In October 2013, Jürgen Dinger, Sabine Möhner, and Klaas Heinemann published the article “Cardiovascular Risk Associated With the Use of an Etonogestrel-Containing Vaginal Ring,” hereafter “Cardiovascular Risk,” in the journal Obstetrics and Gynecology. The authors enrolled patients in the study who were new users of either a vaginal contraceptive ring known as NuvaRing or a combined oral contraceptive pill. A combined oral contraceptive pill contains a formulation of the hormones progesterone and estrogen. They followed up with the patients for two to four years after they had started either hormonal contraceptive treatment to record the incidence of specific cardiovascular events. The authors found that the risks of cardiovascular events when starting use of either NuvaRing or a combined hormonal contraceptive pill were similar to each other in the patients they studied. The results of “Cardiovascular Risk” affirmed the results of similar studies and stated that the risk of cardiovascular events was similar in NuvaRing users to other contraceptive users.

In the 1980s, researchers at the pharmaceutical company Roussel-Uclaf in Paris, France, helped develop a biological compound called mifepristone. When a woman takes it, mifepristone interferes with the function of hormones involved in pregnancy and it can therefore be used to terminate pregnancies. In 2000, the US Food and Drug Administration approved mifepristone, also called RU 486, as part of a treatment to induce abortions using drugs instead of surgery, a method called medication abortion. Women can receive medication abortions earlier in their pregnancies than surgical abortions, and medication abortions often result in less severe side-effects than their surgical counterparts. In that capacity, mifepristone has increased women’s access to abortions throughout the world.

Estrogen is the primary sex hormone in women and it functions during the reproductive menstrual cycle. Women have three major types of estrogen: estrone, estradiol, and estriol, which bind to and activate receptors within the body. Researchers discovered the three types of estrogen over a period of seven years, contributing to more detailed descriptions of the menstrual cycle. Each type of estrogen molecule contains a slightly different arrangement or number of atoms that in turn causes some of the estrogens to be more active than others. The different types of estrogen peak and wane throughout women's reproductive cycles, from normal menstruation to pregnancy to the cessation of menstruation (menopause). As scientists better explained the effects of estrogens, they used that information to develop oral contraceptives to control pregnancy, to map the menstrual cycle, and to create hormone therapies to regulate abnormal levels of estrogen.

Barbara Seaman was a writer, investigator, and advocate for female healthcare rights during the twentieth century in the United States. Seaman’s work addressed the gendered prejudice she observed in the US healthcare system and argued that women of the 1960s lacked the proper tools to make informed decisions about pregnancy care, breastfeeding, childbirth, and contraception. Seaman wrote the book The Doctor’s Case Against the Pill in 1969 to expose the dangers in prescribing and consuming high doses of estrogen in the form of birth control. Seaman’s objective was to expose what she described as pharmaceutical companies’ drive for profit over safety. Her reporting helped provide a voice to many women who lacked proper health information and helped improve the standard of healthcare that women received in the US. Through her publications and activism, Seaman brought women’s healthcare to the public’s attention and contributed to the feminist and women’s healthcare movements of the twentieth century.

Gonzales v. Planned Parenthood Federation of America, Inc. (Gonzales v. Planned Parenthood) was the 2007 US Supreme Court case in which the Court declared the Partial Birth Abortion Ban Act of 2003 constitutional, making partial birth abortions illegal. In 2003, the US Congress passed the Partial-Birth Abortion Ban Act, which prohibited an abortion technique called partial birth abortion. A partial birth abortion is similar to, but not the same as, a Dilation and Extraction or D&X abortion, which is what the Ban was intended to prohibit. Gonzales v. Planned Parenthood eventually reached the Supreme Court, where the Court ruled that the Ban was constitutional. In Gonzales v. Planned Parenthood, the Court ruled for the first time that it was constitutional to ban a method of abortion without providing an exception for cases where a pregnant woman’s life was endangered.

In 2012, Stephen Sidney, T. Craig Cheetham, Frederick A. Connell, and colleagues published “Recent Combined Hormonal Contraceptives (CHCs) and the Risk of Thromboembolism and Other Cardiovascular Events in New Users,” hereafter “Combined Hormonal Contraceptives” in Contraception. The authors gathered records of major cardiovascular events in patients who were using combined hormonal contraceptive treatments, or CHCs. A CHC is a birth control medication that contains both estrogen and progestin hormones. The CHCs of focus, which the authors referred to as the study CHCs, included a pill, patch, and vaginal ring that the US Food and Drug Administration, or FDA, recently approved at the time of publication. The researchers compared the rates of cardiovascular events between users of the study CHCs to users of established CHCs to find any increased cardiovascular risk. “Combined Hormonal Contraceptives” showed that the study CHCs did come with some increased cardiovascular risk, and reconfirmed the known cardiovascular risks of CHCs in general, providing safety information for people who may want to start birth control.

Subscribe to Oral contraceptives