HORMONE
ORAL CONTRACEPTIVES
A
T THE I974 CEREMONY GRANT-
ing an honorary doctorate to Carl Djerassi, who is known as the Father of the Pill, the pres ident of Columbia University noted that perhaps the most significant impact of Djerassi's oral contraceptive re search had been on the emancipation of women. "He had barely finished that sen tence when the entire student body of Barnard, the women's college of Columbia, interrupted the president's address by ris ing in unison and shouting '^eah!' As soon as the women had calmed down, a second cresting human wave arose: the graduating seniors of the then all-male Columbia Col lege. Ύeah!, they thundered, fisted right
FATHER OF T H E P I L L Carl Djerassi, who synthesized norethindrone, the basis of the first effective oral contraceptive.
arms thrust in the air" (Djerassi, Carl, "Steroids Made It Possible," American Chemical Society 1990). Since antiquity, women have ingested every manner of substance—herbs and other plants, lead, mercury, copper, gun powder, and the organs of various ani mals—to achieve birth control. In the 1930s, Russell Marker of Pennsylvania State University found that, for hundreds ofyears, Mexican women had been eating wild yams of the Dioscorea genus for con traception, apparently successfully Mark er determined that a sapogenin, diosgenin, is abundant in the yams. This compound has a chemical structure that is similar to that of progesterone, which had previous ly been demonstrated to stop ovulation in rabbits. Marker succeeded in producing progesterone from the diosgenin raw ma terial in the early 1940s. But progesterone itself is destroyed by the digestive system when taken orally A chemical analog was 92
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turning points in the social history of mankind. It was a huge factor in the re birth of feminism in the 1960s. The enormous strides that women have taken in education and career options most needed. It was in Djerassi's lab at Syntex in certainlywould not have been possible with Mexico City that the first chemical syn out the ability to control pregnancy and thesis of an oral contraceptive steroid, family size. Beginning in 1972, the fraction norethindrone, was achieved in 1951. In 1950, Gregory Goodwin Pincus, a bi of college women marrying a year or two after graduation plummeted. By the midologist at the Worcester Foundation for 1970s, the ratio of women Experimental Biology, in to men had increased in Massachusetts, was invited everyprofession. Likewise, by the Planned Parenthood the age of first marriage Federation of America to steadily increased. Thus, develop an "ideal" contra the Pill brought about in ceptive: one that would be disputable change in the "harmless, entirely reliable, economic and social status simple, practical, universal Norethindrone ofwomen. ly applicable, and aestheti The hormones in the Pill have several cally satisfactory to both husband and wife." mechanisms of action: They prevent ovu During the 1950s, Pincus was studying lation, thicken the mucus in the cervix to norethindrone, which had been sent to him inhibit sperm from reaching the egg, and by Djerassi in 1953, and its double-bond make the uterus less likely to accept im isomer, norethynodrel, in animals. plantation of a fertilized egg. For women Margaret Sanger, women's rights advo who always use the Pill correctly, the ef cate and founder of the organization that fectiveness rate is 99%. Overall, the ef became Planned Parenthood, was in her fectiveness rate is 95%. 80s in 1950, but she was determined to raise money for contraception research. T h e Pill unquestionably improved In 1953, she brought her friend Katharine women's health by reducing pregnancies Dexter McCormick, who was one of the and miscarriages. And in 1988, FDA rec first women graduates of Massachusetts ognized several potential noncontracepInstitute ofTechnology and an heiress, to tive health benefits of the Pill: a decreased visit Pincus and tour his lab. Soon after, McCormick began contributing $ 150,000 NORETHINDRONE to $180,000 per year, eventually reaching a grand total of $2 million. Name:(17a)-17-Hydroxy-19-norpregn4-en-2Q-yn-3-one McCormick also funded the first clini CAS registry: 68-22-4 cal trials, which were conducted by John Introduced: 1964, Ortho, Syntex, Rock, a gynecologist, with patients in his Parke-Davis private practice. In 1956, Science an Sales: $579.8 million in 2003 nounced the success of Rock's clinical tri Did you know that the first oral contra als, and Rock came to be regarded as a ceptives contained 100 to 175 μς of es codeveloper of the Pill. trogen and up to 10 mg of progestin? On May 9,1960, the Food & Drug Ad Over the years, lower and lower ministration approved norethindrone, but dosages have been found to be effec it was not the first oral contraceptive to tive. Today's pills contain 20 to 35 μg of be marketed. G. D. Searle & Co. was the estrogen and 0.1 to 1 mg of progestin. first on the market with Enovid. In I960, Frank B. Colton, a research chemist at incidence of ovarian and endometrial can Searle, had developed Enovid, which con cers, pelvic inflammatory disease, ovarian tains mestranol and norethynodrel. But by cysts, benign breast disease, iron deficien 1964, norethindrone had become the most cy anemia, and dysmenorrhea. widely used active ingredient of the Pill. T h e Pill remains the most popular TWO YEARS after Enovid hit the market, method of reversible birth control in this country. It has been used by 8 0 % of 1.2 million American women were using the Pill; in 1965, 5 million; and in 1973, women in the U.S. at some point during their reproductive lives. Today, approxi about 10 million. In 1993, the British weekly The Economist listed the Pill as one mately 10.7 million American women and as many as 100 million women worldwide of the seven wonders of the modern world. u s e t h e Pill.-JANET D0DD It has also been called one of the major WWW.CEN-0NLINE.ORG;
