Popularly known as the pill, oral contraception was first used in Puerto Rico in 1956; it has, since then, become extremely popular all over the world.
If taken regularly, the pill is the most reliable contraceptive available today. It contains synthetic ovarian hormone-like substances and has three definite effects:
(1) The pill inhibits ovulation and completely rules out the possibility of conception, since there is no ovum which can be fertilised by the sperm.
(2) The development of the endometrium is impaired, making it unsuitable for the embedding of the fertilised ovum.
(3) The cervical mucus becomes thick and hostile to penetration by sperms.
The reasons for the high acceptability of the pill in several countries are: (1) The pill is very reliable; (2) It is easy to take; (3) It results in highly regular periods, if taken correctly, and the bleeding which occurs when the use of the pill is discontinued is quite scanty; (4) It is convenient to take, once the habit is well established; (5) Its use is unrelated to the sex act.
The pill, however, becomes unacceptable when it leads to side effects such as giddiness, nausea, etc., especially during the first few months. Some of the other side effects are weight-gain, headache, depression, suppression of lactation, etc.
Though pills are provided free of cost through official family planning programmes in many countries, they are not cheap, if they are bought in the open market.
Many women also find it difficult to discipline themselves to take the pill regularly. It is sometimes feared that its continuing use may result in some long-term effects, since the pill exerts an influence on most systems of the body.
Up till now, however, evidence is available only of the risk of thromo-embolic disease; women on the pill are found to be more prone to it, especially if they are above the age of 35.
It is, therefore, usually recommended that women should take the pill only under medical supervision and avoid it in the presence of positive contra-indications, such as:
(1) The presence of history of some episode of thrombosis or embolism;
(2) The presence of impaired live function;
(3) The presence or history of an estrogen dependent tumour, that is, a cancer of the breast or of the genitalia.