The first pill was marketed by the Searle pharmaceutical company for women with irregular periods or heavy bleeding, not for pregnancy prevention. Advertisers decided this was the best way to sell the product, given the social and religious norms in 1960 America, particularly concerning influences of the conservative the Roman Catholic Church. The pill offered twenty-one days of ovulation-stopping hormone plus seven days of placebo or sugar pills to then solicit beginning of a period (menses). Even though doctors were encouraged to prescribe it only to women who had irregular periods or very heavy bleeding, many women used the pill off-label from the beginning to prevent pregnancy.
By 2010, some fifty years after the pill was introduced, much has changed regarding birth control and treating hormonal issues. Injections, patches and implants that slowly released hormone over a matter of months, are giving more choices than was known of the birth control pill of 1960. They help regulate problems like pre-menstrual syndrome, pre-menstrual dysphonic disorder, depression, hormonal migraines, and more. The only thing that really hasn’t changed much are the directions in the pill packs for the 21/7 day cycle birth control, which tell the user to take the hormone pill for twenty-one days then taking the seven days of placebo (sugar) pill to cause a period to begin.
However, off-label use is becoming more common for the 21/7 pill today for women who suffer from severe symptoms, like migraines and other problems that might keep them from normal daily life during those days of a period. A study published in 2002 was an example of many studies done between 1966 and 2005. The studies may be responsible for new direction in doctor-patient decisions on how the pill considered. Anita L. Nelson, et.al., Harbor-UCLA Medical Center reported results in her 2007 article, Impact of Placebo Pills on Patient Symptoms. Women were asked to take one of the hormone pills from the pack each day for twenty-one days. During what would have been the seven days of placebo, they skipped the placebos and began taking the first week of the next packet. The outcome goal was that there would be little to no period or other menstrual symptoms at all. Nearly 65% of the women in the study wanted to keep using the pills without taking the seven days of placebo. Less than 15% chose to return to the 21/7 routine and the remaining women chose to stop taking the pill for a variety of reasons from pregnancy desire to being in menopause.
By getting their periods less often, women can suffer through less symptoms like severe headaches, cramping, and other issues with menstrual cycles. Other possible advantages of taking the pill in this way could be lower risk of certain cancers and endometriosis. Serious side effects are not common, but each woman’s health needs are different and consultation with a doctor who knows her case is important. It is vital to first talk with a doctor before changing the way any medication is taken.
Impact of Placebo Pills on Patient Symptoms, by Anita L. Nelson, MedScape-2007;3(5):529-35 Timeline of The Pill, Public Broadcasting System
Birth Control, History .com