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HORMONAL BIRTH CONTROL
I. INTRODUCTION
a. Birth control changed society
b. Many barrier methods being used for years
c. Birth control pill developed in 1960
d. Hormonal birth control becomes one of the most effective and reliable methods of birth
control following the pill’s development
e. THESIS: What are the current methods of hormonal birth control and how were they
developed?
II. HOW PREGNANCY OCCURS
a. An understanding of how pregnancy occurs must be developed in order to create ways to
prevent it
b. Normal menstrual cycle includes ovulation
I. Started by hormones
II. Release of egg from ovary, which travels down fallopian tube
III. After egg is released, progesterone levels increase, preventing the formation and/or
release of more eggs
IV. Egg can be fertilized by sperm following intercourse, which then attaches to lining of
uterus and begins cell division to form a baby
III. OVERVIEW OF METHODS OF PREVENTING PREGNANCY
a. To prevent sperm and egg from joining, one can prevent sperm from traveling up the cervix,
called barrier methods.
I. Idea of barrier methods has been around for centuries
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b. To prevent sperm from reaching egg, sperm can be killed with spermicides
I. Spermicide idea was used in BC times.
c. The newest and most successful way of preventing pregnancy is to prevent the egg from
even being released in the first place.
I. Progesterone, a hormone that increases in amount after an egg is developed and
released from the ovary, prevents production and/or release of new eggs. Increased
progesterone throughout the menstrual cycle will prevent ovulation from occurring at any
time, thus voiding no egg for sperm to fertilize.
IV. PEOPLE OF THE PILL
a. Margaret Sanger wanted to legalize effective methods of birth control out of personal
tragedy
b. Sanger wanted to develop the oral contraceptive
c. Katherine McCormick promoted women’s rights; met with Margaret Sanger and supported
her cause
d. The two women met with endocrinologist Gregory Pincus in 1953 with the idea of creating
an oral contraceptive
I. Had heard that Pincus achieved in vitro fertilization in rabbits
V. DISCOVERING AND EXPERIMENTING WITH PROGESTERONE
a. Gregory Pincus had heard of progesterone working to prevent ovulation
b. Katherine McCormick funded Pincus and his colleague, MinChueh Chang, in their
experiments with progesterone
c. Margaret Sanger secured a small grant from her new foundation, Planned Parenthood, for
Pincus’ research.
d. Pincus and Chang proved that repeated progesterone injections halted ovulation in animal
test subjects.
VI. TURNING PROGESTERONE INTO A PILL
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a. Pincus sought funding from Searle Pharmaceuticals to create an oral antiovulation pill.
I. At first turned him down because of strict laws against forms of birth control, but then
gave in.
b. Pincus and Chang created a pill containing both synthetic progesterone and synthetic
estrogen
c. Held successful clinical trials in Puerto Rico because contraception was outlawed in the
United States
d. The pill was approved by the FDA in 1957 as a treatment for menstrual disorders, called
Enovid.
I. “Side affects” included the prevention of pregnancy
II. Many women claimed to have menstrual disorders in order to gain access to a
prescription for the new pill
e. In 1960 was approved as the first birth control pill
VII. SIDE EFFECTS OF THE PILL
a. Like all drugs, birth control pill has side effects
b. Minor side effects
I. Nausea/vomiting
II. Breast tenderness
III. Spotting or breakthrough bleeding between periods
IV. Headaches
V. Mood changes
VI. Weight loss or gain
c. Serious side affects
I. High blood pressure
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II. Blood clots
III. Heart attack
IV. Stroke
V. Heart disease
VIII. CHANGES IN THE PILL
a. Original standard dose of ten milligrams lowered in 1980s
b. Many low dose options offered, as low as one milligram
c. Lower dose reduces or eliminates side effects
d. Many different brands and types of pill now offered
I. Minipill is progestinonly, which only thickens cervical mucus
II. Seasonale gives a woman her period only four times a year
III. Lybrel eliminates monthly periods, 365 days of active pills a year
IV. Some, like Yaz, are formulated especially for the treatment of PMS/PMDD and
acne
V. The original birth control pill was a monophasic pill, meaning that all the active
pills contained the same dose of hormones. Biphasic and triphasic pills are newer
versions of the pill, and the pills are given in phases.
e. Today, an outstanding 15.6 percent of American women aged 1544 use the oral
contraceptive.
IX. RELIABILITY OF THE ORAL CONTRACEPTIVE
a. The oral contraceptive is anywhere from 97 percent to over 99 percent reliable.
X. OVERVIEW OF OTHER TYPES OF HORMONAL BIRTH CONTROL
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a. Since the dawn of hormonal birth control with the development of the oral contraceptive,
many other methods have been introduced to provide hormonal birth control to women.
b. There are many ways to deliver hormones that aid in preventing pregnancy to the human
body.
I. Hormonal Intrauterine Device (IUD)
II. Injection
III. Patch
IV. Vaginal ring
XI. THE HORMONAL INTRAUTERINE DEVICE
a. Two types
I. One that constantly releases progesterone, can be used for up to one year.
(Progestasert)
II. One that releases a low hormone amount similar to progesterone each day, also
called an intrauterine system. (Mirena)
III. Placed in uterus by a doctor to prevent pregnancy.
XII. THE HORMONAL INTRAUTERINE DEVICE – PROS AND CONS
a. PROS
I. Can remain in place for one to five years, depending on type of device
II. Can be removed at any time
III. No daily, weekly, or monthly routine needed.
b. CONS
I. Can have side effects such as cramping, abnormal bleeding, pelvic inflammatory
disease, and the perforation of uterus.
II. Must be inserted and removed by a doctor.
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XIV. THE HORMONAL INTRAUTERINE DEVICE – STATISTICS
a. Reliability – over 98 percent effective
b. Popularity – About 0.7 percent of American women aged 1544 use an intrauterine device.
XV. THE INJECTION
a. Highdose injections of progesterone given once a month or once every three months
depending on the brand
b. Given in the buttocks, thigh, or arm.
I. Lunelle is given once a month
II. DepoProvera is given once every three months
XVI. THE INJECTION – PROS AND CONS
a. PROS
I. Very private form of birth control
II. No daily or weekly routine needed
III. Can help protect women fromcancer of the lining of the uterus
IV. Can reduce bleeding and anemia that may occur during periods
V. Some women may stop having their periods (pro or con)
b. CONS
I. Many women experience side effects like bloating, weight gain, headaches,
depression, libido changes, and hair loss.
II. Can take 18 months or more for fertility to return after shots are discontinued
III. Shots can be painful
IV. DepoProvera is shown to cause some bone loss in longerterm users.
XVII. THE INJECTION – STATISTICS
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a. Reliability – Perfect use, higher than 99 percent; typical use, about 97 percent
b. Popularity – Though the exact number or percent of women using the hormonal injections
is not known, the injections have decreased in popularity due to their side effects.
XVIII. THE PATCH
a. The patch was developed as an alternative method to a “cumbersome daily pill”. (that
lawyer site)
b. The patch is placed on the lower abdomen, buttocks, or upper body.
c. Hormones estrogen and progestin are absorbed transdermally.
d. Replaced once a week for three weeks (fourth week menstruation)
XIX. THE PATCH – PROS AND CONS
a. PROS
I. Convenient, apply a new patch once a week for three weeks straight and do not
wear one for the fourth week to allow for menstruation.
II. Good for those who have trouble swallowing pills or remembering to take them.
b. CONS
I. Minor side effects such as breast changes, nausea, and weight gain to major
ones such as depression, serious urinary tract infections, and death from blood
clots.
II. Patch users are three times more likely to develop a blood clot than those using
the typical oral contraceptive, which can be fatal.
III. Patch may irritate skin of some users
XX. THE PATCH – STATISTICS
a. Reliability – Over 99 percent effective in perfect users; typical rates unknown
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b. Popularity – After being released in 2002, five million American women used the patch in
the first three years. (onlinelawyersource.com)
c. Was named one of Time Magazine’s “Coolest Inventions” in 2002.
XXI – THE VAGINAL RING
a. Flexible, vinyl ring inserted into the vagina
b. Worn for three weeks, discarded in the fourth week to allow for menstruation.
c. Slowly releases an even amount of estrogen and progestin which is absorbed into the
bloodstream.
XXII. THE VAGINAL RING – PROS AND CONS
a. PROS
I. Easy to insert
II. No daily routine needed
b. CONS
I. If the ring is out of the vagina for more than three hours during the three week
wearing period, a backup method must be used until the reinserted ring has been
in place for three days.
II. Can cause vaginal discharge, infection, or irritation.
XXIII. THE VAGINAL RING – STATISTICS
a. Reliabilty – Over 99 percent effective in users
b. Popularity – Still a fairly new product, numbers are not known, but growing in popularity due
to ease of use.
XXIV. MY TAKE ON BIRTH CONTROL
a. Is hormonal birth control worth the risks?
b. Which method do I feel is the safest and/or most effective?
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XXV. CLOSING
a. Hormonal birth control is the most effective form of birth control.
b. Hormonal birth control is easy to use and extremely reliable.
c. Though hormonal birth control has some unpleasant side effects, it also has some that
women may find beneficial to their health and wellbeing.
d. Overall, hormonal birth control is the preferred method of birth control for many women and
has had a significant impact on modern society.