The Pill Demystified

The urge to control procreation and prevent pregnancy is certainly nothing new. Aristotle recommended the use of olive oil as a spermicide, encouraging women to “anoint their wombs.” The ancient Indians used red chalk, powdered palm leaves and honey as pessaries to prevent pregnancy. The ancient Greeks preferred willow, date palm and silphium as a contraceptive.

2017-04-06 The Pill Demystified Featured Photo

Thankfully, with ever-improving medical knowledge and efforts in public health and reproductive rights, the rates of unwanted pregnancy have starkly declined over the ages.

However, our fascination with contraception remains strong.

The pill garners so much media attention because of what it represents. It is not only a medication, but also a catalyst for debate about some of the most contentious and controversial issues of our time. The pill not only represents sexual freedom, but introduces a discussion about a woman’s right to control her body, about the interplay between religion and medicine, and about just how much we trust pharmaceutical companies.

Despite being used by over 100 million women worldwide, the contraceptive pill is still something of a mystery to many. Falsification, fabrication and fear-mongering have always seemed to surround the tiny tablet. A quick Google search will tell you the pill is responsible for almost any disease or ailment that can afflict the female body; weight gain, weight loss, depression, cancer, blood clots, heart attacks, infertility, abortion, and even promiscuity and demonic possession.

With the myriad of information available it is often difficult to distinguish what is true from what is false; what is a genuine risk, and what is overstated.

Here, Professor Euan Wallace, Director of the Ritchie Centre and the Medical Director for Monash Women’s Maternity Services sheds some light on some of the most prevalent myths surrounding the contraceptive pill.

Note the following interview has been lightly edited for clarity.

Does the pill cause breast cancer?

‘To a certain extent, yes. Both the combined oral contraceptive pill (COCP) and to a lesser extent, the progestin only pill (POP, “mini pill”) increase the risk of breast cancer very slightly. The size of that increased risk depends on the age of the woman, with a much smaller effect in younger women than in older women.

‘However, the breast cancers seen in conjunction with the COCP are smaller and more amenable to treatment than other breast cancers. It is also likely that the already low rate of COCP-related breast cancer is falling with the newer low dose pill preparations. Overall, there are much more important risk factors for breast cancer.’

 

Is skipping your period dangerous to your health?

‘Definitely not. Monthly periods, while the modern norm, are not “normal.” As a species, we are not meant to have a period every month. Prior to “modern life,” women were largely either pregnant or breastfeeding and therefore not menstruating much at all during their reproductive years.

‘However the ‘freedom from the tyranny of excessive fertility’ (as Sir Dugald Baird famously called it) that the COCP has afforded women is a major win. Women are now much healthier and have a longer life expectancy than they did in the past.

‘In short, it is good for individual women to have fewer children. However, the resultant monthly period brings with it increased risk of anemia and ovarian and endometrial cancer. Running several packets of the COCP together to result in fewer periods (typically 3-4 per year) reduces the risk of anemia, ovarian and endometrial cancer without any major risks.’

Does the pill cause infertility?

‘Again, certainly not. Some women experienced episodes of delayed menses when coming off the pill – so called ‘post pill amenorrhea’. These episodes of less frequent periods would likely have happened in these women anyway. Certainly, the pill is not associated with infertility once it is stopped.

‘Of course, the sexual freedom that the pill affords women is often associated with an increased number of total sexual partners. Increasing numbers of sexual partners without barrier to contraception does increase the risk of exposure to sexually transmitted infections, which can cause infertility, but it is definitely not the pill itself that causes infertility.’

 

Can the pill protect you from sexually transmitted infections?

‘It is very important to note that the pill offers no protection against sexually transmitted infections. As yet, only barrier contraceptive methods like the condom can decrease your risk of infections, and accordingly these methods are always recommended.

‘However, it is important to keep in mind that whilst barrier contraception does decrease your risk of contracting STIs if used correctly, no method can offer 100% protection.’

It is impossible to adequately tackle all the rumours that surround the tiny tablet. Like any medication, it is subject to its own risks and benefits. But it is also subject to its own unique controversy. No other medication in history has been discussed in quite the same philosophical realm as the OCP. And no another medication has to live up to as much moral scrutiny as it has scientific scrutiny. And whilst reproductive rights been thrust into the spotlight in the past few decades, there is still a long way to go in ensuring all women have access to safe and affordable contraception. And that’s a hard pill to swallow.

For more information regarding the safety and suitability of the OCP, contact your local GP or gynecologist.

The views and opinions expressed in this article are those of the author and do not necessarily represent those of the Doctus Project.