birth control pills

from Wikipedia, the free encyclopedia
The first birth control pill in the Museum of European Cultures in the special exhibition Wedding Dreams
Typical packaging for a birth control pill

The so-called birth control pill , also known as the contraceptive pill and pill for short , is a hormonal contraceptive to be taken. The effect is created by suppressing ovulation ( inhibition of ovulation ).

The birth control pill has been since the late 1960s and especially during the first half of the 1970s in the industrialized world, the most widely used for the prevention of pregnancy and reached by easing the medical prescribing practices since 1970 in Germany in 1976 with 32.8% pill users in of childbearing age their maximum value. The hormones contained in the pill correspond to those of the female sex cycle. They prevent the egg cell from maturing and thus prevent monthly ovulation. Specifically, it is a hormone preparation to be taken regularly orally , which contains the female hormones estrogen and progestinContains different compositions and doses and, if used correctly, is one of the safest means of preventing accidental conception. The Pearl index of method safety (when used ideally) is 0.3, according to which out of 1000 women who use contraception, about 3 become pregnant within a year. According to various studies, the Pearl index of safety in use (practical value) is between 1 and 8.

designation

The term "birth control pill" was in use in Germany soon after its introduction and also appeared in the press headlines. In 1964, in a question time , the federal government criticized the use of the term “birth control pill” as “grossly offensive” and “linguistic abuse”. Some doctors also expressed their disapproval. Many doctors did not initially prescribe them. The chemist and writer Carl Djerassi , who helped develop the pill in 1951, also criticized the designation “birth control pill” because the pill is not a means against babies, but a means for women's independence and self-determination.

In the GDR an attempt was made to establish the term “wish-child pill” based on a suggestion by the social hygienist Karl-Heinz Mehlan , which was given a more positive connotation than the word “birth control pill” used in the West. It did not prevail over the long term. The “contraceptive pill” used in English or “pilule contraceptive” in French corresponds to the German term “contraceptive pill”.

history

Development and marketing

The Anovlar Pill - 1961

In 1921, the Innsbruck physiologist Ludwig Haberlandt was the first to publish a concept of hormonal oral contraception. Before he could put his discoveries into practice, Haberlandt died in 1932 at the age of 47.

One of the fathers of the contraceptive pill is the gynecologist Carl Clauberg , who, as part of his medical experiments in Block 10 of the Auschwitz concentration camp, developed hormone preparations in cooperation with Schering-Kahlbaum AG . On January 21, 2020, Arte broadcast the film Medizinversuche in Auschwitz , which was made the year before under the direction of Sonya Winterberg and Sylvia Nagel and reported on Clauberg and the women from Block 10 - so the subtitle:

“At that time, Carl Clauberg was one of the world's leading reproductive medicine specialists, an ambitious, aspiring doctor who placed himself in the service of the Nazi regime in order to pursue a scientific career. With his research he laid the foundations for the birth control pill, his work on birth control and infertility are still part of the medical canon today - but without making any reference to his medical experiments in Auschwitz. "

- ARD program

In 1951 the chemist Carl Djerassi , Luis E. Miramontes and George Rosenkranz, who emigrated from Vienna to the USA in 1939, synthesized norethisterone as researchers at the pharmaceutical company Syntex , the first orally active synthetic variant of progestin. With the norethynodrel for Searle make Frank B. Colton was soon followed by a second. On this basis, Gregory Pincus and John Rock , supported by the women's rights activist Margaret Sanger , developed Enovid , which Searle initially marketed as a preparation for menstrual cramps from 1957. Before that, they tested the drug in San Juan , Puerto Rico, on residents of the local slums. Over 200 of the mostly poor and large women volunteered; the drug was given free of charge.

On June 23, 1960, the FDA officially approved it as a contraceptive, and on August 18, Enovid was the first birth control pill in the United States. Berliner Schering AG first launched its first contraceptive pill , Anovlar , on January 1, 1961 in Australia and on June 1 of the same year in Germany. Their compilation was based on examinations by the Belgian gynecologist Ferdinand Peeters . Compared to Enovid , this drug was significantly more reliable and had fewer side effects.

The birth control pill was so revolutionary after its market launch and was so little accepted socially and politically that by the end of the 1960s in Germany only very few doctors and even these only with great reluctance and exclusively as a means of correcting menstrual disorders and moreover only Prescribed to married women who have had 3 or 4 children and are over 30 years old. At the end of 1964, the proportion of women using hormonal contraception was still below 0.3% and in 1965/66 it was 1 to 2%

After the publication of a study by the Food and Drug Administration in the USA, about which the Spiegel first reported to the public in October 1966, increased press coverage of sexuality in general and contraception in particular began in the FRG in 1967/68 . Nevertheless, it was very "difficult ... in the supposedly wild 68ers ... to get the pill" for most women , because most doctors at that time hardly knew about hormonal contraceptives, they also rejected them because of medical and moral concerns and therefore initially took the pill only prescribed extremely restrictively to married women (see above) who already had several children and were over 30. In addition, the thalidomide scandal , which was intensively reported in the media at the start of the thalidomide trial in May 1968, as well as reports on the cancer-causing effects of certain combinations of active ingredients of the birth control pill in animal experiments in 1969 shook the public's trust in drug safety and the reliability of risk studies and lead to the withdrawal of a number of hormonal contraceptives and a temporary decline in interest in hormonal contraception.

It was not until the end of 1970 that the medical profession relaxed its restrictive stance towards the pill - after the all-clear with new positive study results regarding cancer and thrombosis risks and the subsequent publication of the “Guidelines for the Prescription of Oral Ovulation Inhibitors” and wide-ranging training courses for the medical profession by the medical association . Thereafter, sales of hormonal contraceptives began to rise rapidly to 25.6% at the end of 1971 and in 1976 it reached the highest level in the FRG with a share of 32.8% women using the pill.

In addition to the decision-making bodies in the SED leadership and in the specialist ministries, the pharmaceutical industry, health authorities such as the sex and family counseling centers, gynecologists and church representatives were involved in the introduction, distribution and use of the pill in the GDR . It was introduced under the name Ovosiston in 1965, initiated by Karl-Heinz Mehlan . From 1972 the pill was given out free of charge in the GDR.

Moral viewpoints

The contraceptive pill was highly controversial in all countries and clashed with the moral standards of the time. Like its forerunners in the USA, Schering introduced it as a "remedy for menstrual disorders ". The contraceptive effect was mentioned in passing with the phrase “No conception occurs during the artificial anovulatory cycles”. Initially, the pill was only prescribed to married women.

Some denominations, such as the Roman Catholic Church , generally reject the use of artificial contraception methods. In the encyclical Humanae vitae (on the transmission of human life) of July 25, 1968, Pope Paul VI. argues that against the background of observance of the natural law of morality, "every conjugal act of its own accord must remain related to the production of human life".

Impact on society

The Economist described the birth control pill as the invention that shaped the 20th century significantly. In 1965, five years after it was first approved, 41% of married women under 30 in the United States were using it. It was not until 1972 that the decision in the Eisenstadt v. Baird also gives unmarried women in the United States access. In 1976, three-quarters of 18- and 19-year-old women used oral contraceptives. With the introduction of the contraceptive pill , a marked drop in birth rates can be observed in many industrialized nations, which is often described as a “ pill break ”.

Mechanism of action

Most birth control pills contain the artificial estrogen ethinylestradiol , which is combined with various synthetic gestagens . A pill without estrogens is the so-called " mini pill ".

Estrogens and progestins are naturally produced in a woman's body. They regulate the course of menstrual cycles and the course of pregnancy. Estrogens promote egg maturation in the ovary ( ovarian ), the follicle ( ovulation ) and the willingness to conception . In brief, the background to this is that the estrogens in the ovarian follicle increase its FSH receptor density and, via the increase in FSH sensitivity on day 6 of the cycle, lead to the selection of the most receptor- strong follicle for the so-called lead follicle . By LH -Rezeptordichteerhöhung in the granulosa cells is increased progesterone forming the luteinization and thus the second portion of the cycle initiated. The rising estrogen now inhibits the release of FSH in the pituitary gland through negative feedback and thereby lowers its own production in the non-dominant follicles again. As a result, the preliminary stages of the estrogens, which are also known as "precursors", i.e. the androgens such as testosterone and androstenedione , accumulate in these follicles and ultimately lead to their death, the so-called follicular atresia . The estrogens increase the LH secretion in the pituitary gland and lead to an increase in androgen and estrogen production, which is also known as positive feedback, which culminates in the so-called "LH peak" on day 14 and leads to ovulation about 10 hours later.

If an egg cell ( oocyte ) has been fertilized by a sperm cell ( sperm ) and subsequently implantation in the uterine lining, the corpus luteum is induced by the HCG formed by the blastocyst to continue to produce progestin, which prevents and prevents the maturation of a new egg cell prevents further ovulation. The rejection of the uterine lining is suppressed and the blastocyst can grow into an embryo . The progestin maintains pregnancy: for example, it thickens the mucus that closes the cervix (the cervix uteri ) so that it becomes impermeable to sperm, and it changes the structure of the uterine lining so that no more eggs can implant.

Combination preparations

The estrogen contained in the birth control pill lowers the secretion of FSH , which is responsible for the maturation of the follicles. In this way, it suppresses ovulation, as the finely tuned mechanism of folliculogenesis described above can no longer take place and maturation comes to a standstill. The progestin prevents an egg cell from fertilizing and implanting if it should have ovulated. Most of the “pills” create a regular “cycle” by taking either no tablet or an inactive tablet for 7 days after taking the tablets for 21 days. The last variant has the consequence that - for the sake of simplicity - one tablet is taken every day and the tablet-taking break does not inadvertently last longer than 7 days, which would no longer protect against conception. Because no hormones are taken during the intake break, the built-up uterine lining is not maintained, and withdrawal bleeding occurs (withdrawal bleeding ). Since withdrawal bleeding is often less pronounced than menstruation , the contraceptive pill is also used to treat heavy menstrual bleeding ( hypermenorrhea ) with simultaneous contraception. In addition to the conservative intake schedule, intake in the long-term cycle is increasingly used. In this case, tablets containing active ingredients are taken continuously and there is no more withdrawal bleeding. This can e.g. B. cause an improvement for women with severe menstrual cramps . However, no long-term studies are known about the effects of long-term use.

The first birth control pills contained high doses of the hormones. Nowadays, lower-dose “pills” ( micro- pills ) are just as safe and have fewer side effects. A distinction is made between preparations with:

  • monophasic combination (fixed combination): estrogen and gestagen components are dosed unchanged in all active ingredient-containing tablets
  • Bi- or triphasic combination (sequential combination): the estrogen and gestagen dose varies in two or three phases within the monthly intake cycle

Single substance preparations

The estrogen- free mini pill works primarily by thickening the mucus that closes the cervix. In the case of preparations containing the active ingredient levonorgestrel , the frequency of 24 hours must be adhered to very precisely. Newer mini pills with the active ingredient desogestrel also prevent ovulation and allow a more generous intake frequency.

In some cases, ovulation can occur with low-dose progestin supplements ("breakthrough ovulation"). In these cases, fertilization of the egg is prevented by the thicker secretion of the cervix , which the sperm cannot penetrate.

Pharmacoepidemiology of birth control pills

Comprehensive data on the pharmacoepidemiology of the use of contraceptives are available for the Federal Republic of Germany from several population-representative studies that were carried out from 1984 to 1999 . The data from these long-term planned federal health surveys also make it possible to show the use of the birth control pill in connection with the clinical-chemical parameters of the users.

application areas

In addition to being used as a contraceptive, contraceptive pills are also prescribed for menstrual cramps , for regular withdrawal bleeding , for acne or for excessive body hair ( hypertrichosis ).

Costs and assumption of costs

Germany

The “pill” costs between five and 22 euros per month in Germany, depending on the preparation and the pack size. All privately insured women have to bear the cost of contraceptives themselves. For women with statutory health insurance up to the age of 22 (until March 28, 2019, until the age of 20), the health insurance companies will cover the costs of all prescription contraceptives - including the pill. All older women have to pay for contraceptives themselves. However, some municipalities have a special fund from which women in need may be reimbursed for the cost of contraceptives. The allocation of this money for contraceptives is, however, handled individually by each municipality that has set up such a fund. The job centers , health authorities or pregnancy advice centers on site provide information.

United States of America

In early 2012, the Obama administration passed a law requiring health insurers to pay for the pill for women insured. There was then a scandal among Catholic institutions and others who reject the pill on religious grounds: The law violates the constitutional right to religious freedom . Some Republican candidates who wanted to become top Republican candidates in the 2012 presidential election used the topic to raise their profile.

Obama modified the law in February 2012, according to which the costs are now borne directly by health insurers. US President Trump changed the regulation in October 2017: all private-sector employers are no longer obliged to offer health insurance protection that includes the pill and other contraceptives.

Side effects

General

The pill can cause side effects such as nausea , vomiting , weight gain, migraines , feelings of tightness in the breasts, changes in mood and a decrease in libido . In rare cases, more severe side effects such as high blood pressure , liver disorders and thrombosis can occur.

Thrombosis

A known side effect of the use of combined oral contraceptives is the occurrence of venous thromboembolic events , which is pointed out in the product information. The risk is higher for birth control pills with certain 3rd and 4th generation progestogens compared to those that contain norethisterone or levonorgestrel. Within a few years of the launch of birth control pills with the then new active ingredient drospirenone in 2000, they were suspected of increasing the risk of thrombosis more than older drugs . In January 2014, the European Medicines Agency published the result of a risk assessment process for combined oral contraceptives containing desogestrel, gestodene, norgestimate, etonogestrel, drospirenone, dienogest, chlormadinone, nomegestrol or norelgestromin. Accordingly, the estimated risk of venous thromboembolic events per 10,000 women per year is:

  • About 5 to 7 cases in women taking a combination containing levonorgestrel, norgestimate, or norethisterone
  • About 6 to 12 cases in women taking a combination containing etonogestrel or norelgestromin
  • About 9 to 12 cases in women who take a combination containing gestodene, desogestrel or drospirenone.

The available data on combination preparations containing chlormadinone, dienogest or nomegestrol are not sufficient to be able to assess the risk. For comparison: women who do not use oral contraceptives (non-users) and are not pregnant have about 2 cases of VTE per 10,000 women annually.

In December 2018, according to a new study evaluation , the risk for dienogest- ethinylestradiol combinations was also quantified, which is estimated at 8 to 11 cases per 10,000 women per year and is therefore also slightly higher than first-generation birth control pills.

The risk is increased especially in the first three months after starting taking it. To reduce the risk of thrombosis, a contraceptive pill with a low dose of estrogen, e.g. B. less than 50 ug ethinylestradiol recommended. In a meta-analysis from 2013, no difference was found between preparations containing levonorgestrel and either 20 or 30 µg ethinylestradiol. The combination of levonorgestrel with 50 µg ethinylestradiol, however, increases the risk of venous thrombosis by a factor of 5.2 and is therefore the most unfavorable combination of active ingredients. Even higher doses of ethinylestradiol in combination with desogestrel was associated with a significantly higher risk of venous thromboembolism .

Psychiatric effects

It was published 50 years ago that the contraceptive pill could cause mood swings and the package insert lists mood changes as well as depression as possible side effects. In turn, major depression is a well-known risk factor for suicidal behavior and suicide . In 2018, a Danish working group published the results of a study in which they examined suicide and attempted suicide in connection with the use of hormonal contraceptives in around half a million women aged 15 and over living in Denmark. As a result, both current and previous users showed an increased risk of a first suicide attempt compared to non-users; younger users were at a higher risk than older users. The risk of suicide attempts increased within the first few weeks of starting use and was about twice as high for oral combined hormonal contraceptives in the first year of use than for non-users. In the following years the risk slowly decreased. As a result, on the recommendation of the EMA committee, a new warning was included in the product information and instructions for use of contraceptive pills, even if the review by the Pharmacovigilance Committee of the European Medicines Agency (EMA) had shown that a causal relationship was not clear due to methodological limitations of the study is occupied. The professional association of gynecologists and the German Society for Gynecology and Obstetrics criticized the Danish study for "considerable methodological errors". However, the warning is intended to make members of the health professions aware of the need to educate their patients accordingly and inform them to consult their doctor if mood changes and symptoms of depression occur.

Contraindications

The “pill” is not suitable for women with previous or existing thromboembolic diseases (this includes genetic dispositions such as a factor V Leiden mutation and thrombosis of the deep leg veins, pulmonary embolism and strokes), women with acute or chronic liver diseases and women who have high blood pressure that is difficult to treat or who have severe diabetes mellitus (diabetes) with changes in the blood vessels. Women over 35 years of age or who smoke are advised to seek medical advice before opting for the pill.

Impairment of effectiveness

Diarrhea and vomiting can make the pill less effective. Caution should be exercised if other drugs are taken in addition to the pill. The following medicines, among others, can make the pill less effective:

Antibiotics , St. John's wort , anti-epileptic drugs such as carbamazepine , antacids (drugs that bind gastric acid), Modafinil (especially for mini and micro pills) and slimming products (whose effects are based on binding dietary fats).

Change in cancer risks

In 2003 Valerie Beral u. a. from the Cancer Research UK Epidemiology Unit, Oxford , suggests that prolonged use of birth control pills may increase the relative risk of developing cervical cancer in women . If the pill is taken for five to ten years, the risk of cervical cancer increases to one and a half times; if it is taken for ten years or more, it doubles. This increase is independent of other risk factors, such as smoking and a promiscuous lifestyle that increases the risk of infection with a papilloma virus . Women who are infected with papillomavirus increased their already increased risk from the pill even further. After ten years it will triple. If the pill is stopped, the risk will decrease again, but it is not yet known to what extent. Studies from 2005 confirmed these side effects, but there are also contradicting studies.

According to studies, the birth control pill also increases the risk of developing breast cancer. A connection between oral contraceptives and other types of cancer is being discussed without any clear results.

On the other hand, the risk of ovarian carcinoma developing into cancer is halved by long-term use of oral contraceptives. The Nurses' Health Study in the USA (running since 1976) provides extensive epidemiological data .

On the basis of the research published so far, the International Agency for Research on Cancer of the World Health Organization concluded in the summer of 2005 that the pill reduced the likelihood of some types of cancer, but increased the likelihood of developing other types of cancer, and that it was possible that they could all have a public health benefit.

The US National Cancer Institute offers a good overview.

2005 was a study International Agency for Research on Cancer ( International Agency for Research on Cancer (IARC)) found in Lyon that the risk for breast cancer, cervical cancer and liver cancer increased and for ovarian and endometrial cancer was reduced.

A British long-term study, on the other hand, which examined data from 46,000 women from 1968 onwards, partially refuted an increased risk in 2007. She showed that this was only possible with older preparations. In fact, the likelihood of developing some types of cancer drops by 12 percent. Today there are modern birth control pills that contain less estrogen. Although these have fewer side effects than previous oral contraceptives, they still appear to increase the risk of developing breast cancer.

Effects on the ecosystem

The synthetic estrogen ethinylestradiol , which is contained in most birth control pills, is excreted in the urine . Today's sewage treatment plants cannot remove these chemicals, which means that they get into the natural water cycle and ultimately u. U. back into the drinking water. This form of pollution has been shown to have an impact on the ecosystem . Effects on aquatic life including fish , frogs and zooplankton have been proven . The feminization of male fish to the point of producing eggs is a known effect. Changes in the kidneys and liver of female and male fish as well as a slowdown in the reproductive cycle can also be observed.

See also

literature

  • Bernard Asbell: The pill and how it changed the world (Original title: The Pill. Translated by Thomas Lindquist), In: The woman in society. (Fischer-Taschenbuch, 13662). Frankfurt am Main 1998, ISBN 3-596-13662-8 (license published by Antje Kunstmann , Munich).
  • Stephan Broda: The "pill" without a prescription: Consequences of a release of oral contraceptives With a preface by Horst Skarabis, Deutscher Universitätsverlag, Wiesbaden 2001, ISBN 3-8244-4459-3 (dissertation FU Berlin 1998, under the title: The pill without a prescription - more freedom for women? ).
  • Jonathan Eig: The Birth of the Pill: How Four Pioneers Reinvented Sex and Launched a Revolution . Macmillan 2015.
  • Carl Djerassi : The mother of the pill - autobiography. New York 1991, ISBN 3-453-09307-0 .
  • Beate Keldenich: The history of the birth control pill from 1960 to 2000 - its development, use and importance as reflected in two medical journals: "Zentralblatt der Gynäkologie" and "Lancet" . Shaker, Aachen 2002, ISBN 3-8322-0018-5 ( dissertation RWTH Aachen 2001, 430 pages).
  • Christian Mähr : From alcohol to sugar - twelve substances that changed the world. DuMont, Cologne 2010, ISBN 978-3-8321-9549-6 .
  • Eva-Maria Silies: Love, lust and burden: the pill as a female generation experience in the Federal Republic of 1960–1980 (= Göttingen studies on generation research. Volume 4). Wallstein Verlag , Göttingen 2010, ISBN 978-3-8353-0646-2 ( dissertation Georg-August-Universität Göttingen 2008/09).
  • Gisela Staupe, Lisa Vieth (Ed.): The pill. Of lust and love. Rowohlt, Berlin 1998, ISBN 3-87134-257-2 (exhibition catalog of the German Hygiene Museum in Dresden, from June 1 to December 31, 1996).
  • Michael von Wolff, Petra Stute: Gynecological endocrinology and reproductive medicine: The practice book. Schattauer Verlag, 2013, ISBN 978-3-7945-2792-2 .
  • Christoph Anthüber, Matthias W. Beckmann, Johannes Dietl, Wolfgang Frobenius: Challenges: 100 Years of the Bavarian Society for Obstetrics and Gynecology. Georg Thieme Verlag, Stuttgart 2012, ISBN 978-3-13-171571-5 .

Web links

Wiktionary: Birth control pill  - explanations of meanings, word origins, synonyms, translations
  • Familienplanung.de - The pill. Information portal of the Federal Center for Health Education (BZgA), July 15, 2016
  • AOK fact box (PDF) 23 September 2016
  • Fact box. Harding Center for Risk Literacy, as of March 2019

Individual evidence

  1. ↑ a b c Christoph Anthüber, Matthias W. Beckmann, Johannes Dietl, Wolfgang Frobenius: Challenges: 100 Years of the Bavarian Society for Obstetrics and Gynecology. Georg Thieme Verlag, Stuttgart 2012, ISBN 978-3-13-171571-5 .
  2. ↑ Beate Keldenich: The history of the birth control pill from 1960 to 2000: Their development, use and importance in the mirror of two medical journals: Zentralblatt der Gynäkologie and Lancet . Shaker Verlag , 2002, ISBN 3-8322-0018-5 .
  3. ↑ Gerd K. Döring: Contraception. A guide for doctors and students. Thieme Verlag, Stuttgart 1981, ISBN 3-13-326508-3 .
  4. ↑ How the pill works , accessed on November 18, 2018.
  5. ↑ a b c d e Michael von Wolff, Petra Stute: Gynecological endocrinology and reproductive medicine: The practice book . Schattauer Verlag, 2013, ISBN 978-3-7945-2792-2 .
  6. ↑ James Trussell: Contraceptive Efficacy. In: Robert A. Hatcher u. a .: Contraceptive Technology. (19th rev. Ed.), Ardent Media, New York 2007, ISBN 978-0-9664902-0-6 , (online)
  7. ↑ Ralf Dose: The implantation of the birth control pill in the 60s and early 70s . In: Z. Sexualforsch. , 3, 1990, pp. 25-39.
  8. ↑ a b Eva-Maria Silies: Love, lust and burden: The pill as a female generation experience in the Federal Republic of 1960–1980. Wallstein Verlag, October 2013, p. 97 ff.
  9. ↑ Heinz Kirchhoff . In: Der Spiegel . No. 9 , 1964 ( online ).
  10. ↑ “I hate her, I can tell you right away, because: it's funny! I think German is the only language where the name birth control pill is used for the (...) contraceptive. In all other languages, i.e. in English the pill, la pilule, la pillola, la píldora and so on. Well, this is not a pill against babies, this is first and foremost a pill for women and for wanted children. So if you really want to use such a complicated anti-word, you should call it the anti-unwanted baby pill ”. "Not a pill for babies" . Carl Djerassi in conversation with Katrin Heise, Deutschlandfunk , April 29, 2009.
  11. ↑ The co-inventor of the "pill" is dead welt.de, January 31, 2015.
  12. ↑ MDR time travel: Innovation in the history of contraception - birth control pills vs. Desired child pill . accessed January 30, 2028.
  13. ^ Dasan ( Memento from September 24, 2006 in the Internet Archive ) Ludwig Haberlandt birth control pill.
  14. ↑ Hans-Joachim Lang : The women of Block 10. Medical experiments in Auschwitz . Weltbild, Augsburg 2018, ISBN 978-3-8289-5857-9 . See also Uwe Stolzmann: Laboratory of Horror. In: Deutschlandfunk Kultur. February 9, 2012, accessed February 1, 2020 .

  15. ↑ Medical experiments in Auschwitz. Clauberg and the women from Block 10. In: Arte Geschichte. Accessed January 31, 2020 .
  16. ↑ Medical experiments in Auschwitz. In: ARD program. January 21, 2020, accessed January 31, 2020 .
  17. ^ Theo Löbsack: For and against the birth control pill . In: DIE ZEIT, January 19, 1962
  18. ↑ Ronald D. Gerste: The birth control pill has been on the market for 50 years . In: Neue Zürcher Zeitung, August 18, 2010
  19. ^ Suzanne White Junod, Lara Marks: Women's Trials: The Approval of the First Oral Contraceptive Pill in the United States and Great Britain . (PDF) In: Journal of the History of Medicine. Vol. 57, April 2002 ISSN  0022-5045 (PDF; 1.1 MB)
  20. ↑ Die Welt : Die Pill - Chemical cocktail for contraception made to measure , January 31, 2010.
  21. ↑ Schering history: Milestones in the company's history 1961 to 1990 ( Memento of March 7, 2014 in the Internet Archive ).
  22. ^ "Neighbor Belgium": Newsletter of the Belgian Embassy in Berlin, March / April 2010 edition.
  23. ↑ a b c Björn Schwentker: Data reading: Pill kink? Can you bend! Spiegel Online , March 19, 2014
  24. ↑ a b Interview: 50 years of the pill in Germany. Pro Familia. (Archive) .
  25. ↑ Lt. Die Welt vom: October 22, 1964.
  26. ↑ Die Welt from: January 4, 1966: according to the pharmacists' association under 1%, H. Laegner (1981): according to a study by Schering Pharma Germany in December 1965 at 2.4%.
  27. ↑ "Birth control pill: fog cleared". Der Spiegel 41/1966 of October 3, 1966, pp. 165-167. In it the - somewhat hasty - résumé: "The medical issue, on the other hand - whether the continuous use of the birth control pill is responsible - has now been decided."
  28. ^ Volkmar Sigusch: Young girls and the pill. Comments on hormonal contraception from a sexual science perspective. In: "Sexualmedizin" issue 6/1974, pp. 288–297.
  29. ↑ Prevention is justified, but no need to panic. It all depends on the cycle. Die Welt vom: October 31, 1970.
  30. ↑ Eva-Maria Silies: Between medical necessity and moral judgment. The German medical profession, the BGGF and the implementation of the pill in the 1960s. In: Challenges: 100 Years of the Bavarian Society for Obstetrics and Gynecology. Ed .: Christoph Anthüber, Matthias W. Beckmann, Johannes Dietl, Wolfgang Frobenius, Georg Thieme Verlag, Stuttgart 2012, ISBN 978-3-13-171571-5 , pp. 217–226.
  31. ↑ Christian Lauritzen: Possibilities for a differentiated application of the contraceptives available in the trade. Obstetrics and Gynecology 1971 (31).
  32. ^ Klaus Christoph: Medicine and Contraception: a contribution to the analysis of the self-image of West German doctors. Contributions to Sexualforschung Volume 55, Enke Verlag, Stuttgart 1975, ISBN 3-432-88051-0 .
  33. ↑ Christian Lauritzen: Commentary on the guiding principles. In: Sexualmedizin 4 (1975) 12, pp. 756-760.
  34. ^ Margarete Metzler-Raschig, Reimut Reiche, Volkmar Sigusch: Sexual medicine training for doctors. Sexualmedizin 5 (1976) 6, pp. 405-412.
  35. ↑ Helmut Laengner: 20 years of Schering contraceptives - from Anovlar to Triquilar. In: Schering Pharma Germany (Ed.): The pill is turning 20. This is how it began ... and there we are today. Symposium Berlin, May 25, 1981. Berlin 1981, pp. 6.1–6.5. [The figures on pill sales between 1966 and 1971 are sometimes quite heterogeneous depending on the source, intention, survey method and publication quality, cf. also literature apparatus] .
  36. ↑ Ralf Dose: The enforcement of chemical-hormonal contraception in the Federal Republic of Germany. Publication series of the research group Health Risks and Prevention Policy Wissenschaftszentrum Berlin, Berlin 1989, ISSN  0935-8137 , P89-204.
  37. ↑ Helmut Laengner: Newer methods of contraception . In: Buchholz, Wander. 1975, pp. 166-173.
  38. ↑ Beate Keldenich: The history of the birth control pill from 1960 to 2000: Their development, use and importance in the mirror of two medical journals: Zentralblatt der Gynäkologie and Lancet . Shaker Verlag , 2002, ISBN 3-8322-0018-5 .
  39. ^ The dream child pill in the GDR , accessed on February 4, 2018.
  40. ^ Hermann Schäfer: Anovlar and Ovosiston - birth control pill versus dream child pill. In: German history in 100 objects. Piper Publishing, November 2015.
  41. ^ Catechism of the Catholic Church, No. 2366–2372
  42. ↑ Irish abortion debate reveals arch-conservative structures spiegel.de, December 23, 2012.
  43. ↑ Humanae vitae , No. 11.
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