How The Pill Changed the World

the podcast. I'm Josh Clark. There's Charles W Chuck Bryant, and there's the ghost of Jerry Rouran and the empty chair. Thanks you love this, Thanks again to Ramsey. Yeah, thanks Ramsey. How do we feel about this? I feel great. The pill is it has everything. This might be I just love this episode already. I do too, but I kind of like when we did the female Puberty episode. I just feel nervous. This is gonna be fine. Dude, explaining female reproduction. I just I don't know. Hey, man, We're

just we're just explaining stuff. I know. I know. It's not like we're we're We're just we're just explaining stuff. Just be cool. Hey, before we get going, dude, do you mind if I do a little pluggage for my movie Crush show? Do you plug away? So everybody murdering nos out there, you know, I love my favorite murder of the podcast and just got back from l A and Karen and Georgia were kind enough to sit in and do a movie crush with me. That's awesome, man,

that's huge. It was huge because I'm such a fan and they were great and murderingos you should know. They are warm and friendly and lovely and generous. And I was a little nervous meeting them because I was like, ah, what if it's gone to their heads and their jerks. But they were great. They were so awesome and nice and we had a blast, and of course I they let me pick the movie because it's a Murderino special and we did the Silence of the Lambs. Oh man,

that's a great movie. Yeah. So not only that, but we talked about their life and live shows and touring and their rise to podcast stardom and about all the people they've kidnapped and killed. Yeah, it's great, man. It's an hour and forty minutes long, so it's supersized and you're gonna love it. And even if you don't like my favorite murder, it might be a good chance for you to check out movie Crush. Yeah, so go check it out. Everybody. When's that one coming out? Chuck, it's

already out. Just drop this last Friday. So wait, so you guys don't even have to wait wait wait, wait, wait, listen to this episode first and then go listen to that movie Crushed. Actually doesn't matter, just listen to them both. All right, you ready to get to this? Yeah? Man, all right, so let's talk the pill. Yeah, the opposite of having kids, the pharmaceutical so famous that it's called the pill. It is there. I read this New Yorker article about a book on the birth of the pill,

and now I'm talking about it, so everything comes full circle. Um. And they were saying, like, there's like, you don't call anything else the pill, Like viagra is not the pill, Antibiotics isn't the pill. Um, you don't call it the vacuum or the meat grinder, right, Like, there's there's really nothing like that, nothing compares to it. And it's it's for good reason. I mean, the pill is monumentally huge as far as pharmaceuticals and medicine goes on the scale

of antibiotics easily. Yeah, and it's um, it's the very first medication that was designed for a non therapeutic purpose too. Yes, very interesting and so it's really difficult to over to overstate how much of an impact the pill had when they released it in I think nineteen sixties when it first history first. Yeah, let's let's do that. So let me set the stage for you please. Oh, you're bringing a couch out back in back in the day. I'm gonna do my Charles Nelson Riley one man show impression.

Back in the day. Um, if you were a woman and you didn't want to get pregnant, you had to coordinate with your husband, Um that he wear a condom. Okay, sure, your boyfriend, Well, that's like a whole other kettle fish at this time, supposedly and socially that went on all the time. There's plenty of premrital sex, but socially speaking, only single men were allowed to have premarital sex, which

is like, who are they having premarital sex with? Then? Right, if they're the only ones allowed to have premarital sex, considering considering everyone refused to officially recognize homosexuality even existed. And where you're getting okay, so there's a lot of

double standards, a lot of repression going on. But if you were if you were a woman and you wanted to have sex, so whether it was with the guy you were having sex with or your husband, you you basically had to say you got to wear a condom. And if you said no, well you were s O L one way or another, either you weren't having sex or you're gonna have sex without a condom. And if that happened, there was a really good chance that you

were going to end up getting pregnant just from having sex. Yeah, the ball was entirely in the man's court and women did not have much say in the matter. No, they didn't. There were a couple of things on the market so before the industrial the Industrial revolution, they were like folk remedies where you could use herbs and stuff like that. Basically I think they're called herbal douches where you're just like squeezing stuff in there and hoping for hoping for

the best, right. Um, And then by the depression there's something there's a whole line of stuff called uh, gynecological aids or feminine hygiene, I think is what it is called. And some of them worked, some of them kind of worked, some of them didn't work. Some of them worked but

would kill you or give you chemical burns. There was a lot of problems, so you didn't have a lot of options, right, And then along with the fact that you you actually didn't have that many options socially, in nineteen fifty, thirty states and the federal government said you can't have anything that that can be used as a contraceptive, and you can't even learn about it from your doctor or from school. Thirty states in the federal government. This

is nineteen fifty. Ten years later, the pill comes out, and a couple of years after that, five million American women are using it as a contraception, and they now it was in their hands. They had the ability to decide for themselves whether sex laed to pregnancy or not. Well, and sort of even then, right because not all states allowed it and not all doctors would give it out right, So it wasn't like, oh, the FDA said it's good

to go, so we can all get it. It was still a fight for years and years of decades it really was. So I guess we should start with a woman named Margaret Sanger. She is very controversial figure, uh, founder of planned parenthood. She's a nurse, and she wrote in nineteen twelve about a magic pill that could prevent conception. Yeah, just a theoretical hypothetical pill, right, and um, she's controversial for many reasons, um, not the leases which is her

she was anti abortion. Um, kind of when she was most famous, she was anti abortion and kind of went all in on the pill and was like, this is the way to do it, is to prevent the pregnancy once you're pregnant. Sorry. Uh, and then you know there's the whole eugenics thing. We should do a podcast on her probably at some point we should, because that's a that's a rabbit hole right there. Yeah. So, but she was the early champion of it. She was she coined

the term birth control and I think nineteen twelve as well. Yeah. So in nineteen fourteen she started a newsletter called The Woman Rebel. That's where birth control was first typed out and distributed the words like you said. And then in the nineteen twenties, some breakthroughs happened, uh in science where they were able to identify a progesterone and estrogen and

realized kind of how it all worked. Yeah, so at first they were looking at this stuff as our fertility drugs, and then they noticed that it actually could suppress fertility. And as they were I think this is in the forties when they were really starting in earnest or is it the twenties. Well, I mean they were sy synthesizing it from animals, and it was in early ninety one. I don't think they were even synthesizing. I think they were extracting it. And then that's what you got in

your pill was animal hormones. Well it's says synthis eyes from animals, so maybe it was a process. But um, eventually Dr Marker, Dr Russell Marker, I just said it like James Bond. For some reason, he discovered how to synthesize the synthetic form of progesterone, which is called progestine, and that really this is from wild yams, believe it or not. So he did that and that changed everything. It did. It made it cheaper, it made it easier

to obtain. You could research all of a sudden, right, but you still couldn't really research right, because there were laws on even doing research on birth control. So the people who were doing this it started out as Margaret Sanger she um, she hooked up with a doctor named Pinkus and Gregory Pinkus who was a biologist and he

was interested in in coming up with birth control as well. Um. Mary McCormick was there for St Mary Catherine Catherine McCormick of the McCormick Uh, I guess the spices, okay, so um she uh. She lent a tremendous amount of her wealth to this to this research. And then a guy named John Rock who was a doctor who was also working on a birth control pill. Um. They all joined forces in the nineteen fifties and started working on this

really hard. But they had a lot of roadblocks up against him, and they cut a lot of corners and getting this thing out into market. Yeah, like going to Puerto Rico too, because they had to trials, right, and so this is not like Puerto Rico was like, we don't want this, but you're forcing it on us. Anyway, Puerto Rico had the exact opposite attitude towards birth control that the United States did at the time. So there

was a good place to do it. They just didn't inform anybody what was going on with this, that this was a clinical trial. They just gave him some pills and said you take these, they'll keep you from getting pregnant. Yeah,

which they kind of came about by accident. Uh. Some of the pills were contaminated with s regen and they used that in scare quotes, I guess just because what they really mean is mixed by accident, and that reduced a lot of the side effects because that was one of the big problems at first and continue to be for a while. And eventually they landed on UM, a drug company called Cyril. There were two competing ones, another one of Syntax and Cyril. So you pronounced it Cyril cyrile.

That's what I'm going with. S A R L e u he Zerril. They finally came up with they thought was the right formulation and uh. In nineteen sixty two, Syntax came out with their version and then pretty soon it was being marketed and distributed after FDA approval in so yeah. So Cyril was the one who hooked up with UM Sanger in in Rock Yeah and UM they were the ones who provided the pills for the clinical trial,

and Puerto Rico. There was also a clinical trial in at a women's mental asylum in Massachusetts, and the patients there didn't have any informed consent. And when they released this formula um, first it was for gonecological disorders things like O vary insists. They knew it could be used to treat that, and Cyril at the time was like,

they had no expectations for this whatsoever. And then within a year there were half a million women in America who were suddenly using this for gnecological problems, and Cyril figured out, well, no, they're actually using it for contraception.

And so when they went and saw at FDA approval and got it, that was when the floodgates opened, Like there was now a pill on the market that could prevent contraception that was the woman's to take, and um, all of a sudden there was the first year there was one point two million American women on the pill, and Cyril at first thought, they're not gonna want this. Women are gonna want to take a pill every day

to keep from getting pregnant. But they couldn't even finish the name pregnant before like the pills were being grabbed from their hand. Yeah, you know, there was a huge deal, it was uh. And then these pills were not very safe. That's that's the upshot of this. The estrogen. There was

way too much estrogen. It was dangerous, it was causing cancer. Uh. And in nineteen sixty nine, a very famous book came out called The Doctor's Case against the Pill, written by a medical journalist named Barbara Sieman, and she got together with a bunch of doctors and researchers and women uh and made a case against the pill that it wasn't safe.

It was a senator named gay Lord Nelson who read the book took on birth control um in Senate hearings, and in January in the Senate Chamber there was this testimony about the pill going on, of course run only by men, with only men testifying providing witness testimony. But there was a one in their named Alice Wolfson and her group, the DC Women's Liberation Group. They were sitting there just getting more and more steamed. Yeah, in these

in these hearings. At this time, these hearies were kind of under the radar until Alice Wolfson, Like the Blue c Span wasn't a thing yet, so they were just getting more and more steamed watching all these men get up there and talking about women's reproductive health. And but not only that, they were also these people were talking about how how dangerous the side effects were with the pill, hypertension, blood coots, heart attacks, high blood pressure, um stroke, all

of these things. And these the women in the DC Women's lib Movement uh and including Alice Wilson, were like, We've never heard this before in our lives. How did our doctors not tell us this? Well, that was the backstory, is that the none of the doctors were sharing this information because they were getting and it's you know, I think there's always been a problem not across the board, but with doctors and pharmaceutical companies pushing start and drugs

over others. But even but at the time it was way worse than it is now, Like there was an actual yeah, there was. There was a a mentality among doctors, male doctors, um who who believed that if if you a woman was better off not knowing, you didn't want to get her all upset by giving her all the information, and um if you did tell her, you ran the risk. Since women were so suggestible she might develop a stroke just by thinking about it so much, so it was

better off just not telling her about it. That was the entire medical establishment at the time. And so the pill went from this feminist icon in the sixties to buy nineteen seventy becoming a an icon for white male patriarchy. Medical patriarchy and how UM patients informed consent was was a paramount issue now and it just took on this other role well, and informed consent was literally born that day.

At that hearing, they finally heard an expert say estrogen is to cancer what fertilizer is to wheat, and Alice Wolfson stood up and started screaming. She was screaming, why are you using women as guinea pigs? Why are you letting drug companies murderers for profit and convenience? And it got a lot of media attention, and really the aftermath of those hearings is when this consumer health movement started

and they started informed consent. They started having to list um side effects on bottles, and you know, it wasn't an overnight thing, but it really changed the form uh pharmaceutical industry forever. So the pill managed to accept this um UH I guess iconography, right, it became a symbol

for this other thing. Yeah, but still and if you keep on keeping on like like, I think eighteen seven percent of women between eighteen and forty nine in the US followed those hearings once um Alice Wolfson and the DC Women's Lib movement like made it a national thing, um and I think eighteen percent of them stopped taking the pill as a result. But the pill really didn't

fall out of popularity. It stood in as the as the icon for informed consent, and then just after that was established, it just went back to being the pill. I think that's amazing because it was this huge thing in nineteen sixty for one thing, huge thing in nineteen seventy for another thing, and now it's it's it's part of the cultural zeite guys, forever. Should we take a break, Yes, all right, we're gonna take a break. We're all excited

about history and now we're gonna get into uh science. Hey, let's talk menstrual cycles? All right, let's man, because that's all that's going on here is the pill manipulates the menstrual cycle by tricking the body with synthetic hormones. Yes, it tricks the body into thinking it's already released an egg. It's pretty brilliant, it is. It is, UM, but it's also kind of low fi if you think about it, it is very low it's neat. So we should kind of give you um an idea of what the menstrual

cycle is. Right, it's twenty eight days generally, Yes, that's the that's the rule of thumb. But yes, it's certainly different. And I think it's also down to like hours and stuff like that too. It's not just dateies. It's a human construct you now, But have you stopped and never thought about, like how interesting it is that the cycle of the moon is like twenty eight days as well. Yeah, I think it's fascinating. No, I didn't say it when fascinating.

I never stopped it. I just just in researching this, I was like, that's the cycle of the moon as well. That's interesting. So anyway, UM, over the say roughly twenty eight day period. UM, the whole thing starts with the pituitary gland getting a little froggy and saying, hey, I'm going to release some follicle stimulating hormone at s H and that stuff floods the body and it makes its way down to the ovaries and it stimulates follicles, hence

the name, that's right. It makes these follicles and the ovaries grow, and it just sets off a big series of events. Basically, estrogen is triggers that pituitary gland again, yeah, because the follicles then in turn release estrogen, right, yeah, And so the pewitary gland is busy because then it secretes what's called gonadotropin releasing hormone G little in big R, big H, one of the better abbreviations ever, Yeah, because it looks sort of like guns and roses a little bit. Yeah. Uh.

And that triggers arise in lutenizing hormone LH. Right, and so lutenizing hormone goes back down to the ovarian follicles and it what it gets one of the follicles. So, if you have a bunch of ovarian follicles growing, one of them is going to clearly it's the lead horse, right, It's going to develop into an egg. And as the lutenizing hormone stimulates it to develop into an egg, the egg pops off. The rest of the other follicles wither and die. And then the egg travels down um, the

fallopian tube, where it may or may not be fertilized. Yeah, this is called ovulation. And while this is going on in the background, the uterine lining the endometrium is thickening up right, it's getting ready for business. And the reason that is is because the estrogen and the lutenizing hormone are are causing that to happen. Yeah, they're just rising and rising. So, Um, the the mucus in the vagina

I'm saying, like even more than usual right now. But the mucus in the in the vagina also, um, does it thicken? So it thickens? Is that after the egg has been fertilized, because I think it would make it, it would become okay, so it d thickens. The uterine lining thickens. I think the vaginal mucus makes it makes it easier for sperm to make its way correct, Okay. So that's so if all that goes um according to the genetic plan, then those sperm are gonna make their

way to an egg. The egg is gonna be come fertilized. It's gonna come down the flop and to attached to the uterus. And it's going to start to grow into a child. It might also not happen either. Um. The woman involved might not have sex, so there might be no sperm. Um, the sperm might not make it. There might be some sort of barrier method being made, or

the dude may have that sperm. Sure. Um. Regardless of how this happens, If the egg is not fertilized, the egg eventually weathers up itself and dissolves, and that thickened endometrium uh is shed. Basically, yeah, the uterine lining is shed. Yes, so um, when they have like kind of iron rich blood tissue, Okay, that is menstruation, that's menstruation. So when you think of, um, but that's your period. Yeah, the

whole thing's menstruation. But yeah, okay, it's like a twenty eight day cycle is menstruation because I always think of like, yeah, the periods menstruation. No, that's actually the end of menstruation. And then the whole cycle begins again. Right after that time, the pituitary glands like oh, all right, I'll release some follicle stimulating hormone. The whole thing begins again. The pill interrupts this by making the body think it's already released

an egg. Like when the egg comes off of the follicle and makes its way down in the fallopian tube, the ovum makes its way down the fallopian tube. Um, that's when the estrogen and the progesterone levels are high. Okay, So the pill introduces progesterone and estrogen levels and keeps them high at all times, and therefore the body stops releasing eggs because it thinks it's already released in egg. Yeah, just hijacks that whole process. Synthetically, the woman's body is

amazing when you think about all that's going on. Yeah, our body is not doing anything even remotely like that. It's making like farts. That's what I thought when I was researching this. I was like, man, I've never felt less important, and like the insides of my body are just I got some lungs doing some things. I got a heart, And then like, I guess I'm still making sperm. I don't even know. I've got like a weezy old donkey running the show in there kind of dirty. Oh goodness.

Uh So, the endometrium still builds up in the uterus and is released, but it's known as a withdrawal period. So this is if you're on the pill. But that's why your period while on the pill is going to be generally lighter and shorter. Yeah, and so um, technically this the pill mimics the structure called the corpus luteum, which is the thing that releases progesterone and estrogen once an egg is released. So the body's like, oh, the corpus luteam's got it going on. I don't need to

release another egg. I Also, I am not going to have a period because during this time after the pill um, those hormone levels start to become like a normal baseline in the woman's body. There's no endometrium that builds up, and therefore there's no endometrium to shed right, And I don't think we mentioned this yet. Progestin, which is the synthetic progesterone, it's gonna make that vaginal mucus thicker, so you're right earlier. It is thinner to make the sperm,

make it excess the eggs easier. It will thicken it up that mucus to make it harder by the sperm. So it's and I think it's just sort of like a one two punch to make it even harder to get pregnant, although you can still get pregnant, usually due to misuse of the pill, because what you do is you take the pill at the same time every day. It's all very uh synchronous and depends on that timing, and if you don't time it out right, um, your

chances are getting pregnant or a little bit more. But apparently if you're taking it exactly right at the same time, then your failure rate is going to be point three percent. So it's still technically possible. Yes, it is point three percent possible, which offers up the question like why, Like when they were developing the pill, they had it completely in their control as to what they wanted to do with the Minstreul cycle, and they decided and I never

knew this, it's very interesting. They decided to keep it on that twenty eight day cycle because for a lot of reasons, they thought, um, Dot the Rock thought the Catholic Church, because he was a Catholic, they might be more willing to approve it if it seemed more natural. I guess right here. They thought way off. He thought that women would be more apt to take it if it didn't seem like it was disrupting things too much, Like it still in my regular cycle, right, because you

do have that withdrawal period. Um, it's not an actual real period, but it does come at that at the end of that the pill cycle. Yeah, but they could have gotten rid of the period altogether. Right in a lot of people are like, well, go do that. And there are pills on the market that we'll talk about that do take away women's periods. There's others that put them at different like spaces of them out like like

four times a year or something like that. And people started looking into this and they're like, well, wait a minute, like should shouldn't women be having periods? And the answer is not necessarily right, Yeah, I mean it's controversial, like if you're not if you're not ovulating, you technically don't have to have a period. And this Molly Edmonds wrote this really interesting pill article. Um, like is a period necessary?

I think is what it's called. And um, women today have many more periods than our ancestors, right, something on the order of like four hundred and fifty periods over the average woman's lifetime, about three times as many as

our ancestors. Yeah, so like back in like hunter gatherer pre pre pre agricultural women had about a hundred and sixty or something, right, and that was because they had more kids, they breast fed longer, they didn't live as long yet, And so some people make the point like, well, women are having more more periods than ever before, and the body wasn't meant for this. It's actually kind of

rough on the body to have a period. Like when the the ovum pops off of the fallopian tube, it leaves a scar on the ovary and that scar has to be repaired. And to repair the cells in the ovary have to divide, and as long as they divide correctly that that damage will be repaired. If they divide incorrectly, that damage can turn into ovary and cancer. So that's that's a that's a problem with it. Um there's also scarring with um endo, the shedding of the endometrium, like

actually having your period itself can leave scarring. Same deal, right, Yeah, And I think does an iron deficiency come into play? So that's actually a benefit of having a period. You you get rid of excess iron, which can lead to cardiovascular disease. Well, and there are a couple of weeks during the mental minstrel cycle where women have a lot

a significant reduction in blood pressure. So during the years you know, their reproductive years, at least they are at uh, I guess a slightly lower risk of stroke and heart attack, think like ten percent lower. Yeah, well it's not bad, No, not at all. So, um, there's pros and there's cons to having a period. The thing is, and this is what Molly ultimately points out, is we actually don't know

if a period is necessary. Like the pill is still relatively new, and um, I think that she quoted a doctor in their doctor Susan Rothko, I think or roco um, and she called the the pill that does away with periods entirely the greatest unregulated medical experiment of all time. And um, she she makes a chilling point like we don't really know what the side effects yet because all of this is too new, especially the pill that that

does away with the period altogether. Well, yeah, and they haven't done there are no long term studies of minstrual suppression from oral contraceptives. At least they don't know about

what that means for a woman. They don't know because most of this testing is done for women over eighteen, so they don't know what it means for women under eighteen UM at all because they're just not involved in the research, even though they do have research that shows about two thirds of women would get rid of their period if they could do so safely. Because I mean, we have any mentioned PMS or PPMD, which is just isn't that like a really really severe yeah form of

p MS? Yes, it's like much worse. Yeah yeah, But whereas like p MS is is not a picnic to begin with, this is this is like go the hospital bad, right, can be at least? So, yeah, that's really interesting to think about it. Also, UM treats a very insists there's other uses for UM for birth control pills too. Yeah. Do you want to take another break and get back to it? Okay, okay, Chuck, where are we we were talking about? I'm over here hanging but on this cliff

by my fingernails. I think you're doing great? Aren't you doing great? Everybody? Yes? So remember so there are side effects both positive and negative to taking the pill UM. There's some very common negative side effects like UM Nausea is a big one. UM weight gain spotting, which is called breakthrough menstruation, which is where you have bleeding during the actual pill cycle, not the prescribed um period cycle

of the pill. Yeah. I don't think we mentioned yet either that in the pill uh prescription, in that monthly dose there are seven not always, but the way they designed it was their seven placebo pills that are in there because you only take the pill for twenty one days a month, but they put those extra seven pills in there to keep women on that. I guess the thinking was, if they're used to taking this pill every day,

they need to keep doing it. Yeah, if they don't for seven days, they might forget on the eighth day, and that's bad news. Yeah, So that's that's the most common way to do it. And those that's a very easy type of um of pill to take, right because all of them are the same level of hormone and the um the seven inert ones are usually a different color and they come at the end of the month. It's supposed to be easy. There's actually a recall right

now of Ta Tula. Did you see that Ta Tula has made it by Alurgan I think, and they recalled a lot of their pills because they put the inert ones at the beginning of the cycle accidentally just bad packaging, yes, oh my gosh. And if you look, you can clearly see that the first like seven or different color, but where they're supposed to be at the end, there at the beginning, and that is bad news if you're taking that pill. So if you have ta tula, go check

it right now and uh go get some more. Yeah, but um I think it interrupted you on the side effects nausea, headaches, breastworness, acne, depression, moodiness, weight gain, decrease, libido, and sometimes these can be um like if if you start out on the pill, it can be worse. A few cycles in it might get better, and if it doesn't, you can There are different pills out there, there are there's UM so the the when those pills originally came out, that first four formula um I think it was called

like a novid. That was the first one by Cyril um cereal and they had ten milligrams of um progesterone or progestin and point one five milligrams of estrogen and that is like a nuclear bomb pill. Women had the worst side effects from it, like all these side effects, like each of them mac truck and they were still willing to go through it to to like have control of their body as far as pregnancy went. UM, but they very quickly figured out through further research, you can

do the same. And the reason they selected that is like they knew that there was not going to be any ovulation with ten milligrams of progesterone and UM, so they figured out that you could formulate with a much lower amount of both progestin and estrogen and still get the job done. And they still do that today. I think the estrogen gets down into the micrograms and you can get like um two point five milligrams or progesterone

in in some forms of the pill. Yeah. And then if so, if the pill is mistreating you, what you're saying is there are options, right, Well, yeah, there are three main types of oral let's say types I think I did. You also said, Cyril. There are three main types of the oral contraceptive pills now combination pills, progestin only, and extended release, which are the newest ones out there. The combination pill is the most common pill that you

will get UM. The mini pill is the progestin only and for some women that's better like if you're breastfeeding and you can't have the estrogen, like this is gonna affect your milk, you'll probably be on the mini pill uh, and the mini pill peel. It works in a couple of different ways. It makes the endometrium too thin to accept that egg, uh, and it won't allow it to attach. And again with the vaginal mucus, that makes it too

thick to allow the sperm to reach the egg. But it is a little less um effective, but still effective, but a little less than the combination pill because it's almost like a different different they're different mechanisms. Yeah, Like it's twenty eight active pills for the mini pill, right, but rather than tricking the body into thinking it's released an egg, this is just making it hard to get pregnant. Yes, right, exactly. It's almost like a different kind of pill. And then

there's um, what's the other kind. Well, the combination pill the most common. There's a few subtypes of that pill as well. Right, So there's monophasic, which is what I was talking about, where you've got twenty one pills and all of them are the same dose of progestion, progestin and um estrogen and then you've got the seven inert pills, and some women say I'm not gonna have a period this this month, and then you just rather than taking those seven inert pills, you just move on to the

next month's twenty one pills. Yes, and believe with the monophasic, if you miss a day, you can double up the next day because it's the same amount of pills or the same level of hormones. Right, So, yeah, that's and that's far away the most common. There's bi phasic, which has two different levels of hormones, and then tryphasic has

three different levels. And the point of of biphasic and tryphasic is it's they're designed to give you the absolute minimum amount of synthetic hormones that your body requires to keep from ovulating. Because the point is is the lower the amount of hormones you have in there, probably the better off you are. Whether it's cancer risk, moodiness, who knows, you're um, you're you're just better off with the least

amount that does the trick. Yeah, and the kind of progestin and each of these is gonna vary, but the type of synthetic estrogen is the same, right, it's called ethnel estradi all deerk estrada estradiol. That's it ethanol estradiol. Yeah. But the progestin is the thing that that differs sometimes, right and depending if like you're on a pill that uses going type of progestine, you can say, oh, I want to try a different type of progestin and they'll

say here you go. Uh. And then the extended cycle, which we talked about, this is the newest, the newest one on the market, and I believe isn't this the one that is can reduce your period to like a few for four times a year. Yeah. So there's, um, there's a couple of different there's seasonal and seasonique and they're called that because that four time of year period it'll just be like, oh it's fall up, it's summer. Uh, not in that order, but you know what I'm saying.

And then there's libral and I'm sure there's other ones on the market too. We don't mean to buzz market or anything like that. So there's there's um, there's one that's like three sixty five days, and then there's others that are eighty four days, so that you have or either no periods at all or four periods a year. So there you go. So there's a couple of other things I want to hit on, um, the pills. It's so much larger than just birth control. I mean, just

the fact that his birth control is an enormous thing. Like, like you said, John Rock thought he was going to be able to convince the Catholic Church that that this is an okay thing. That was not the case. Um. In the late sixties, the Black power movement really zeroed in on the pill, especially the men of the Black Power movement, and said like this is this is tantamount

to black genocide. And there they definitely had like a case, like there were plenty of cases of um of black women who went into hospitals and gave birth and then came out unknowingly sterilized, like the doctor had just taken it upon himself to sterilize er after delivering her baby. UM. So they're like they had this, they had this evidence to back this up, and it was never shown like, yes, there was a conspiracy to um to wipe out Black

power in America through the pill. But you like, there were plenty of black women at the time who said like yeah, I can get birth control pills easier than anything, um that you know down the like corner clinic or

something like that. And even even with the early trials from John Rock and Gregory Pinkus, Like, one of the things that they zeroed in on Puerto Rico for was because they thought that if they could show that backwards Puerto Ricans of color could could learn how to take the pill regularly, it would demonstrate that women in the

inner cities could or women in developing countries could. So there was definitely like a mentality toward the white establishment being on board with the idea of at least providing the tools for other for minorities to to control their rate of birth. That was just pure and simple. That was a thought of it. It was, and it's had tremendous amount of benefits too, but there were some there was some darkness in the place that it originally came from as well. Well. Yeah, and of course, um, anti

abortion groups. I think that the pill still to this day is an abortion causing agent what they call in do you know how to pronounce that a borda fashion aborda fashion? I think so, yeah, I think that's right, Um, which you know that's that's long been their argument. Well, they their argument is that it makes the uh, the uterus hostile to a fertilized egg, like prolonged use would prevent a fertilized egg that would otherwise attach from attaching.

And so that's for all intensive purposes abortion in their position, right, And yeah, that is I don't think that one settled by any stretch of the imagination. So you got anything else, I got nothing else. As I predicted, this is a good one. I think it was good. I think it was great. Yeah, because we're not like patronizing. We've never been patronizing. That might be like white dudes, but we're

very much aware that we're white dudes. And let me leave you with this, white dude, If you're a white dude, whether it's in America or the West or anywhere, your one job is to have some perspective. That's your first and foremost job. Take yourself out of your own shoes once in a while, look around, put yourself in other people's shoes. Your eyes will open widely and in agog some say, walk a mile. Sure, why not get a

little weight off? Right? At least go check the mail if you want to know more about the pill, just type in the pill. Uh. It'll bring up some cool stuff on how stuff works dot com. Uh. And there's also a really great American Experience site on PBS that had a man that was good, so good. Um And since I said American Experience and Chuck said so good,

it's time for listening man. Oh no, it's not uh no listener mail today because we we've had some milestones here lately, and as we sit here today in real time, we are as a company are celebrating the tenure anniversary of Stuff you Should Know again again, but we're actually having the party today. And on the same day, um Apple announced at their um there w d c C. Yeah, their developers conference, got up on stage and this one kind of hit me like we had the thousand episodes

that was good. The ten years kind of hit me in a big way. But they got up on stage today and they said that Stuff you Should Know is now the first podcast in history, first and only to reach five hundred million downloads and streams on their platform, which is I didn't know. No, it hit me too. Somehow. Adam Carolla is in Aguinness Book of World Records. But here we are yeah, as the only one, and that's because of you all out there. Yes a gazillion times.

But without you, there is no us. We would have been long gone if not for your support. So we continue to give thanks. Thank you again. Yeah we and we will continue to give thanks, and we will continue to podcast. Yes we will, Chuck, Yes we will. And that's all I got. If you want to get in touch with us, you can hang out with me. I'm

on Twitter at joshuam Clark. I'm on Instagram and Josh I'm Clark to Chuck's on Facebook dot com, Slash Charles W. Chuck Bryant and Slash movie Cross check them out at both. You can send us all an email the Stuff podcast at how stuff works dot com and as always, joined us that are extraordinarily grateful home on the web. Stuff you should know Doc. For more on this and thousands of other topics, visit how stuff Works dot com. M HM