It's a funny coincidence that the 50th anniversary of the birth control pill's own birth happens to fall on Mother's Day--this Sunday, May 9. Given how much the pill has changed women's reproductive lives, though, I suppose it's apropos. Where our grandmothers had five or six children, women now typically have two or three–thanks to the latest generation of highly effective contraceptive methods. And more babies today are born to women over 35 than to teenagers, according to a study released on Thursday by the Pew Research Center--a clear sign we're taking measures to delay reproduction. To no surprise, four out of five Americans in an April poll conducted by Harris Interactive believe that the advent of the pill has been good for society. So how exactly has the pill changed our lives?
1. The pill increased a woman's earning potential. By enabling women to delay childbearing, the pill appears to have made women more financially secure. That's the finding of a recent study from the University of Maryland and the University of California at Los Angeles, which shows that women who gave birth after age 26 were financially better off in their 50s than those who gave birth earlier. The reason is fairly obvious: Women who get their careers going before having kids are more likely to get the education and work experience needed to get and keep better-paid positions, even if they later take time off to raise kids. Interestingly, the researchers also found that those who delay motherhood but eventually have children make as much over the long haul as women who remain childless.
2. The pill made infertility into an epidemic. To be clear, oral contraceptives don't cause infertility; ovulation usually resumes within a month or two after going off the pill. But the trend toward shifting reproduction from a woman's early 20s (when she's most fertile) to her late 30s or early 40s (when fertility is on the wane) has dramatically increased since the pill became widespread, to the extent that 20 percent of couples contend with the issue of infertility at one time or another. Fertility centers that offer treatments like in vitro fertilization are booming. "Unfortunately, infertility increases with age, and IVF and other treatments don't work as well in those over 40," says contraception researcher Abbey Berenson, a professor of obstetrics and gynecology at the University of Texas Medical Branch in Galveston. Adding insult to injury, adoption agencies often have age limits.
3. The pill alleviated many menstrual problems. "There's no question that the pill helps with menstrual cycle problems like severe cramps, migraines and excessive bleeding," says Berenson. That's because the pill's withdrawal bleed (during the placebo days) is really a fake period, much lighter and fueled by a smaller hormonal dip than normal periods triggered by the ovulation cycle. (In fact, some women choose to skip periods all together with newer formulations that they take continuously.) Pill users also tend to have less trouble with endometriosis, in which the uterine lining grows around the fallopian tubes, and they have lower rates of ovarian cancer. The risk of blood clots and strokes, however, increase with pill use especially in those who smoke or are over 35. And it's still not known whether there's any link between the pill and breast cancer.
4. The pill opened the door for other hormonal birth control options. Hormonal contraceptives have come a long way in the past 50 years—even the pill today would hardly be recognizable to a pharmacist from 1960. "The doses of estradiol [estrogen] have declined steadily from 150 micrograms in the 1960 version to 20 to 30 micrograms in today's products," says Berenson, and that drop alleviated many of the early side effects like nausea, vomiting and headaches, which made the first pill impossible for many women to tolerate. The synthetic progesterone component has also changed over time, she says, to act less like a male hormone and, thus, less likely to cause acne, mood swings and facial hair growth. In fact, a newer formulaton, Yaz, purports to clear up acne and premenstrual syndrome. For women who prefer not to take a daily pill (or frequently forget), they can choose other hormonal delivery methods like the skin patch, vaginal ring, and progesterone-releasing intrauterine device. A progesterone shot, Depo Provera, is also an option, though Berenson's research has shown a link between Depo Provera and significant weight gain; about one-quarter of users gain upwards of ten pounds.
5. The pill lowered likelihood of unplanned pregnancies and abortions. When used correctly—taken at the same time every day—the pill's effectiveness rate is about 99 percent, comparable to other hormonal contraceptives. That's far better than older barrier methods like condoms, diaphragms and spermicides, which are about 90 to 95 percent effective when used with every sexual encounter, and the pill may account for a lower rate of unplanned pregnancies and abortions, according to a 2009 Guttmacher Institute study. Note: barrier methods are still vital for preventing sexually transmitted diseases, which the pill doesn't protect against.
6. The pill altered women's sex drives and sex lives. Some research suggests that the pill and other hormonal contraceptives quash a woman's natural sexual urges by lowering levels of the "libido" hormone, testosterone. "But I don't think we have good definitive studies on that," says Berenson. "Sex drive is such a complicated process, usually very dependent on a woman's age, her stress levels, how much sleep she's getting and the culture in which she was raised." Of course, the pill is also credited for ushering in the sexual revolution of the 60s. Without fear of pregnancy, women may have been more "in the mood."
7. The pill inspired the idea for a male pill. Emphasis on "idea," since several pills that have been tested for curtailing a male's fertility haven't made it beyond clinical trials. "There may be a pill for men at some point," says Berenson, "but nobody's talking about it hitting the market any time soon."