Celebrating Mexico’s Contributions to the Birth Control Pill

September 15 to October 15 is National Hispanic Heritage Month. We’re celebrating by shining the spotlight on Mexico’s role in developing the birth control pill, one of the most important medical breakthroughs of the 20th century.

Humanity cannot fully unlock its potential until we release the bonds of oppression from all marginalized groups.

Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses in traditional medicine — and it would change history forever when scientists figured out how to wrest valuable chemical compounds from it, a discovery that led directly to the development of the birth control pill.

Russell Marker. Image: Penn State University ArchivesIn the 1940s, hormones held an untapped potential for research, but there was no cost-effective method of producing large quantities of them — including progesterone, the Pill’s essential ingredient. An American chemist named Russell Marker set out to find a way to synthesize progesterone in abundance, hypothesizing that plants from the genus Dioscorea, which includes yams and agaves, would be a good source for starting material. After some research, he set his sights on wild-growing yams that were found only in Mexico.

Marker’s hunch brought him south of the U.S. border, where locals helped him find and gather these yams, enabling him to develop a method for synthesizing large batches of progesterone — more than had ever been in one place. When pharmaceutical companies would not invest in further research in Mexico, Marker relocated to Mexico City and put his money where his mouth was. In January 1944, he co-founded a lab named Syntex — a portmanteau of “synthesis” and “Mexico” — devoted to finagling hormones from wild Mexican yams. That yam was called barbasco by the indigenous population, and it was the industry’s choice for the raw material in hormone synthesis. Continue reading

Let’s Talk Contraception: Contraceptive Patches

Is there a topical birth control available, you ask? No contraceptive cream or ointment has been developed yet, but yes, there is a patch that can be applied to your skin that is almost 99 percent effective at preventing pregnancy.

Patches are easy to use, discreet, and provide excellent birth control.

It’s called a transdermal patch and there is only one available by prescription in the United States. The Ortho Evra patch (or the generic version, called Xulane) is a small, sticky plastic patch that you apply to your skin: one patch each week for three weeks and then no patch for one week before you start the cycle again. While you wear a patch, it releases both a progesterone hormone, norelgestromin, and an estrogen hormone, ethinyl estradiol. This hormone combination is absorbed through your skin and enters your bloodstream to prevent pregnancy, much like oral birth control pills. It is discreet and can be worn comfortably and confidently during bathing, showering, swimming, and exercising without fear of its falling off. As a matter of fact, the patch has been rigorously tested in many situations, and these studies have shown that when applied properly, the patch loosens or falls off less than 2 percent of the time.

Contraceptive patches come in boxes of three for each month. To use a patch, you open a packet and apply one patch to clean, dry, intact (not irritated or injured) skin. It is recommended to apply it to areas on the buttocks, abdomen, upper torso but not breasts, or outer part of upper arm. It should not be applied to areas where it could be rubbed off, such as under a bra strap. Most users apply the patch the first day of their period or the Sunday after the start of their period. When you initially start using the patch, you will need to use a back-up contraceptive method such as a condom for the first seven days. If you are switching to the patch from birth control pills or the vaginal ring, you apply your first patch on the day you would usually start your next pill pack of pills or insert your next vaginal ring. In that case you do not need to use a back-up method of birth control. Continue reading

The History of the Birth Control Pill, Part 6: Los Campesinos

Welcome to the final installment of our series chronicling the history of the birth control pill. In earlier installments, we learned how chemists were able to extract a chemical from a wild yam called barbasco and convert it into progesterone, the active ingredient in the Pill.

In 1960, the FDA approved oral contraceptives for marketing. At this time, more than 2 million Americans were already using the Pill — and more than 100,000 Mexican campesinos (a Spanish word for peasants) were harvesting barbasco, the wild yam necessary for its production. By 1974, 125,000 Mexicans were collecting and selling barbasco. Every week, during the barbasco trade’s peak, an excess of 10 tons of the plant were removed from tropical Mexico.

Until the barbasco supply started to dwindle in the 1970s, Mexico enjoyed prominence as the world’s supplier of progesterone.

Though they were paid subsistence-level wages for their labors (half a peso per kilo of dried root), and the work itself was dangerous and backbreaking, they were putting Mexico on the map in the scientific community. After establishing a hormone synthesis industry in Mexico, the European stranglehold on hormones was loosened and the price of progesterone plummeted from $80 per gram to less than a dollar per gram. By 1954, Syntex, a Mexican laboratory, was the largest producer of steroids in the world, having usurped Europe’s monopoly.

Scientists depended on the campesinos’ knowledge of soil conditions and growth cycles, as well as their ability to differentiate between different species of yams. The campesinos relied on their knowledge of weather patterns, differences in root coloration, and size variations to determine when they could dig up roots with the highest concentrations of sapogenin, the chemical that was converted into progesterone in the laboratory. Over the decades, the campesinos slowly gained an education in organic chemistry. Continue reading

The History of the Birth Control Pill, Part 5: Clinical Trials

Gregory Pincus, Min-Chueh Chang, and John Rock, three scientists employed by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Gregory Pincus, Min-Chueh Chang, and John Rock were hired by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Welcome to the fifth installment of our series chronicling the history of the birth control pill. In the previous installment, Margaret Sanger and Katharine McCormick envisioned and bankrolled the development of the birth control pill. Now it had to be tested in large-scale trials.

John Rock, Gregory Pincus, and Min-Chueh Chang had collaborated in the Pill’s development; now it was time to conduct clinical trials. The first study observed 60 women, some of whom were infertility patients while others were nurses. These small trials involved daily temperature readings, vaginal smears, and urine samples, as well as monthly endometrial biopsies. Although the initial results seemed promising, the sample size was small and few of the subjects complied with the protocol.

The approval of the Pill in 1960 marked a turning point in our history.

More test subjects were needed. At this point, historians’ accounts differ. Elaine Tyler May claims that, unable to locate an acceptable pool of volunteers, the researchers tested the Pill on subjects who could not give their consent, such as psychiatric patients. According to Bernard Asbell, however, Rock was scrupulous when it came to informed consent, despite it not being a legal requirement — or even much of a concept at all at this time in history.

Willing participants notwithstanding, conducting such trials in the United States posed a challenge, due to laws against contraception. So the first large-scale clinical trials were conducted in Puerto Rico in 1956. Puerto Rico was densely populated and there was a high demand for alternatives to permanent sterilization, which was widespread on the island due to funding from a wealthy eugenicist named Clarence Gamble, who advocated sterilization for the world’s poor. The clinical trials in Puerto Rico were conducted by Drs. Edris Rice-Wray and Adaline Sattherthwaite; the brand of birth control pill tested was named Enovid. Volunteers were so easy to come by that some clinics had waiting lists. Continue reading

The History of the Birth Control Pill, Part 4: Margaret Sanger’s “Magic Pill”

Katharine McCormick

Katharine McCormick

Welcome to the fourth installment of our series chronicling the history of the birth control pill. In the previous installment, progesterone, the birth control pill’s active ingredient, could only be administered intravenously. Scientists working in Mexico figured out how to alter its chemical structure so that progesterone would be active when taken orally.

Katharine McCormick was born into a moneyed family and was, in 1904, the second female graduated by the Massachusetts Institute of Technology. After receiving her degree in biology, she married a wealthy man, but shortly into the marriage she gained control of her husband’s estate due to his illness. She put a lot of this money to good use: In the 1920s, she aided Margaret Sanger’s efforts to smuggle diaphragms into the country.

Katharine McCormick, a philanthropist and one of the first scientifically trained women, provided early funding for the Pill.

Her involvement with Sanger didn’t end there; indeed, both Sanger and McCormick had a lot in common, despite Sanger’s working-class childhood and McCormick’s privileged upbringing. According to historian Elaine Tyler May, McCormick and Sanger both had “a tremendous faith in the possibility of science,” and Sanger “believed that science held the key to contraception and to women’s emancipation.” Back in the ’20s, Sanger wrote:

Science must make woman the owner, the mistress of herself. Science, the only possible savior of mankind, must put it in the power of woman to decide for herself whether she will or will not become a mother.

In 1950, McCormick again joined forces with Sanger. In the mid-’40s, after a countrywide tour of family-planning clinics, Sanger had come to the conclusion that the diaphragm was not an adequate form of birth control, revitalizing her hope for a “magic pill.” Neither pharmaceutical companies nor the government wanted to invest in contraceptive research, considering it a “disreputable” area of study, so Sanger hatched a scheme to bankroll the independent development of an oral contraceptive. At Sanger’s behest, McCormick provided the lion’s share of funding for the project — more than $2 million (compared to the value of a dollar in the year 2000, that would be about the equivalent of $12 million). Sanger and McCormick tapped Gregory Pincus to conduct the research. McCormick, thanks to her education in biology, oversaw the research in addition to funding it. Continue reading

Endometriosis Treatment

endo medsIt’s still March, so it’s still Endometriosis Awareness Month! Today we’ll be looking at endometriosis treatment questions and answers. If you missed the first two posts in this series, you can click to read more about an overview of endometriosis as well as info about diagnosing endometriosis.

Why are there so many treatment options? Which one is best?

There are so many options because there is no “magic bullet” option — that is, no single treatment that works best for everyone. The two main categories of treatment include medication and surgery, but each option has its own benefits and drawbacks. When deciding on the best option for a given individual, some helpful questions to consider might be:

  • Do I have any current health concerns that would render some treatments unsafe? What types of health risks are acceptable to me?
  • Am I currently trying to conceive, or will I be in the next six to 12 months? Will I ever want to be pregnant in the future?
  • Aside from significant health risks, what types of factors — side effects, treatment frequency or duration, cost — would make a treatment difficult for me? How long do I need this treatment to last before I can reevaluate?

For specific questions, your best bet is to check with your health care provider. Continue reading

The History of the Birth Control Pill, Part 3: From Injection to Ingestion

Carl Djerassi with his assistant, Arelina Gonzalez, 1951

Carl Djerassi with his assistant, Arelina Gonzalez, 1951

Welcome to the third installment of our series chronicling the history of the birth control pill. In the previous installment, we learned about the iconoclastic chemist Russell Marker, who figured out how to synthesize large quantities of progesterone — the birth control pill’s active ingredient — from a yam called barbasco that grew wild in Mexico.

In 1949, Russell Marker dropped out of science — “I considered all chemists to be crooks,” he bitterly opined — and a scientist named Carl Djerassi was hired to head the lab at Syntex, the hormone-synthesizing laboratory in Mexico that Marker had co-founded in 1944. Within a few years, Syntex was a major player on the synthetic-hormone scene in Europe and the Americas.

After Luis Miramontes’ successful experiments, all of the elements for Sanger’s “magic pill” were in place.

Although progesterone could be manufactured in large quantities at this time, it could only be given intravenously. Progesterone was being used therapeutically to prevent miscarriage and treat excessively heavy menstrual periods. The lack of alternatives to injections represented a problem for these people — a daily pill would be easier and more convenient than frequent injections. In 1950, Syntex set their sights on the development of a synthetic form of progesterone that was more effective in smaller doses and could be administered orally rather than by intravenous injections. Such a development would be necessary before Margaret Sanger’s dream of a “magic pill” could come true. Continue reading