Tag Archives: hormones

The History of the Birth Control Pill, Part 5: Clinical Trials

Posted on by
Reply
Gregory Pincus, Min-Chueh Chang, and John Rock, three scientists employed by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Gregory Pincus, Min-Chueh Chang, and John Rock were hired by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Welcome to the fifth installment of our series chronicling the history of the birth control pill. In the previous installment, Margaret Sanger and Katharine McCormick envisioned and bankrolled the development of the birth control pill. Now it had to be tested in large-scale trials.

John Rock, Gregory Pincus, and Min-Chueh Chang had collaborated in the Pill’s development; now it was time to conduct clinical trials. The first study observed 60 women, some of whom were infertility patients while others were nurses. These small trials involved daily temperature readings, vaginal smears, and urine samples, as well as monthly endometrial biopsies. Although the initial results seemed promising, the sample size was small and few of the subjects complied with the protocol.

The approval of the Pill in 1960 marked a turning point in our history.

More test subjects were needed. At this point, historians’ accounts differ. Elaine Tyler May claims that, unable to locate an acceptable pool of volunteers, the researchers tested the Pill on subjects who could not give their consent, such as psychiatric patients. According to Bernard Asbell, however, Rock was scrupulous when it came to informed consent, despite it not being a legal requirement — or even much of a concept at all at this time in history.

Willing participants notwithstanding, conducting such trials in the United States posed a challenge, due to laws against contraception. So the first large-scale clinical trials were conducted in Puerto Rico in 1956. Puerto Rico was densely populated and there was a high demand for alternatives to permanent sterilization, which was widespread on the island due to funding from a wealthy eugenicist named Clarence Gamble, who advocated sterilization for the world’s poor. The clinical trials in Puerto Rico were conducted by Drs. Edris Rice-Wray and Adaline Sattherthwaite; the brand of birth control pill tested was named Enovid. Volunteers were so easy to come by that some clinics had waiting lists. Continue reading →

Let’s Talk Contraception: Do Birth Control Pills Cause Blood Clots?

Posted on by
Reply

Alarming ads urge you to call a lawyer if you’ve been “injured” taking certain birth control products, such as Yaz, Yasmin, or NuvaRing. These injuries include venous thromboembolisms (VTEs), heart attacks, and strokes. It’s frightening to wonder if you are endangering your health by taking a pill to prevent pregnancy or treat dysmenorrhea (painful cramps).

Should you stop taking your pills? What is a VTE and why should you worry? VTE is a blood clot that usually starts in your leg, but may break loose and travel to your heart or brain and cause a heart attack or stroke. It can be life-threatening, so it is a serious side effect to be concerned about. All birth control pills may increase your risk for a VTE, but it has always been considered so small that most women can safely take the pill. About 3 to 9 women in 10,000 who use birth control pills for more than one year may have a VTE compared to 1 in 5 women out of 10,000 who are not pregnant and not on the pill.

Birth control pills are considered very safe for the majority of women, but all medications carry some risk of adverse effects.

When oral birth control pills were first developed, they contained much higher doses of estrogens and progestins — types of hormones — especially estrogen. It was also noticed that there was a higher risk for developing a blood clot while using birth control pills than in nonpregnant women who didn’t take the pill. It was thought that the high dose of estrogen was responsible for this risk. So, with continuing research and development, eventually the dose of estrogen was decreased to the lower level used today to minimize the chance of a clot. The type of estrogen in pills today is almost exclusively ethinyl estradiol. Continue reading →

The History of the Birth Control Pill, Part 4: Margaret Sanger’s “Magic Pill”

Posted on by
Reply
Katharine McCormick

Katharine McCormick

Welcome to the fourth installment of our series chronicling the history of the birth control pill. In the previous installment, progesterone, the birth control pill’s active ingredient, could only be administered intravenously. Scientists working in Mexico figured out how to alter its chemical structure so that progesterone would be active when taken orally.

Katharine McCormick was born into a moneyed family and was, in 1904, the second female graduated by the Massachusetts Institute of Technology. After receiving her degree in biology, she married a wealthy man, but shortly into the marriage she gained control of her husband’s estate due to his illness. She put a lot of this money to good use: In the 1920s, she aided Margaret Sanger’s efforts to smuggle diaphragms into the country.

Katharine McCormick, a philanthropist and one of the first scientifically trained women, provided early funding for the Pill.

Her involvement with Sanger didn’t end there; indeed, both Sanger and McCormick had a lot in common, despite Sanger’s working-class childhood and McCormick’s privileged upbringing. According to historian Elaine Tyler May, McCormick and Sanger both had “a tremendous faith in the possibility of science,” and Sanger “believed that science held the key to contraception and to women’s emancipation.” Back in the ’20s, Sanger wrote:

Science must make woman the owner, the mistress of herself. Science, the only possible savior of mankind, must put it in the power of woman to decide for herself whether she will or will not become a mother.

In 1950, McCormick again joined forces with Sanger. In the mid-’40s, after a countrywide tour of family-planning clinics, Sanger had come to the conclusion that the diaphragm was not an adequate form of birth control, revitalizing her hope for a “magic pill.” Neither pharmaceutical companies nor the government wanted to invest in contraceptive research, considering it a “disreputable” area of study, so Sanger hatched a scheme to bankroll the independent development of an oral contraceptive. At Sanger’s behest, McCormick provided the lion’s share of funding for the project — more than $2 million (compared to the value of a dollar in the year 2000, that would be about the equivalent of $12 million). Sanger and McCormick tapped Gregory Pincus to conduct the research. McCormick, thanks to her education in biology, oversaw the research in addition to funding it. Continue reading →

The History of the Birth Control Pill, Part 3: From Injection to Ingestion

Posted on by
2
Carl Djerassi with his assistant, Arelina Gonzalez, 1951

Carl Djerassi with his assistant, Arelina Gonzalez, 1951

Welcome to the third installment of our series chronicling the history of the birth control pill. In the previous installment, we learned about the iconoclastic chemist Russell Marker, who figured out how to synthesize large quantities of progesterone — the birth control pill’s active ingredient — from a yam called barbasco that grew wild in Mexico.

In 1949, Russell Marker dropped out of science — “I considered all chemists to be crooks,” he bitterly opined — and a scientist named Carl Djerassi was hired to head the lab at Syntex, the hormone-synthesizing laboratory in Mexico that Marker had co-founded in 1944. Within a few years, Syntex was a major player on the synthetic-hormone scene in Europe and the Americas.

After Luis Miramontes’ successful experiments, all of the elements for Sanger’s “magic pill” were in place.

Although progesterone could be manufactured in large quantities at this time, it could only be given intravenously. Progesterone was being used therapeutically to prevent miscarriage and treat excessively heavy menstrual periods. The lack of alternatives to injections represented a problem for these people — a daily pill would be easier and more convenient than frequent injections. In 1950, Syntex set their sights on the development of a synthetic form of progesterone that was more effective in smaller doses and could be administered orally rather than by intravenous injections. Such a development would be necessary before Margaret Sanger’s dream of a “magic pill” could come true. Continue reading →

The History of the Birth Control Pill, Part 2: Barbasco and the Roots of Hormonal Contraception

Posted on by
2
Russell Marker. Image: Penn State University Archives

Russell Marker. Image: Penn State University Archives

Welcome to the second installment of our series chronicling the history of the birth control pill. Previously, we learned about the role a sex hormone called progesterone plays in inhibiting ovulation. Scientists had no easy way to isolate significant amounts of this chemical and wanted to find a quick and inexpensive method for synthesizing large quantities of progesterone.

Russell Marker was born to Maryland sharecroppers in 1903. Hoping to escape rural life, Marker was one of only two students in his junior-high class to attend high school. He graduated in three years and enrolled at the University of Maryland, where he earned bachelor’s and master’s degrees in chemistry. He needed one more class to receive his doctorate, but refused to take it, believing he had already mastered his chosen subject, organic chemistry. He was only interested in working in the lab and thought the required course would be a waste of his time. (The university did eventually award him an honorary doctorate in 1987.)

A wild-growing yam in Mexico provided chemicals that could be refined into progesterone, the active ingredient in the Pill.

At the time, the scientific community was abuzz with discoveries being made about hormones. They held tremendous potential for research, but scientists couldn’t figure out how to isolate large quantities of them for study. Up for a challenge, Marker set out to find a way to synthesize one hormone, called progesterone, in abundance. He hypothesized that plants from the genus Dioscorea, which includes yams and agaves, would be cheap sources of steroid hormones. Marker was specifically hoping to find plants rich in sapogenins, which are chemically similar to cholesterol. Continue reading →

The History of the Birth Control Pill, Part 1: Hormones, Our “Chemical Messengers”

Posted on by
2

Welcome to the first installment of our series chronicling the history of the birth control pill, from our discovery of how hormones work, to the synthesis of these hormones from an inedible wild Mexican yam, to the creation of a pill that changed the world.

Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses. Indigenous people used it as a fish poison, and traditional Mesoamerican healers used it to treat rheumatism, snakebites, muscular pain, and skin conditions. When the root was fermented in alcohol and put on aching joints, it was believed to work as a pain reliever.

The idea of a birth control pill was born in 1912 when Margaret Sanger dreamed of a “magic pill.”

Barbasco’s medicinal uses might not be surprising, given that scientists derived a chemical from the yam that led to the development of cortisone and oral contraceptives, both of which had sizable impacts on medicine and society. Oral contraceptives would not have been possible without a cheap and abundant source of progesterone, which was easily synthesized from the root after an American chemist, Russell Marker, discovered a process for converting a cholesterol found in barbasco’s roots to progesterone, a key ingredient in the Pill.

In the decades before this chemist’s excursion to Mexico, first-wave feminism was brewing in turn-of-the-century United States, and birth-control pioneer Margaret Sanger demanded access to contraception — in 1915, she invented the term “birth control,” and as early as 1912, the idea of a birth control pill had been envisioned — again, by Sanger, who wrote of her hope for a “magic pill.” A nurse, Sanger was spurred to action by the horror of watching women die prematurely after having too many children, while other women died from botched abortions. Continue reading →

Pro-Choice Book Club: Histories of Oral Contraceptives

Posted on by
1

Hormonal birth control has an incredible history that stretches back almost a century, when Margaret Sanger wrote of her dream of a “magic pill” in 1912. In the ensuing decades, scientists were busy piecing together the complex system of the body’s “chemical messengers,” hormones, and when they learned how to synthesize them in the ’40s, Sanger’s dream was but a few steps away from being fulfilled. Three engaging accounts of the Pill’s development — The Pill: A Biography of the Drug That Changed the World by Bernard Asbell (1995), America and the Pill: A History of Promise, Peril, and Liberation by Elaine Tyler May (2010), and Jungle Laboratories: Mexican Peasants, National Projects, and the Making of the Pill by Gabriela Soto Laveaga (2009) — contain some overlap, while offering different perspectives.

Each author tells the inspiring story of Russell Marker, the chemist who first finagled progesterone from a wild-growing Mexican yam. Despite a near lack of support from pharmaceutical companies and the scientific community, he traveled to rural Mexico on a hunch — and ended up co-founding a laboratory that became the world’s top hormone supplier for the next few decades. Before Marker formulated a way to synthesize hormones in abundance, they were derived from slaughterhouse byproducts and were prohibitively expensive. Marker’s experiments enabled further medical research in hormones, and progesterone was soon used not only in oral contraceptives, but as a precursor for other medications such as cortisone.

While Carl Djerassi is often credited as the “father of the Pill,” both Asbell and May tip their hats to Margaret Sanger and Katharine McCormick, the Pill’s “mothers.” These two women also have fascinating biographies. As a nurse in the early twentieth century, Sanger was acquainted with the horrors that arose when women did not have control over their fertility. Many of her patients became infected or even died as the result of illegal or self-induced abortions, which motivated Sanger to become an activist for contraception’s legalization — an avocation that saw her illegally smuggling diaphragms into the country and serving time in jail after opening a family-planning clinic in Brooklyn. Continue reading →