New uses for the old Pill

The Pill, oral contraceptive pill, is the most important innovation of the 20th century. (I’m a woman, sue me.)

Margaret Sanger, founder of Planned Parenthood, pushed relentlessly and heroically for its discovery and legalization. In 1910, Sanger, a nurse in New York City, witnessed the burden of unwanted pregnancies on women and families and the horror of self-induced abortions. (Her own mother had 18 pregnancies in 22 years and died young.) Birth control, she thought, would allow a woman to be “the absolute mistress of her own body," improving her well being and social equality.

Since the inception of the first pill, Enovid, in 1960, the Pill has come a long way.

Today, I take the Pill’s contraceptive benefit very much for granted. Most times, it’s not even my first choice for birth control. Yet I prescribe the Pill, a lot, for many good reasons other than or in addition to contraception.  

First, heavy bleeding.

Many women live with heavy periods, doubling tampons with pads. Iron deficiency is common. In mild cases, they feel slow and sluggish. In bad cases, they crave weird stuff. I’ve had women nibbling on toilet paper and chewing ice until their teeth chipped.   

The menstrual cycle is governed by a complex hierarchy of chemicals, easily thrown off course. But the Pill overrides the system like a malware virus. In some preparations, a few drops of blood constitute a period. 

Second, timing.

While a traditional package runs 28-day cycle, newer pills can stretch a cycle to three months, a year or none at all.

Let’s say you need to postpone your period by a few days or weeks for a business trip, a triathlon, a swim with sharks in the Bahamas. You can do so by taking the active pills and skipping the placebo. Really, it’s that easy.

Also, the Pill helps reduce acne, menstrual cramps, migraines, etc. But the Pill’s life isn’t all roses either. Irregular bleeding is the most common reason why women stop using it. Talk to and work with your doctor.  

For birth control, I prefer intrauterine devices (IUDs) and implants. The American College of Obstetricians and Gynecologists has a nice video titled “Contraception” on its website, acog.org.

Modern IUDs come with or without hormones, and last anywhere from three to 10 years. They are safe and well tolerated. You can take them out anytime you want. But once they’re in, they’re in – you don’t need to think about it. Currently, they’re the recommended first-line contraceptive methods for most women, including teens.

The Pill was born at a time of powerful opposition – the church, the federal government and most states had anti-birth control laws. Sanger was driven by her passion in liberating women. Her lead researcher, the brilliant Dr. Gregory Pincus, was driven by, well, unemployment. At the time, he was “dropped” by Harvard and working out of a lab in a converted garage. A colleague said, “[Pincus] wasn’t afraid to go out on a limb because he didn’t have any limb.”

Who says desperation doesn’t work?

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Volume 10, Issue 10, Posted 9:36 AM, 05.15.2018