Today (11 May 2010) marks the 50th anniversary of the oral contraceptive pill. Since it was first made available 50 years ago, “the Pill” has played an important role in the lives of women, giving them the freedom to pursue education, career and planned parenthood.
First approved for use in the United States in 1960, the history of the oral contraceptive pill dates back to 1901 when physiologist Ludwig Haberlandt was the first to understand the connection between ovulation and pregnancy. However, the history of contraception can be traced back much further than that, to ancient times, when the Greeks and Egyptians used a variety of suppositories including ground up pomegranate seeds and crocodile dung to try to prevent pregnancy.
During the Middle Ages people used condoms made from a variety of materials including animal intestines and linen, a practice which continued up until the 1850s when the first rubber condom was invented.
In the 1870s German biologist Oskar Wilhelm August Hertwig became the first person to observe the process of fertilisation – the penetration of a sperm into an egg. Ten years later the first rubber diaphragm was developed which covered the cervix and created a barrier that prevented sperm from reaching the egg.
About 15 years after Ludwig Haberlandt began his pioneering research, American social reformer Margaret Sanger coined the term “birth control” and began her decades-long crusade to bring safe and effective contraception into the mainstream.
In 1919, Ludwig Haberlandt was able to demonstrate that when the ovaries of pregnant rabbits were transplanted into non-pregnant animals, ovulation was inhibited and therefore pregnancy was prevented. This was the first indication that hormonal contraception was a viable option.
In the 1920s the first intrauterine devices (IUDs) were developed in Germany. Initially, IUDs were made from various materials including silkworm intestines and silver. In the same decade, English reformer Marie Stopes opened birth control clinics and the diaphragm was first introduced in Australia. The first birth control clinic in Australia was opened in Sydney in 1933.
In 1938, Hans Herloff Inhoffen and Walter Hohlweg at Bayer Schering Pharma (then Schering) developed the first synthetic oestrogen (female sex hormone) – ethinyl estradiol – which remains the most effective and widely used oestrogen component in oral contraceptives today. The first oral progestin (a synthetic hormone that acts in a similar way to progesterone when administered orally and a common ingredient in modern contraceptive pills), was discovered by Inhoffen and Hohlweg in the same year.
In 1942, American chemist Russell Marker found that diosgenin, a compound extracted from the wild yam roots, Dioscorea, that grew in Mexico, could be efficiently manufactured into a progestin. Marker was able to achieve a reduction in the cost of producing synthetic progesterone (now called progestin) which provided other biologists with ready access to the hormone for experimentation.
In the early 1950s, Margaret Sanger introduced reproductive physiologist and leader in hormone research Gregory Pincus, to suffragist Katherine McCormick. McCormick provided financial support for developing a medicinal method of contraception. Both Sanger and McCormick continued to be central figures in the fight for birth control and were driven by a vision to help alleviate the misery that unwanted pregnancy can cause, particularly in poor and immigrant populations.
Pincus along with John Rock, an American gynaecologist from Harvard became a major developer of the Pill. However, because Massachusetts law banned the use of contraceptives, the first large-scale clinical trials of the modern-day Pill had to take place in Puerto Rico in 1956.
On 11 May 1960, the first oral contraceptive pill was introduced to the US market. Nine months later on 1 February 1961, Australia was the first country in the Asia Pacific Region to offer the oral contraceptive pill to women. However, initially only married women had access to the Pill.
Throughout the 1960s, research into the development of other hormones progressed and in the coming years, oral contraceptives were developed which resulted in a reduction in the level of hormones and side effects, without compromising reliability.
The introduction of the Pill has possibly had a greater influence on our society than any other pharmaceutical product in history. It can be argued that this one little Pill changed the course of history, giving women control over their own fertility which in turn, gave women the freedom to pursue education and career goals in ever increasing numbers.
Over the last 50 years, the Pill has developed to meet the changing needs of women and today, the Pill provides contraceptive efficacy with a lower hormone dose, as well as benefits beyond contraception such as less acne and a reduction in severe premenstrual symptoms.
The availability of the Pill paved the way for the introduction of other longer-acting forms of hormonal contraception. However, 50 years after it was first introduced, the Pill remains the preferred method of contraception for more than 100 million women worldwide.