Mestranol/norethynodrel was the first

combined oral contraceptive pill The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. The pill contains two important hormones: progest ...

(COCP) being

mestranol Mestranol, sold under the brand names Enovid, Norinyl, and Ortho-Novum among others, is an estrogen medication which has been used in birth control pills, menopausal hormone therapy, and the treatment of menstrual disorders. It is formulated in c ...

and norethynodrel. It sold as Enovid in the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...

and as Enavid in the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...

. Developed by

Gregory Pincus Gregory Goodwin Pincus (April 9, 1903 – August 22, 1967) was an American biologist and researcher who co-invented the combined oral contraceptive pill. Early life Gregory Goodwin Pincus was born in Woodbine, New Jersey to Jewish parents, who we ...

at G. D. Searle & Company, it was first approved on June 10, 1957 by the U.S.

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...

for treatment of

menstrual disorder A menstrual disorder is characterized as any abnormal condition with regards to a person's menstrual cycle. There are many different types of menstrual disorders that vary with signs and symptoms, including pain during menstruation, heavy bleeding ...

s. The FDA approved an additional indication for use as a contraceptive on June 23, 1960, though it only became legally prescribable nationwide and regardless of the woman's marital status after ''

Eisenstadt v. Baird ''Eisenstadt v. Baird'', 405 U.S. 438 (1972), was a landmark decision of the U.S. Supreme Court that established the right of unmarried people to possess contraception on the same basis as married couples. The Court struck down a Massachusetts la ...

'' in 1972. In 1961, it was approved as a contraceptive in the UK and in Canada.

Medical uses

Mestranol/noretynodrel was indicated in the treatment of

gynecological Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area ...

and

s. Originally it was not legal to use contraception so it was marketed for menstrual relief with the side effect of inability to conceive. It has also been used to suppress

lactation Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process naturally occurs with all sexually mature female mammals, although it may predate mammals. The proces ...

and to treat

endometriosis Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, f ...

in women.

Available forms

The medication contained 0.15 mg

and 10 mg

noretynodrel Noretynodrel, or norethynodrel, sold under the brand name Enovid among others, is a progestin medication which was previously used in birth control pills and in the treatment of gynecological disorders but is now no longer marketed. It was availa ...

. Additional formulations containing 0.075 mg mestranol and 5 mg noretynodrel as well as 0.1 mg mestranol and 2.5 mg noretynodrel were subsequently introduced. One formulation also contained 0.075 mg mestranol and 3 mg noretynodrel.

History

The first published case report of a

blood clot A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of c ...

and

pulmonary embolism Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain p ...

in a woman using Enavid (Enovid 10 mg in the U.S.) at a dose of 20 mg/day did not appear until November 1961, four years after its approval, by which time it had been used by over one million women. It would take almost a decade of

epidemiological Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidenc ...

studies to conclusively establish an increased risk of

venous thrombosis Venous thrombosis is blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. If a thrombus breaks off (embolizes) and flows to the lungs to ...

in oral contraceptive users and an increased risk of

stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

and

myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...

in oral contraceptive users who

smoke Smoke is a suspension of airborne particulates and gases emitted when a material undergoes combustion or pyrolysis, together with the quantity of air that is entrained or otherwise mixed into the mass. It is commonly an unwanted by-product ...

or have

high blood pressure Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...

or other cardiovascular or cerebrovascular risk factors. These risks of oral contraceptives were dramatized in the 1969 book ''The Doctors' Case Against the Pill'' by feminist journalist

Barbara Seaman Barbara Seaman (September 11, 1935 – February 27, 2008) was an American author, activist, and journalist, and a principal founder of the women's health feminism movement. Early years Seaman, whose parents, Henry J. Rosner and Sophie Kimels, ...

who helped arrange the 1970

Nelson Pill Hearings In 1970, Barbara Seaman brought the dangers of combined oral contraceptive pill use to the attention of Senator Gaylord Nelson with her book ''The Doctors Case Against the Pill''. Nelson, who at the time was also busy organizing the first Earth Da ...

called by Senator

Gaylord Nelson Gaylord Anton Nelson (June 4, 1916July 3, 2005) was an American politician and environmentalist from Wisconsin who served as a United States senator and governor. He was a member of the Democratic Party and the founder of Earth Day, which launche ...

. The hearings were conducted by senators who were all men and the witnesses in the first round of hearings were all men, leading

Alice Wolfson Alice Wolfson is an American activist. A Barnard College graduate and former Fulbright Scholar, she is a veteran political activist in women's reproductive health issues, a lawyer, and a co-founder of the National Women's Health Network. She playe ...

and other feminists to protest the hearings and generate media attention. Their work led to mandating the inclusion of

patient package insert A package insert is a document included in the package of a medication that provides information about that drug and its use. For prescription medications, the insert is technical, providing information for medical professionals about how to p ...

s with oral contraceptives to explain their possible side effects and risks to help facilitate

informed consent Informed consent is a principle in medical ethics and medical law, that a patient must have sufficient information and understanding before making decisions about their medical care. Pertinent information may include risks and benefits of treatme ...

. Today's standard dose oral contraceptives contain an estrogen dose that is one third lower than the first marketed oral contraceptive and contain lower doses of different, more potent progestins in a variety of formulations. Enovid was discontinued in the U.S. in 1988, along with other first-generation high-estrogen COCPs.

References

External links

* {{DEFAULTSORT:Mestranol norethynodrel Combined oral contraceptives

Medical uses

Available forms

History

See also

References

External links