prevent weight gain.

Though oral contraceptive pill have a long history and are widely used, many women still have surprising misconception about the pill. Many think it may compromise fertility and cannot be used by women over a certain age.

Some of the misconceptions arise from the results of a couple of large studies. Early in the 1980s, long term research concluded that there was an age related risk of heart attack in pill users, but it was highest among the smokers. At that point, women over the age of 35 who smoked were advised to get off and stay off the pill, or to stop smoking. But somehow, the message got over simplified, and many healthy non smoking women over 35-and their doctors-no longer considered the pill a reasonable option.

How long is too long on the pill? Women going through the transition years leading up to menopause can often safely take the pill. “Generally, I think women in premenopausal age group should certainly look at the use of oral contraceptive pill.” Says Derzko. These pills not only offer health benefits, but also have a strong ability to reduce or eliminate most of the cyclic and premenopausal symptoms that can drive women to distraction.

According to Derzko, the current thought is that many women can easily stay on the pill until about age of 55-in most cases completely bypassing the uncomfortable transition into menopause. The pill does not change the timing of the process: it only helps to keep symptoms to a minimum and cycles predictable.  

To determine when the transition is complete, doctors can check the oestrogen levels in the blood during a week off the pill. Some women may even start to feel a symptom such as hot flushes on those days. What happens next is between the doctors and patients: some women are fin simply coming off the pill, others may go onto a low dose on HRT temporarily to wean themselves off and still others may benefits from a move directly into regular HRT.

“We are really moving into different areas now,” says Derzko. “It is the boomers, pushing the envelope again, saying, I’m healthy, and I don’t like these symptoms that I’m having.”

And the new pill may be just the cure they are looking for.