The topic of birth control has taken progressive strides over the last few years, and its transparency helped make reproductive education and products more accessible. Yet the fight for reproductive freedom is far from over — in the U.S alone, states like Texas and Florida recently passed appalling laws banning abortions.
Now more than ever, informed conversations about contraceptives and reproductive health are extremely important. There are countless facts about birth control that still aren't widely known by users.
However, women like Elizabeth Ruzzo, who received her PhD from Duke University in human genetics and genomics, are leading the charge toward change.
Ruzzo is the founder and CEO of adyn, which is a medical company that strives to make the birth control experience easier by ensuring inclusiveness and patient-centricity.
"Because most clinical research is based on single-sex studies of males, women, on the whole, are disproportionately affected. Implicit bias in healthcare is real and well-documented," says Ruzzo. "Medical gaslighting is an unfortunate reality which disproportionately impacts BIPOC, LGBTQ, and women, and has real & measurable consequences that can result in life-threatening scenarios—the most blatant being maternal mortality rates in non-Hispanic black women and American Indian/Alaska Native women."
Here are 10 interesting (and surprising!) facts about birth control:
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1. No IUD has been designed by a woman (yet).
While female ob-gyns are now the majority, the gynecology field was historically dominated by men. Even as recently as 1970, only 7% of women were gynecologists. And while women have contributed to its creation, IUDs have historically been designed by men.
"The unfortunate fact is that our scientific knowledge of women and people of non-European descent is insufficient," says Ruzzo. "Women weren’t required to be included in clinical trials in the US until 1993, which led to less research around women’s health as well as less knowledge about how women experience diseases and conditions that impact everybody."
Ruzzo believes it's important for inventors and decision-makers to not only consider, "a woman’s reproductive and health goals, but also her preferences when considering a birth control method." And according to her, both copper and hormonal IUDs are a highly effective method of birth control that can work well for some people.
2. The pill has a four-week cycle because of the Catholic Church.
The way women have been advised to take contraceptive pills in the last 60 years is directly linked to Catholicism (namely, the Pope). Oral contraceptive pills are designed to be taken for 21 days, followed by a seven-day break. During this break, women refrain from taking the pill, which leads to vaginal bleeding. It should be noted this method, however, increases the likelihood of unplanned pregnancies.
Carl Djerassi, a Bulgarian-American chemist, was nicknamed the "father of the pill" for his contribution to the development of oral contraceptive pills. Djerassi said the seven-day break was an intentional design with one very specific purpose in mind — to persuade the Vatican to accept contraception. The hope was that the Church would view the pill as an "extension" of the natural menstrual cycle.
3. Birth control was the biggest factor in enabling women to stay in college.
Planned Parenthood found that access to the pill before the age of 21 was the most influential factor in enabling women who were in college to stay in college. After the legalization of birth control, the number of women who complete higher education is now six times what it was before!
Another fun fact: women also make up the majority of undergraduate students in the U.S.
4. Birth control pills pollute rivers and affect wildlife.
Many will be surprised to learn that the synthetic estrogen found in the birth control pill has unexpected effects on aquatic ecosystems. A British study found that synthetic estrogen negatively impacted the reproductive cycles of the fathead minnow. It interfered with the species' ability to reproduce and nearly lead to the population's extinction.
And as recently as 2020, another study showed that estrogenic steroids are more potent than previously thought and can further harm fish populations by malformations, decreased egg production, and DNA methylation, which represses gene transcription.
5. You don't have to put up with side effects of birth control.
A common misconception Ruzzo often hears is that "Side effects and birth control are a package deal; it’s just the price to pay for avoiding unwanted pregnancies."
"Side effects do not have to be part of your experience with birth control," Ruzzo explains.
"The best birth control is not only effective, but side-effect free. The best birth control for you is the one that is optimized for your body, your genetics, and your preferences."
This is why Ruzzo emphasizes the importance of choosing a method that works best for your individual body — a pill that works for one person may not work for you.
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6. The U.S had "chastity laws" that labeled contraceptives "obscene."
The man responsible was an American post inspector named Anthony Comstock, whose "anti-obscenity" crusade was fueled by his Christian faith.
Comstock drafted an anti-obscenity bill in 1872, which included a ban on contraceptives, and took it to Washington. The Comstock Act was later passed by Congress on March 3, 1873, and defined contraceptives as "obscene and illicit." In turn, the statute made it a federal offense to distribute birth control through the mail or across state lines.
These laws remained unchallenged until birth-control advocate Margaret Sanger was arrested in 1916 for opening the first birth control clinic in America. Her initial arrest is what prompted the first successful change in the law.
7. Ancient women used a myriad of methods to prevent pregnancies.
Ancient Egyptian and Mesopotamian women used crocodile dung, which was mixed with other ingredients, to create a type of pessary. The Egyptians also used honey and acacia fruit & leaves as spermicides, which they would insert inside of themselves before having sex.
In Greece, the philosopher Aristotle proposed that women should use olive and cedar oils to decrease sperm mobility. Greek and Roman women also used an oral contraceptive called "silphium," which was a type of giant fennel that eventually became extinct due to its extreme usage.
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Globally, ancient women from civilizations like Egypt, Assyria, Greece, and China all consumed liquid mercury, lead, or arsenic to prevent unwanted pregnancies. While this was technically an effective method, these poisons lead to horrific consequences such as organ failure, brain damage, and death.
8. There are almost 200 types of hormonal birth control in the U.S.
All of which have varying formulations, Ruzzo says. "Having that much choice is a blessing and a curse: there is no way to know whether you or your doctor are choosing the right one - until now! This is the problem Adyn is solving."
Other methods besides pills and UIDs are birth control shots, implants, and patches, as well as vaginal rings, diaphragms, spermicide, and tubal ligation/vasectomy.
According to Ruzzo, the most effective form of birth control is the one picked based on your unique biology — one that is optimized for your body, your genetics, and your preferences. "There are statistics about birth control method efficacy, but pinpointing one as singularly more effective than another is complicated," she adds.
9. Birth control pills may affect who you're attracted to.
Dr. Sarah Hill, a research psychologist and professor who studies women, health, and sexual psychology, suggested birth control pills can, "influence pretty much everything that matters when it comes to love, sex, and relationships."
Though Hill specifies this research is still "in its infancy," there's already data to back this theory up. One study showed that heterosexual women who started taking the pill found men with "less masculine" faces to be more attractive. A second study confirmed that not only do pill-taking women prefer less masculine features; they are also more likely to choose such men as partners.
10. Contraception isn't a modern invention.
While the methods & products we have today surpass those used by our ancestors by a long shot, you may be surprised to hear that contraception goes way, way back!
Researchers believe a French cave painting, which could be 15,000 years old, depicts what some think is the first illustration of a man wearing a condom. Similarly, there are mentions of condoms in Greek legends that date back to 3000 BC — specifically that of the infamous King Minos of Crete.
The 18th-century memoirs of Giacomo Casanova also show us that Casanova believed he "invented" a type of cervical cap, which was made of partly squeezed lemon halves. However, researchers believe these "caps" were probably used as protection against venereal disease rather than pregnancy.
