Contraceptive Pills

60 Years of the Contraceptive Pill

May 2021 marks 60 years since the oral contraceptive pill became available on the NHS. 

Better known as ‘the pill’, oral contraceptives are used by 151 million people worldwide[i], typically falling into two main categories: Combined Oral Contraceptives (COCs), which contain two hormones – oestrogen and progestogen – and the Progestogen-only Pill (POP), also known as the mini pill, which contains only progestogen. While both types of contraceptive pill work similarly, POPs are usually recommended for people who menstruate who cannot take medication containing oestrogen, such as those who breastfeed, and for over-35s who smoke[ii].

Although offered on the NHS since 1961, the pill was initially only accessible to cisgender, married women. Those who were unmarried in England and Wales could not access oral contraceptives until the passing of the NHS Family Planning Act in 1967 – this came a year later in Scotland, while the pill did not become widely available in Northern Ireland until 1972[iii]. Even then, these decisions were largely based on concerns surrounding the financial strain created by unplanned children[iv], rather than a drive to promote reproductive autonomy.

Contraceptive Pill Timeline.png

Access to the contraceptive pill nonetheless provided unprecedented control over pregnancy and fertility, greater sexual freedom, and protection against ovarian cancer and pelvic inflammatory disease, the latter a major cause of infertility.

While undoubtedly a turning point for reproductive health, the pill did not come without its issues. Concerns surrounding the pill’s safety have pervaded its history, in particular through health scares linking its use to the onset of deep vein thrombosis. The European Medicines Agency, however, continues to assure that the benefits of using the pill outweigh the risks[v].

Today’s oral contraceptives contain far lower hormone doses and are considered much safer than the first marketed pill, Enovid10[vi], but what does the future hold for contraception here in the UK?

Although the pill remains the UK’s most popular method of contraception, uptake fell from 45% in 2014/15 to 38% in 2019/20, while the uptake of long-acting reversible contraception (LARC) has steadily increased over the last decade[vii]. Research into a male contraceptive pill remains limited[vii], with resistance to the potential side effects, a controversial barrier as such side effects are already experienced by many people using female oral contraceptives. Progress has, however, been seen in other areas: in the coming years, we may see POPs become available over the counter for the first time in UK history, “a landmark opportunity for [reproductive] health” (Michelle Riddalls, Chief Executive of PAGB), providing easier-than-ever access to hormonal contraceptives[ix].

Sexual Health services deliver more than just clinically excellent care and treatment; they are just as crucial in reducing stigma, raising awareness, and proactively empowering local residents to lead safe, fulfilling sex lives and relationships through education and promotion. Having delivered a number of Sexual Health tenders for our clients, HealthBid not only have a vital insight into Commissioners’ expectations when it comes to sexual health and reproductive healthcare provision but also valuably recognise and apply its role within each local healthcare system through our expertise.

To find out more about our services and how we can help you write winning tenders, contact info@healthbid.co.ukor Laura Moore on 0113 479 0803.

Written by Natalie York, Bid Writer at HealthBid

References
[i]https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf

[ii] https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/

[iii] https://www.fpa.org.uk/factsheets/history-family-planning-services

[iv] https://onlinedoctor.lloydspharmacy.com/uk/contraception-advice/when-was-the-pill-invented

[v] https://www.ema.europa.eu/en/medicines/human/referrals/combined-hormonal-contraceptives

[vi]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520685/#:~:text=The%20pill%20brings%20change&text=The%20first%20marketed%20pill%2C%20Enovid,%CE%BCg%20of%20the%20estrogen%20mestranol.&text=Today’s%20pills%20contain%20dramatically%20lower,to%2050%20%CE%BCg%20of%20estrogens

[vii] https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2019-20

[viii] https://www.nhsinform.scot/healthy-living/contraception/the-pill/the-pill-for-men

[ix]https://www.bbc.co.uk/news/uk-56054265

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