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Sunday, November 10, 2019

Intergovernmental Panel on Climate Change

From Wikipedia, the free encyclopedia
 
Emblem of the United Nations.svg
Intergovernmental Panel on Climate Change Logo.svg
AbbreviationIPCC
Formation1988; 31 years ago
TypePanel
Legal statusActive
HeadquartersGeneva, Switzerland
Head
Hoesung Lee
Parent organization
World Meteorological Organization United Nations Environment Program
Websiteipcc.ch
A coloured voting box.svg Politics portal
Global Warming Map.jpg Global warming portal

The Intergovernmental Panel on Climate Change (IPCC) is an intergovernmental body of the United Nations that is dedicated to providing the world with an objective, scientific view of climate change, its natural, political, and economic impacts and risks, and possible response options.

The IPCC was established in 1988 by the World Meteorological Organization (WMO) and the United Nations Environment Programme (UNEP) and was later endorsed by the United Nations General Assembly. Membership is open to all members of the WMO and UN. The IPCC produces reports that contribute to the work of the United Nations Framework Convention on Climate Change (UNFCCC), the main international treaty on climate change. The objective of the UNFCCC is to "stabilize greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic (human-induced) interference with the climate system". The IPCC's Fifth Assessment Report was a critical scientific input into the UNFCCC's Paris Agreement in 2015.

IPCC reports cover the "scientific, technical and socio-economic information relevant to understanding the scientific basis of risk of human-induced climate change, its potential impacts and options for adaptation and mitigation." The IPCC does not carry out original research, nor does it monitor climate or related phenomena itself. Rather, it assesses published literature, including peer-reviewed and non-peer-reviewed sources. However, the IPCC can be said to stimulate research in climate science. Chapters of IPCC reports often close with sections on limitations and knowledge or research gaps, and the announcement of an IPCC special report can catalyse research activity in that area.

Thousands of scientists and other experts contribute on a voluntary basis to writing and reviewing reports, which are then reviewed by governments. IPCC reports contain a "Summary for Policymakers", which is subject to line-by-line approval by delegates from all participating governments. Typically, this involves the governments of more than 120 countries.

The IPCC provides an internationally accepted authority on climate change, producing reports that have the agreement of leading climate scientists and consensus from participating governments. The 2007 Nobel Peace Prize was shared between the IPCC and Al Gore.

Following the election of a new Bureau in 2015, the IPCC embarked on its sixth assessment cycle. Besides the Sixth Assessment Report, to be completed in 2022, the IPCC released the Special Report on Global Warming of 1.5 °C in October 2018, released an update to its 2006 Guidelines for National Greenhouse Gas Inventories—the 2019 Refinement—in May 2019, and delivered two further special reports in 2019: the Special Report on Climate Change and Land (SRCCL), published online on August 7, and the Special Report on the Ocean and Cryosphere in a Changing Climate (SROCC), released on September 25, 2019. This makes the sixth assessment cycle the most ambitious in the IPCC's 30-year history. The IPCC also decided to prepare a special report on cities and climate change in the seventh assessment cycle and held a conference in March 2018 to stimulate research in this area.

Origins and aims

The IPCC developed from an international scientific body, the Advisory Group on Greenhouse Gases set up in 1985 by the International Council of Scientific Unions, the United Nations Environment Programme (UNEP), and the World Meteorological Organization (WMO) to provide recommendations based on current research. This small group of scientists lacked the resources to cover the increasingly complex interdisciplinary nature of climate science. The United States Environmental Protection Agency and State Department wanted an international convention to agree restrictions on greenhouse gases, and the conservative Reagan Administration was concerned about unrestrained influence from independent scientists or from United Nations bodies including UNEP and the WMO. The U.S. government was the main force in forming the IPCC as an autonomous intergovernmental body in which scientists took part both as experts on the science and as official representatives of their governments, to produce reports which had the firm backing of all the leading scientists worldwide researching the topic, and which then had to gain consensus agreement from every one of the participating governments. In this way, it was formed as a hybrid between a scientific body and an intergovernmental political organisation.

The United Nations formally edorsed the creation of the IPCC in 1988. Some of the reasons the UN stated in its resolution include
"[C]ertain human activities could change global climate patterns, threatening present and future generations with potentially severe economic and social consequences"
"[C]ontinued growth in atmospheric concentrations of "greenhouse" gases could produce global warming with an eventual rise in sea levels, the effects of which could be disastrous for mankind if timely steps are not taken at all levels."
The IPCC was tasked with reviewing peer-reviewed scientific literature and other relevant publications to provide information on the state of knowledge about climate change.

Organization

The IPCC does not conduct its own original research. It produces comprehensive assessments, reports on special topics, and methodologies. The assessments build on previous reports, highlighting the latest knowledge. For example, the wording of the reports from the first to the fifth assessment reflects the growing evidence for a changing climate caused by human activity.

The IPCC has adopted and published "Principles Governing IPCC Work", which states that the IPCC will assess:
This document also states that IPCC will do this work by assessing "on a comprehensive, objective, open and transparent basis the scientific, technical and socio-economic information relevant to understanding the scientific basis" of these topics. The Principles also state that "IPCC reports should be neutral with respect to policy, although they may need to deal objectively with scientific, technical and socio-economic factors relevant to the application of particular policies."

Korean economist Hoesung Lee has been the chair of the IPCC since 8 October 2015, with the election of the new IPCC Bureau. Before this election, the IPCC was led by Vice-Chair Ismail El Gizouli, who was designated acting Chair after the resignation of Rajendra K. Pachauri in February 2015. The previous chairs were Rajendra K. Pachauri, elected in May 2002; Robert Watson in 1997; and Bert Bolin in 1988. The chair is assisted by an elected bureau including vice-chairs and working group co-chairs, and by a secretariat.

The Panel itself is composed of representatives appointed by governments. Participation of delegates with appropriate expertise is encouraged. Plenary sessions of the IPCC and IPCC Working Groups are held at the level of government representatives. Non-Governmental and Intergovernmental Organizations admitted as observer organizations may also attend. Sessions of the Panel, IPCC Bureau, workshops, expert and lead authors meetings are by invitation only. About 500 people from 130 countries attended the 48th Session of the Panel in Incheon, Republic of Korea, in October 2018, including 290 government officials and 60 representatives of observer organizations. The opening ceremonies of sessions of the Panel and of Lead Author Meetings are open to media, but otherwise IPCC meetings are closed. 

There are several major groups:
  • IPCC Panel: Meets in plenary session about once a year. It controls the organization's structure, procedures, and work programme, and accepts and approves IPCC reports. The Panel is the IPCC corporate entity.
  • Chair: Elected by the Panel.
  • Secretariat: Oversees and manages all activities. Supported by UNEP and WMO.
  • Bureau: Elected by the Panel. Chaired by the Chair. 34 members include IPCC Vice-Chairs, Co-Chairs of Working Groups and the Task Force, and Vice-Chairs of the Working Groups. It provides guidance to the Panel on the scientific and technical aspects of its work.
  • Working Groups: Each has two Co-Chairs, one from the developed and one from developing world, and a technical support unit. Sessions of the Working Group approve the Summary for Policymakers of special reports and working group contributions to an assessment report. Each Working Group has a Bureau comprising its Co-Chairs and Vice-Chairs, who are also members of the IPCC Bureau.
    • Working Group I: Assesses scientific aspects of the climate system and climate change. Co-Chairs: Valérie Masson-Delmotte and Panmao Zhai
    • Working Group II: Assesses vulnerability of socio-economic and natural systems to climate change, consequences, and adaptation options. Co-Chairs: Hans-Otto Pörtner and Debra Roberts
    • Working Group III: Assesses options for limiting greenhouse gas emissions and otherwise mitigating climate change. Co-Chairs: Priyadarshi R. Shukla and Jim Skea
  • Task Force on National Greenhouse Gas Inventories. Co-Chairs: Kiyoto Tanabe and Eduardo Calvo Buendía
    • Task Force Bureau: Comprises the two Co-Chairs, who are also members of the IPCC Bureau, and 12 members.
  • Executive Committee: Comprises the Chair, IPCC Vice-Chairs and the Co-Chairs of the Working Groups and Task Force. Its role includes addressing urgent issues that arise between sessions of the Panel.
The IPCC receives funding through the IPCC Trust Fund, established in 1989 by the United Nations Environment Programme (UNEP) and the World Meteorological Organization (WMO), Costs of the Secretary and of housing the secretariat are provided by the WMO, while UNEP meets the cost of the Depute Secretary. Annual cash contributions to the Trust Fund are made by the WMO, by UNEP, and by IPCC Members. Payments and their size are voluntary. The Panel is responsible for considering and adopting by consensus the annual budget. The organization is required to comply with the Financial Regulations and Rules of the WMO.

Assessment reports

The IPCC has published five comprehensive assessment reports reviewing the latest climate science, as well as a number of special reports on particular topics. These reports are prepared by teams of relevant researchers selected by the Bureau from government nominations. Expert reviewers from a wide range of governments, IPCC observer organizations and other organizations are invited at different stages to comment on various aspects of the drafts.

The IPCC published its First Assessment Report (FAR) in 1990, a supplementary report in 1992, a Second Assessment Report (SAR) in 1995, a Third Assessment Report (TAR) in 2001, a Fourth Assessment Report (AR4) in 2007 and a Fifth Assessment Report (AR5) in 2014. The IPCC is currently preparing the Sixth Assessment Report (AR6), which will be completed in 2022. 

Each assessment report is in three volumes, corresponding to Working Groups I, II, and III. It is completed by a synthesis report that integrates the working group contributions and any special reports produced in that assessment cycle.

Scope and preparation of the reports

The IPCC does not carry out research nor does it monitor climate related data. Lead authors of IPCC reports assess the available information about climate change based on published sources. According to IPCC guidelines, authors should give priority to peer-reviewed sources. Authors may refer to non-peer-reviewed sources (the "grey literature"), provided that they are of sufficient quality. Examples of non-peer-reviewed sources include model results, reports from government agencies and non-governmental organizations, and industry journals. Each subsequent IPCC report notes areas where the science has improved since the previous report and also notes areas where further research is required. 

There are generally three stages in the review process:
  • Expert review (6–8 weeks)
  • Government/expert review
  • Government review of:
    • Summaries for Policymakers
    • Overview Chapters
    • Synthesis Report
Review comments are in an open archive for at least five years.

There are several types of endorsement which documents receive:
  • Approval. Material has been subjected to detailed, line by line discussion and agreement.
    • Working Group Summaries for Policymakers are approved by their Working Groups.
    • Synthesis Report Summary for Policymakers is approved by Panel.
  • Adoption. Endorsed section by section (and not line by line).
    • Panel adopts Overview Chapters of Methodology Reports.
    • Panel adopts IPCC Synthesis Report.
  • Acceptance. Not been subject to line by line discussion and agreement, but presents a comprehensive, objective, and balanced view of the subject matter.
    • Working Groups accept their reports.
    • Task Force Reports are accepted by the Panel.
    • Working Group Summaries for Policymakers are accepted by the Panel after group approval.
The Panel is responsible for the IPCC and its endorsement of Reports allows it to ensure they meet IPCC standards. 

There have been a range of commentaries on the IPCC's procedures, examples of which are discussed later in the article (see also IPCC Summary for Policymakers). Some of these comments have been supportive, while others have been critical. Some commentators have suggested changes to the IPCC's procedures.

Authors

Each chapter has a number of authors who are responsible for writing and editing the material. A chapter typically has two "coordinating lead authors", ten to fifteen "lead authors", and a somewhat larger number of "contributing authors". The coordinating lead authors are responsible for assembling the contributions of the other authors, ensuring that they meet stylistic and formatting requirements, and reporting to the Working Group chairs. Lead authors are responsible for writing sections of chapters. Contributing authors prepare text, graphs or data for inclusion by the lead authors.

Authors for the IPCC reports are chosen from a list of researchers prepared by governments and participating organisations, and by the Working Group/Task Force Bureaux, as well as other experts known through their published work. The choice of authors aims for a range of views, expertise and geographical representation, ensuring representation of experts from developing and developed countries and countries with economies in transition.

First assessment report

The IPCC First Assessment Report (FAR) was completed in 1990, and served as the basis of the UNFCCC. 

The executive summary of the WG I Summary for Policymakers report says they are certain that emissions resulting from human activities are substantially increasing the atmospheric concentrations of the greenhouse gases, resulting on average in an additional warming of the Earth's surface. They calculate with confidence that CO2 has been responsible for over half the enhanced greenhouse effect. They predict that under a "business as usual" (BAU) scenario, global mean temperature will increase by about 0.3 °C per decade during the [21st] century. They judge that global mean surface air temperature has increased by 0.3 to 0.6 °C over the last 100 years, broadly consistent with prediction of climate models, but also of the same magnitude as natural climate variability. The unequivocal detection of the enhanced greenhouse effect is not likely for a decade or more.

Supplementary report of 1992

The 1992 supplementary report was an update, requested in the context of the negotiations on the UNFCCC at the Earth Summit (United Nations Conference on Environment and Development) in Rio de Janeiro in 1992.

The major conclusion was that research since 1990 did "not affect our fundamental understanding of the science of the greenhouse effect and either confirm or do not justify alteration of the major conclusions of the first IPCC scientific assessment". It noted that transient (time-dependent) simulations, which had been very preliminary in the FAR, were now improved, but did not include aerosol or ozone changes.

Second assessment report

Climate Change 1995, the IPCC Second Assessment Report (SAR), was finished in 1996. It is split into four parts:
  • A synthesis to help interpret UNFCCC article 2.
  • The Science of Climate Change (WG I)
  • Impacts, Adaptations and Mitigation of Climate Change (WG II)
  • Economic and Social Dimensions of Climate Change (WG III)
Each of the last three parts was completed by a separate Working Group (WG), and each has a Summary for Policymakers (SPM) that represents a consensus of national representatives. The SPM of the WG I report contains headings:
  1. Greenhouse gas concentrations have continued to increase
  2. Anthropogenic aerosols tend to produce negative radiative forcings
  3. Climate has changed over the past century (air temperature has increased by between 0.3 and 0.6 °C since the late 19th century; this estimate has not significantly changed since the 1990 report).
  4. The balance of evidence suggests a discernible human influence on global climate (considerable progress since the 1990 report in distinguishing between natural and anthropogenic influences on climate, because of: including aerosols; coupled models; pattern-based studies)
  5. Climate is expected to continue to change in the future (increasing realism of simulations increases confidence; important uncertainties remain but are taken into account in the range of model projections)
  6. There are still many uncertainties (estimates of future emissions and biogeochemical cycling; models; instrument data for model testing, assessment of variability, and detection studies)

Third assessment report

The Third Assessment Report (TAR) was completed in 2001 and consists of four reports, three of them from its Working Groups:
  • Working Group I: The Scientific Basis
  • Working Group II: Impacts, Adaptation and Vulnerability
  • Working Group III: Mitigation
  • Synthesis Report
A number of the TAR's conclusions are given quantitative estimates of how probable it is that they are correct, e.g., greater than 66% probability of being correct. These are "Bayesian" probabilities, which are based on an expert assessment of all the available evidence.

"Robust findings" of the TAR Synthesis Report include:
  • "Observations show Earth's surface is warming. Globally, 1990s very likely warmest decade in instrumental record". Atmospheric concentrations of anthropogenic (i.e., human-emitted) greenhouse gases have increased substantially.
  • Since the mid-20th century, most of the observed warming is "likely" (greater than 66% probability, based on expert judgement) due to human activities.
  • Projections based on the Special Report on Emissions Scenarios suggest warming over the 21st century at a more rapid rate than that experienced for at least the last 10,000 years.
  • "Projected climate change will have beneficial and adverse effects on both environmental and socio-economic systems, but the larger the changes and the rate of change in climate, the more the adverse effects predominate."
  • "Ecosystems and species are vulnerable to climate change and other stresses (as illustrated by observed impacts of recent regional temperature changes) and some will be irreversibly damaged or lost."
  • "Greenhouse gas emission reduction (mitigation) actions would lessen the pressures on natural and human systems from climate change."
  • "Adaptation [to the effects of climate change] has the potential to reduce adverse effects of climate change and can often produce immediate ancillary benefits, but will not prevent all damages." An example of adaptation to climate change is building levees in response to sea level rise.

Comments on the TAR

In 2001, 16 national science academies issued a joint statement on climate change. The joint statement was made by the Australian Academy of Science, the Royal Flemish Academy of Belgium for Science and the Arts, the Brazilian Academy of Sciences, the Royal Society of Canada, the Caribbean Academy of Sciences, the Chinese Academy of Sciences, the French Academy of Sciences, the German Academy of Natural Scientists Leopoldina, the Indian National Science Academy, the Indonesian Academy of Sciences, the Royal Irish Academy, Accademia Nazionale dei Lincei (Italy), the Academy of Sciences Malaysia, the Academy Council of the Royal Society of New Zealand, the Royal Swedish Academy of Sciences, and the Royal Society (UK). The statement, also published as an editorial in the journal Science, stated "we support the [TAR's] conclusion that it is at least 90% certain that temperatures will continue to rise, with average global surface temperature projected to increase by between 1.4 and 5.8 °C above 1990 levels by 2100". The TAR has also been endorsed by the Canadian Foundation for Climate and Atmospheric Sciences, Canadian Meteorological and Oceanographic Society, and European Geosciences Union (refer to "Endorsements of the IPCC"). 

In 2001, the US National Research Council (US NRC) produced a report that assessed Working Group I's (WGI) contribution to the TAR. US NRC (2001) "generally agrees" with the WGI assessment, and describes the full WGI report as an "admirable summary of research activities in climate science".

IPCC author Richard Lindzen has made a number of criticisms of the TAR. Among his criticisms, Lindzen has stated that the WGI Summary for Policymakers (SPM) does not faithfully summarize the full WGI report. For example, Lindzen states that the SPM understates the uncertainty associated with climate models. John Houghton, who was a co-chair of TAR WGI, has responded to Lindzen's criticisms of the SPM. Houghton has stressed that the SPM is agreed upon by delegates from many of the world's governments, and that any changes to the SPM must be supported by scientific evidence.

IPCC author Kevin Trenberth has also commented on the WGI SPM. Trenberth has stated that during the drafting of the WGI SPM, some government delegations attempted to "blunt, and perhaps obfuscate, the messages in the report". However, Trenberth concludes that the SPM is a "reasonably balanced summary".

US NRC (2001) concluded that the WGI SPM and Technical Summary are "consistent" with the full WGI report. US NRC (2001) stated:
[...] the full [WGI] report is adequately summarized in the Technical Summary. The full WGI report and its Technical Summary are not specifically directed at policy. The Summary for Policymakers reflects less emphasis on communicating the basis for uncertainty and a stronger emphasis on areas of major concern associated with human-induced climate change. This change in emphasis appears to be the result of a summary process in which scientists work with policy makers on the document. Written responses from U.S. coordinating and lead scientific authors to the committee indicate, however, that (a) no changes were made without the consent of the convening lead authors (this group represents a fraction of the lead and contributing authors) and (b) most changes that did occur lacked significant impact.

Fourth assessment report

The Fourth Assessment Report (AR4) was published in 2007. Like previous assessment reports, it consists of four reports:
  • Working Group I: The Physical Science Basis
  • Working Group II: Impacts, Adaptation and Vulnerability
  • Working Group III: Mitigation
  • Synthesis Report
People from over 130 countries contributed to the IPCC Fourth Assessment Report, which took 6 years to produce. Contributors to AR4 included more than 2500 scientific expert reviewers, more than 800 contributing authors, and more than 450 lead authors.

"Robust findings" of the Synthesis report include:
  • "Warming of the climate system is unequivocal, as is now evident from observations of increases in global average air and ocean temperatures, widespread melting of snow and ice and rising global average sea level".
  • Most of the global average warming over the past 50 years is "very likely" (greater than 90% probability, based on expert judgement) due to human activities.
  • "Impacts [of climate change] will very likely increase due to increased frequencies and intensities of some extreme weather events".
  • "Anthropogenic warming and sea level rise would continue for centuries even if GHG emissions were to be reduced sufficiently for GHG concentrations to stabilise, due to the time scales associated with climate processes and feedbacks". Stabilization of atmospheric greenhouse gas concentrations is discussed in climate change mitigation.
  • "Some planned adaptation (of human activities) is occurring now; more extensive adaptation is required to reduce vulnerability to climate change".
  • "Unmitigated climate change would, in the long term, be likely to exceed the capacity of natural, managed and human systems to adapt".
  • "Many impacts [of climate change] can be reduced, delayed or avoided by mitigation".
Global warming projections from AR4 are shown below. The projections apply to the end of the 21st century (2090–99), relative to temperatures at the end of the 20th century (1980–99). Add 0.7 °C to projections to make them relative to pre-industrial levels instead of 1980–99. (UK Royal Society, 2010, p=10. Descriptions of the greenhouse gas emissions scenarios can be found in Special Report on Emissions Scenarios.

AR4 global warming projections
Emissions
scenario
Best estimate
(°C)
"Likely" range
(°C)
B1 1.8 1.1 – 2.9
A1T 2.4 1.4 – 3.8
B2 2.4 1.4 – 3.8
A1B 2.8 1.7 – 4.4
A2 3.4 2.0 – 5.4
A1FI 4.0 2.4 – 6.4
"Likely" means greater than 66% probability of being correct, based on expert judgement.

Response to AR4

Several science academies have referred to and/or reiterated some of the conclusions of AR4. These include:
  • Joint-statements made in 2007, 2008, and 2009 by the science academies of Brazil, China, India, Mexico, South Africa and the G8 nations (the "G8+5").
  • Publications by the Australian Academy of Science.
  • A joint-statement made in 2007 by the Network of African Science Academies.
  • A statement made in 2010 by the Inter Academy Medical Panel This statement has been signed by 43 scientific academies.
The Netherlands Environmental Assessment Agency (PBL, et al., 2009; 2010) has carried out two reviews of AR4. These reviews are generally supportive of AR4's conclusions. PBL (2010) make some recommendations to improve the IPCC process. A literature assessment by the US National Research Council (US NRC, 2010) concludes:
Climate change is occurring, is caused largely by human activities, and poses significant risks for—and in many cases is already affecting—a broad range of human and natural systems [emphasis in original text]. [...] This conclusion is based on a substantial array of scientific evidence, including recent work, and is consistent with the conclusions of recent assessments by the U.S. Global Change Research Program [...], the Intergovernmental Panel on Climate Change’s Fourth Assessment Report [...], and other assessments of the state of scientific knowledge on climate change.
Some errors have been found in the IPCC AR4 Working Group II report. Two errors include the melting of Himalayan glaciers, and Dutch land area that is below sea level.

Fifth assessment report

The IPCC's Fifth Assessment Report (AR5) was completed in 2014. AR5 followed the same general format as of AR4, with three Working Group reports and a Synthesis report. The Working Group I report (WG1) was published in September 2013.

Conclusions of AR5 are summarized below:
Working Group I

  • "Warming of the climate system is unequivocal, and since the 1950s, many of the observed changes are unprecedented over decades to millennia".
  • "Atmospheric concentrations of carbon dioxide, methane, and nitrous oxide have increased to levels unprecedented in at least the last 800,000 years".
  • Human influence on the climate system is clear. It is extremely likely (95-100% probability) that human influence was the dominant cause of global warming between 1951-2010.
Working Group II

  • "Increasing magnitudes of [global] warming increase the likelihood of severe, pervasive, and irreversible impacts"
  • "A first step towards adaptation to future climate change is reducing vulnerability and exposure to present climate variability"
  • "The overall risks of climate change impacts can be reduced by limiting the rate and magnitude of climate change"
Working Group III

  • Without new policies to mitigate climate change, projections suggest an increase in global mean temperature in 2100 of 3.7 to 4.8 °C, relative to pre-industrial levels (median values; the range is 2.5 to 7.8 °C including climate uncertainty).
  • The current trajectory of global greenhouse gas emissions is not consistent with limiting global warming to below 1.5 or 2 °C, relative to pre-industrial levels. Pledges made as part of the Cancún Agreements are broadly consistent with cost-effective scenarios that give a "likely" chance (66-100% probability) of limiting global warming (in 2100) to below 3 °C, relative to pre-industrial levels.

Representative Concentration Pathways

Projections in AR5 are based on "Representative Concentration Pathways" (RCPs).[86] The RCPs are consistent with a wide range of possible changes in future anthropogenic greenhouse gas emissions. Projected changes in global mean surface temperature and sea level are given in the main RCP article.

Special reports

In addition to climate assessment reports, the IPCC publishes Special Reports on specific topics. The preparation and approval process for all IPCC Special Reports follows the same procedures as for IPCC Assessment Reports. In the year 2011 two IPCC Special Report were finalized, the Special Report on Renewable Energy Sources and Climate Change Mitigation (SRREN) and the Special Report on Managing Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX). Both Special Reports were requested by governments.

Special Report on Emissions Scenarios (SRES)

The Special Report on Emissions Scenarios (SRES) is a report by the IPCC which was published in 2000. The SRES contains "scenarios" of future changes in emissions of greenhouse gases and sulfur dioxide. One of the uses of the SRES scenarios is to project future changes in climate, e.g., changes in global mean temperature. The SRES scenarios were used in the IPCC's Third and Fourth Assessment Reports.

The SRES scenarios are "baseline" (or "reference") scenarios, which means that they do not take into account any current or future measures to limit greenhouse gas (GHG) emissions (e.g., the Kyoto Protocol to the United Nations Framework Convention on Climate Change). SRES emissions projections are broadly comparable in range to the baseline projections that have been developed by the scientific community.

Comments on the SRES

There have been a number of comments on the SRES. Parson et al. (2007) stated that the SRES represented "a substantial advance from prior scenarios". At the same time, there have been criticisms of the SRES.

The most prominently publicized criticism of SRES focused on the fact that all but one of the participating models compared gross domestic product (GDP) across regions using market exchange rates (MER), instead of the more correct purchasing-power parity (PPP) approach. This criticism is discussed in the main SRES article.

Special report on renewable energy sources and climate change mitigation (SRREN)

This report assesses existing literature on renewable energy commercialisation for the mitigation of climate change. It was published in 2012 and covers the six most important renewable energy technologies, as well as their integration into present and future energy systems. It also takes into consideration the environmental and social consequences associated with these technologies, the cost and strategies to overcome technical as well as non-technical obstacles to their application and diffusion. The full report in PDF form is found here.
 
More than 130 authors from all over the world contributed to the preparation of IPCC Special Report on Renewable Energy Sources and Climate Change Mitigation (SRREN) on a voluntary basis – not to mention more than 100 scientists, who served as contributing authors.

Special Report on managing the risks of extreme events and disasters to advance climate change adaptation (SREX)

The report was published in 2012. It assesses the effect that climate change has on the threat of natural disasters and how nations can better manage an expected change in the frequency of occurrence and intensity of severe weather patterns. It aims to become a resource for decision-makers to prepare more effectively for managing the risks of these events. A potentially important area for consideration is also the detection of trends in extreme events and the attribution of these trends to human influence. The full report, 594 pages in length, may be found here in PDF form.

More than 80 authors, 19 review editors, and more than 100 contributing authors from all over the world contributed to the preparation of SREX.

Special Report on Global Warming of 1.5 °C (SR15)

When the Paris Agreement was adopted, the UNFCCC invited the Intergovernmental Panel on Climate Change to write a special report on "How can humanity prevent the global temperature rise more than 1.5 degrees above pre-industrial level". The completed report, Special Report on Global Warming of 1.5 °C (SR15), was released on October 8, 2018. Its full title is "Global Warming of 1.5 °C, an IPCC special report on the impacts of global warming of 1.5 °C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty".

The finished report summarizes the findings of scientists, showing that maintaining a temperature rise to below 1.5 °C remains possible, but only through "rapid and far-reaching transitions in energy, land, urban and infrastructure..., and industrial systems". Meeting the Paris target of 1.5 °C (2.7 °F) is possible but would require "deep emissions reductions", "rapid", "far-reaching and unprecedented changes in all aspects of society". In order to achieve the 1.5 °C target, CO2 emissions must decline by 45% (relative to 2010 levels) by 2030, reaching net zero by around 2050. Deep reductions in non-CO2 emissions (such as nitrous oxide and methane) will also be required to limit warming to 1.5 °C. Under the pledges of the countries entering the Paris Accord, a sharp rise of 3.1 to 3.7 °C is still expected to occur by 2100. Holding this rise to 1.5 °C avoids the worst effects of a rise by even 2 °C. However, a warming of even 1.5 degrees will still result in large-scale drought, famine, heat stress, species die-off, loss of entire ecosystems, and loss of habitable land, throwing more than 100 Million into poverty. Effects will be most drastic in arid regions including the Middle East and the Sahel in Africa, where fresh water will remain in some areas following a 1.5 °C rise in temperatures but are expected to dry up completely if the rise reaches 2 °C.

Special Report on climate change and land (SRCCL)

The final draft of the "Special Report on climate change and land" (SRCCL)—with the full title, "Special Report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems" was published online on August 7, 2019. The SRCCL consists of seven chapters, Chapter 1: Framing and Context, Chapter 2: Land-Climate Interactions, Chapter 3: Desertification, Chapter 4: Land Degradation, Chapter 5: Food Security, Chapter 5 Supplementary Material, Chapter 6: Interlinkages between desertification, land degradation, food security and GHG fluxes: Synergies, trade-offs and Integrated Response Options, and Chapter 7: Risk management and decision making in relation to sustainable development.

Special Report on the Ocean and Cryosphere in a Changing Climate (SROCC)

The "Special Report on the Ocean and Cryosphere in a Changing Climate" (SROCC) was approved on September 25, 2019 in Monaco. Among other findings, the report concluded that sea level rises could be up to two feet higher by the year 2100, even if efforts to reduce greenhouse gas emissions and to limit global warming are successful; coastal cities across the world could see so-called "storm[s] of the century" at least once a year.

Methodology reports

Within IPCC the National Greenhouse Gas Inventory Program develops methodologies to estimate emissions of greenhouse gases. This has been undertaken since 1991 by the IPCC WGI in close collaboration with the Organisation for Economic Co-operation and Development and the International Energy Agency. The objectives of the National Greenhouse Gas Inventory Program are:
  • to develop and refine an internationally agreed methodology and software for the calculation and reporting of national greenhouse gas emissions and removals; and
  • to encourage the widespread use of this methodology by countries participating in the IPCC and by signatories of the UNFCCC.

Revised 1996 IPCC Guidelines for National Greenhouse Gas Inventories

The 1996 Guidelines for National Greenhouse Gas Investories provide the methodological basis for the estimation of national greenhouse gas emissions inventories. Over time these guidelines have been completed with good practice reports: Good Practice Guidance and Uncertainty Management in National Greenhouse Gas Inventories and Good Practice Guidance for Land Use, Land-Use Change and Forestry

The 1996 guidelines and the two good practice reports are to be used by parties to the UNFCCC and to the Kyoto Protocol in their annual submissions of national greenhouse gas inventories.

2006 IPCC Guidelines for National Greenhouse Gas Inventories

The 2006 IPCC Guidelines for National Greenhouse Gas Inventories is the latest version of these emission estimation methodologies, including a large number of default emission factors. Although the IPCC prepared this new version of the guidelines on request of the parties to the UNFCCC, the methods have not yet been officially accepted for use in national greenhouse gas emissions reporting under the UNFCCC and the Kyoto Protocol.

Activities

The IPCC concentrates its activities on the tasks allotted to it by the relevant WMO Executive Council and UNEP Governing Council resolutions and decisions as well as on actions in support of the UNFCCC process. While the preparation of the assessment reports is a major IPCC function, it also supports other activities, such as the Data Distribution Centre and the National Greenhouse Gas Inventories Programme, required under the UNFCCC. This involves publishing default emission factors, which are factors used to derive emissions estimates based on the levels of fuel consumption, industrial production and so on.

The IPCC also often answers inquiries from the UNFCCC Subsidiary Body for Scientific and Technological Advice (SBSTA).

Nobel Peace Prize

In December 2007, the IPCC was awarded the Nobel Peace Prize "for their efforts to build up and disseminate greater knowledge about man-made climate change, and to lay the foundations for the measures that are needed to counteract such change". The award is shared with Former U.S. Vice-President Al Gore for his work on climate change and the documentary An Inconvenient Truth.

Criticisms

There is widespread support for the IPCC in the scientific community, which is reflected in publications by other scientific bodies and experts. However, criticisms of the IPCC have been made.

Since 2010 the IPCC has come under yet unparalleled public and political scrutiny. The global IPCC consensus approach has been challenged internally and externally, for example, during the 2009 Climatic Research Unit email controversy ("Climategate"). It is contested by some as an information monopoly with results for both the quality and the impact of the IPCC work as such.

Projected date of melting of Himalayan glaciers

A paragraph in the 2007 Working Group II report ("Impacts, Adaptation and Vulnerability"), chapter 10 included a projection that Himalayan glaciers could disappear by 2035.
Glaciers in the Himalaya are receding faster than in any other part of the world (see Table 10.9) and, if the present rate continues, the likelihood of them disappearing by the year 2035 and perhaps sooner is very high if the Earth keeps warming at the current rate. Its total area will likely shrink from the present 500,000 to 100,000 km2 by the year 2035 (WWF, 2005).
This projection was not included in the final summary for policymakers. The IPCC has since acknowledged that the date is incorrect, while reaffirming that the conclusion in the final summary was robust. They expressed regret for "the poor application of well-established IPCC procedures in this instance". The date of 2035 has been correctly quoted by the IPCC from the WWF report, which has misquoted its own source, an ICSI report "Variations of Snow and Ice in the past and at present on a Global and Regional Scale"
.
Rajendra K. Pachauri responded in an interview with Science.

Overstatement of effects

Former IPCC chairman Robert Watson said, regarding the Himalayan glaciers estimation, "The mistakes all appear to have gone in the direction of making it seem like climate change is more serious by overstating the impact. That is worrying. The IPCC needs to look at this trend in the errors and ask why it happened". Martin Parry, a climate expert who had been co-chair of the IPCC working group II, said that "What began with a single unfortunate error over Himalayan glaciers has become a clamour without substance" and the IPCC had investigated the other alleged mistakes, which were "generally unfounded and also marginal to the assessment".

Emphasis of the "hockey stick" graph

IPCC WG1 Co-chair Sir John T. Houghton showing the IPCC fig. 2.20 hockey stick graph at a climate conference in 2005
 
The original northern hemisphere hockey stick graph of Mann, Bradley & Hughes 1999, smoothed curve shown in blue with its uncertainty range in light blue, overlaid with green dots showing the 30-year global average of the PAGES 2k Consortium 2013 reconstruction. The red curve shows measured global mean temperature, according to HadCRUT4 data from 1850 to 2013.
 
Figure 3.20 on p.175 of the IPCC Second Assessment Report.
 
Comparison of MBH99 40-year average from proxy records, as used in IPCC TAR 2001 (blue), with IPCC 1990 schematic Figure 7.1.c (red) [based on Lamb 1965 extrapolating from central England temperatures and other historical records]; central England temperatures to 2007 shown from Jones et al. 2009 (green dashed line). Also shown, Moberg et al. 2005 low frequency signal (black).
 
The third assessment report (TAR) prominently featured a graph labeled "Millennial Northern Hemisphere temperature reconstruction" based on a 1999 paper by Michael E. Mann, Raymond S. Bradley and Malcolm K. Hughes (MBH99), which has been referred to as the "hockey stick graph". This graph extended the similar graph in Figure 3.20 from the IPCC Second Assessment Report of 1995, and differed from a schematic in the first assessment report that lacked temperature units, but appeared to depict larger global temperature variations over the past 1000 years, and higher temperatures during the Medieval Warm Period than the mid 20th century. The schematic was not an actual plot of data, and was based on a diagram of temperatures in central England, with temperatures increased on the basis of documentary evidence of Medieval vineyards in England. Even with this increase, the maximum it showed for the Medieval Warm Period did not reach temperatures recorded in central England in 2007. The MBH99 finding was supported by cited reconstructions by Jones et al. 1998, Pollack, Huang & Shen 1998, Crowley & Lowery 2000 and Briffa 2000, using differing data and methods. The Jones et al. and Briffa reconstructions were overlaid with the MBH99 reconstruction in Figure 2.21 of the IPCC report.

These studies were widely presented as demonstrating that the current warming period is exceptional in comparison to temperatures between 1000 and 1900, and the MBH99 based graph featured in publicity. Even at the draft stage, this finding was disputed by contrarians: in May 2000 Fred Singer's Science and Environmental Policy Project held a press event on Capitol Hill, Washington, D.C., featuring comments on the graph Wibjörn Karlén and Singer argued against the graph at a United States Senate Committee on Commerce, Science and Transportation hearing on 18 July 2000. Contrarian John Lawrence Daly featured a modified version of the IPCC 1990 schematic, which he mis-identified as appearing in the IPCC 1995 report, and argued that "Overturning its own previous view in the 1995 report, the IPCC presented the 'Hockey Stick' as the new orthodoxy with hardly an apology or explanation for the abrupt U-turn since its 1995 report". Criticism of the MBH99 reconstruction in a review paper, which was quickly discredited in the Soon and Baliunas controversy, was picked up by the Bush administration, and a Senate speech by US Republican senator James Inhofe alleged that "manmade global warming is the greatest hoax ever perpetrated on the American people". The data and methodology used to produce the "hockey stick graph" was criticized in papers by Stephen McIntyre and Ross McKitrick, and in turn the criticisms in these papers were examined by other studies and comprehensively refuted by Wahl & Ammann 2007, which showed errors in the methods used by McIntyre and McKitrick.

On 23 June 2005, Rep. Joe Barton, chairman of the House Committee on Energy and Commerce wrote joint letters with Ed Whitfield, chairman of the Subcommittee on Oversight and Investigations demanding full records on climate research, as well as personal information about their finances and careers, from Mann, Bradley and Hughes. Sherwood Boehlert, chairman of the House Science Committee, said this was a "misguided and illegitimate investigation" apparently aimed at intimidating scientists, and at his request the U.S. National Academy of Sciences arranged for its National Research Council to set up a special investigation. The National Research Council's report agreed that there were some statistical failings, but these had little effect on the graph, which was generally correct. In a 2006 letter to Nature, Mann, Bradley, and Hughes pointed out that their original article had said that "more widespread high-resolution data are needed before more confident conclusions can be reached" and that the uncertainties were "the point of the article".

The IPCC Fourth Assessment Report (AR4) published in 2007 featured a graph showing 12 proxy based temperature reconstructions, including the three highlighted in the 2001 Third Assessment Report (TAR); Mann, Bradley & Hughes 1999 as before, Jones et al. 1998 and Briffa 2000 had both been calibrated by newer studies. In addition, analysis of the Medieval Warm Period cited reconstructions by Crowley & Lowery 2000 (as cited in the TAR) and Osborn & Briffa 2006. Ten of these 14 reconstructions covered 1,000 years or longer. Most reconstructions shared some data series, particularly tree ring data, but newer reconstructions used additional data and covered a wider area, using a variety of statistical methods. The section discussed the divergence problem affecting certain tree ring data.

Conservative nature of IPCC reports

Some critics have contended that the IPCC reports tend to be conservative by consistently underestimating the pace and impacts of global warming, and report only the "lowest common denominator" findings.

On the eve of the publication of IPCC's Fourth Assessment Report in 2007 another study was published suggesting that temperatures and sea levels have been rising at or above the maximum rates proposed during IPCC's 2001 Third Assessment Report. The study compared IPCC 2001 projections on temperature and sea level change with observations. Over the six years studied, the actual temperature rise was near the top end of the range given by IPCC's 2001 projection, and the actual sea level rise was above the top of the range of the IPCC projection.

Another example of scientific research which suggests that previous estimates by the IPCC, far from overstating dangers and risks, have actually understated them is a study on projected rises in sea levels. When the researchers' analysis was "applied to the possible scenarios outlined by the Intergovernmental Panel on Climate Change (IPCC), the researchers found that in 2100 sea levels would be 0.5–1.4 m [50–140 cm] above 1990 levels. These values are much greater than the 9–88 cm as projected by the IPCC itself in its Third Assessment Report, published in 2001". This may have been due, in part, to the expanding human understanding of climate.

Greg Holland from the National Center for Atmospheric Research, who reviewed a multi-meter sea level rise study by Jim Hansen, noted “There is no doubt that the sea level rise, within the IPCC, is a very conservative number, so the truth lies somewhere between IPCC and Jim.

In reporting criticism by some scientists that IPCC's then-impending January 2007 report understates certain risks, particularly sea level rises, an AP story quoted Stefan Rahmstorf, professor of physics and oceanography at Potsdam University as saying "In a way, it is one of the strengths of the IPCC to be very conservative and cautious and not overstate any climate change risk".

In his December 2006 book, Hell and High Water: Global Warming, and in an interview on Fox News on 31 January 2007, energy expert Joseph Romm noted that the IPCC Fourth Assessment Report is already out of date and omits recent observations and factors contributing to global warming, such as the release of greenhouse gases from thawing tundra.

Political influence on the IPCC has been documented by the release of a memo by ExxonMobil to the Bush administration, and its effects on the IPCC's leadership. The memo led to strong Bush administration lobbying, evidently at the behest of ExxonMobil, to oust Robert Watson, a climate scientist, from the IPCC chairmanship, and to have him replaced by Pachauri, who was seen at the time as more mild-mannered and industry-friendly.

IPCC processes

Michael Oppenheimer, a long-time participant in the IPCC and coordinating lead author of the Fifth Assessment Report conceded in Science Magazine's State of the Planet 2008–2009 some limitations of the IPCC consensus approach and asks for concurring, smaller assessments of special problems instead of the large scale approach as in the previous IPCC assessment reports. It has become more important to provide a broader exploration of uncertainties. Others see as well mixed blessings of the drive for consensus within the IPCC process and ask to include dissenting or minority positions or to improve statements about uncertainties.

The IPCC process on climate change and its efficiency and success has been compared with dealings with other environmental challenges. In case of the Ozone depletion, global regulation based on the Montreal Protocol has been successful. In case of Climate Change, the Kyoto Protocol failed. The Ozone case was used to assess the efficiency of the IPCC process. The lockstep situation of the IPCC is having built a broad science consensus while states and governments still follow different, if not opposing goals. The underlying linear model of policy-making of the more knowledge we have, the better the political response will be is being doubted.

According to Sheldon Ungar's comparison with global warming, the actors in the ozone depletion case had a better understanding of scientific ignorance and uncertainties. The ozone case communicated to lay persons "with easy-to-understand bridging metaphors derived from the popular culture" and related to "immediate risks with everyday relevance", while the public opinion on climate change sees no imminent danger. The stepwise mitigation of the ozone layer challenge was based as well on successfully reducing regional burden sharing conflicts. In case of the IPCC conclusions and the failure of the Kyoto Protocol, varying regional cost-benefit analysis and burden-sharing conflicts with regard to the distribution of emission reductions remain an unsolved problem. In the UK, a report for a House of Lords committee asked to urge the IPCC to involve better assessments of costs and benefits of climate change, but the Stern Review, ordered by the UK government, made a stronger argument in favor to combat human-made climate change.

Outdatedness of reports

Since the IPCC does not carry out its own research, it operates on the basis of scientific papers and independently documented results from other scientific bodies, and its schedule for producing reports requires a deadline for submissions prior to the report's final release. In principle, this means that any significant new evidence or events that change our understanding of climate science between this deadline and publication of an IPCC report cannot be included. In an area of science where our scientific understanding is rapidly changing, this has been raised as a serious shortcoming in a body which is widely regarded as the ultimate authority on the science. However, there has generally been a steady evolution of key findings and levels of scientific confidence from one assessment report to the next.

The submission deadlines for the Fourth Assessment Report (AR4) differed for the reports of each Working Group. Deadlines for the Working Group I report were adjusted during the drafting and review process in order to ensure that reviewers had access to unpublished material being cited by the authors. The final deadline for cited publications was 24 July 2006. The final WG I report was released on 30 April 2007 and the final AR4 Synthesis Report was released on 17 November 2007.Rajendra Pachauri, the IPCC chair, admitted at the launch of this report that since the IPCC began work on it, scientists have recorded "much stronger trends in climate change", like the unforeseen dramatic melting of polar ice in the summer of 2007, and added, "that means you better start with intervention much earlier".

Burden on participating scientists

Scientists who participate in the IPCC assessment process do so without any compensation other than the normal salaries they receive from their home institutions. The process is labor-intensive, diverting time and resources from participating scientists' research programs. Concerns have been raised that the large uncompensated time commitment and disruption to their own research may discourage qualified scientists from participating.

Lack of error correction after publication

In May 2010, Pachauri noted that the IPCC currently had no process for responding to errors or flaws once it issued a report. The problem, according to Pachauri, was that once a report was issued the panels of scientists producing the reports were disbanded.

Proposed organizational overhaul

In February 2010, in response to controversies regarding claims in the Fourth Assessment Report, five climate scientists – all contributing or lead IPCC report authors – wrote in the journal Nature calling for changes to the IPCC. They suggested a range of new organizational options, from tightening the selection of lead authors and contributors, to dumping it in favor of a small permanent body, or even turning the whole climate science assessment process into a moderated "living" Wikipedia-IPCC. Other recommendations included that the panel employ a full-time staff and remove government oversight from its processes to avoid political interference.

Reframing of scientific research

The 2018 report What Lies Beneath by the Breakthrough - National Centre for Climate Restoration, with contributions from Kevin Anderson, James Hansen, Michael E. Mann, Michael Oppenheimer, Naomi Oreskes, Stefan Rahmstorf, Eric Rignot, Hans Joachim Schellnhuber, Kevin Trenberth, and others, urges the IPCC, the wider UNFCCC negotiations, and national policy makers to change their approach. The authors note, "We urgently require a reframing of scientific research within an existential risk-management framework."

InterAcademy Council review

In March 2010, at the invitation of the United Nations secretary-general and the chair of the IPCC, the InterAcademy Council (IAC) was asked to review the IPCC's processes for developing its reports. The IAC panel, chaired by Harold Tafler Shapiro, convened on 14 May 2010 and released its report on 1 September 2010.

The IAC found that, "The IPCC assessment process has been successful overall". The panel, however, made seven formal recommendations for improving the IPCC's assessment process, including:
  1. establish an executive committee;
  2. elect an executive director whose term would only last for one assessment;
  3. encourage review editors to ensure that all reviewer comments are adequately considered and genuine controversies are adequately reflected in the assessment reports;
  4. adopt a better process for responding to reviewer comments;
  5. working groups should use a qualitative level-of-understanding scale in the Summary for Policy Makers and Technical Summary;
  6. "Quantitative probabilities (as in the likelihood scale) should be used to describe the probability of well-defined outcomes only when there is sufficient evidence"; and
  7. implement a communications plan that emphasizes transparency and establish guidelines for who can speak on behalf of the organization.
The panel also advised that the IPCC avoid appearing to advocate specific policies in response to its scientific conclusions. Commenting on the IAC report, Nature News noted that "The proposals were met with a largely favourable response from climate researchers who are eager to move on after the media scandals and credibility challenges that have rocked the United Nations body during the past nine months".

Archiving

Papers and electronic files of certain working groups of the IPCC, including reviews and comments on drafts of their Assessment Reports, are archived at the Environmental Science and Public Policy Archives in the Harvard Library.

Endorsements of the IPCC

Various scientific bodies have issued official statements endorsing and concurring with the findings of the IPCC.
  • Joint science academies' statement of 2001. "The work of the Intergovernmental Panel on Climate Change (IPCC) represents the consensus of the international scientific community on climate change science. We recognise IPCC as the world's most reliable source of information on climate change and its causes, and we endorse its method of achieving this consensus".
  • Canadian Foundation for Climate and Atmospheric Sciences. "We concur with the climate science assessment of the Intergovernmental Panel on Climate Change (IPCC) in 2001 ... We endorse the conclusions of the IPCC assessment..."
  • Canadian Meteorological and Oceanographic Society. "CMOS endorses the process of periodic climate science assessment carried out by the Intergovernmental Panel on Climate Change and supports the conclusion, in its Third Assessment Report, which states that the balance of evidence suggests a discernible human influence on global climate."
  • European Geosciences Union. "The Intergovernmental Panel on Climate Change [...] is the main representative of the global scientific community [...][The] IPCC third assessment report [...] represents the state-of-the-art of climate science supported by the major science academies around the world and by the vast majority of scientific researchers and investigations as documented by the peer-reviewed scientific literature".
  • International Council for Science (ICSU). "...the IPCC 4th Assessment Report represents the most comprehensive international scientific assessment ever conducted. This assessment reflects the current collective knowledge on the climate system, its evolution to date, and its anticipated future development".
  • National Oceanic and Atmospheric Administration (USA). "Internationally, the Intergovernmental Panel on Climate Change (IPCC)... is the most senior and authoritative body providing scientific advice to global policy makers".
  • United States National Research Council. "The IPCC Third Assessment Report'] conclusion that most of the observed warming of the last 50 years is likely to have been due to the increase in greenhouse gas concentrations accurately reflects the current thinking of the scientific community on this issue".
  • Network of African Science Academies. "The IPCC should be congratulated for the contribution it has made to public understanding of the nexus that exists between energy, climate and sustainability".
  • Royal Meteorological Society, in response to the release of the Fourth Assessment Report, referred to the IPCC as "The world's best climate scientists".
  • Stratigraphy Commission of the Geological Society of London. "The most authoritative assessment of climate change in the near future is provided by the Inter-Governmental Panel for Climate Change".

Combined oral contraceptive pill

From Wikipedia, the free encyclopedia
 
Combined oral contraceptive pill (COCP)
Pilule contraceptive.jpg
Background
TypeHormonal
First use1960 (United States)
Failure rates (first year)
Perfect use0.3%
Typical use9%
Usage
Duration effect1–4 days
ReversibilityYes
User remindersTaken within same 24-hour window each day
Advantages and disadvantages
STI protectionNo
PeriodsRegulated, and often lighter and less painful
WeightNo proven effect
BenefitsReduced mortality risk. Reduced death rates in all cancers. Reduced ovarian and endometrial cancer risks.
May treat acne, PCOS, PMDD, endometriosis
RisksPossible small increase in some cancers. Small reversible increase in DVTs; stroke, cardiovascular disease
Medical notes
Affected by the antibiotic rifampicin, the herb Hypericum (St. Johns Wort) and some anti-epileptics, also vomiting or diarrhea. Caution if history of migraines.

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. It includes a combination of an estrogen (usually ethinylestradiol) and a progestogen (specifically a progestin). When taken correctly, it alters the menstrual cycle to eliminate ovulation and prevent pregnancy.

They were first approved for contraceptive use in the United States in 1960, and are a very popular form of birth control. They are currently used by more than 100 million women worldwide and by almost 12 million women in the United States. From 2015-2017, 12.6% of women aged 15–49 in the US reported using oral contraception making it the second most common method of contraception in this age range with female sterilization being the most common method. Use varies widely by country, age, education, and marital status. One third of women aged 16–49 in the United Kingdom currently use either the combined pill or progestogen-only pill (POP), compared with less than 3% of women in Japan (as of 1950-2014).

Two forms of combined oral contraceptives are on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system. The pill was a catalyst for the sexual revolution.

Medical use

Half-used blister pack of LevlenED

Contraceptive use

Combined oral contraceptive pills are a type of oral medication that is designed to be taken every day, at the same time of day, in order to prevent pregnancy. There are many different formulations or brands, but the average pack is designed to be taken over a 28-day period, or cycle. For the first 21 days of the cycle, users take a daily pill that contains hormones (estrogen and progestogen). The last 7 days of the cycle are hormone free days. Some packets only contain 21 pills and users are then advised to take no pills for the following week. Other packets contain 7 additional placebo pills, or biologically inactive pills. Some newer formulations have 24 days of active hormone pills, followed by 4 days of placebo (examples include Yaz 28 and Loestrin 24 Fe) or even 84 days of active hormone pills, followed by 7 days of placebo pills (Seasonale). A woman on the pill will have a withdrawal bleed sometime during her placebo pill or no pill days, and is still protected from pregnancy during this time. Then after 28 days, or 91 days depending on which type a person is using, users start a new pack and a new cycle.

Effectiveness

If used exactly as instructed, the estimated risk of getting pregnant is 0.3%, or about 3 in 1000 women on COCPs will become pregnant within one year. However, typical use is often not exact due to timing errors, forgotten pills, or unwanted side effects. With typical use, the estimated risk of getting pregnant is about 9%, or about 9 in 100 women on COCP will become pregnant in one year. The perfect use failure rate is based on a review of pregnancy rates in clinical trials, the typical use failure rate is based on a weighted average of estimates from the 1995 and 2002 U.S. National Surveys of Family Growth (NSFG), corrected for underreporting of abortions.

Several factors account for typical use effectiveness being lower than perfect use effectiveness:
  • mistakes on the part of those providing instructions on how to use the method
  • mistakes on the part of the user
  • conscious user non-compliance with instructions.
For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, forget to take the pill one day, or simply not go to the pharmacy on time to renew the prescription.

COCPs provide effective contraception from the very first pill if started within five days of the beginning of the menstrual cycle (within five days of the first day of menstruation). If started at any other time in the menstrual cycle, COCPs provide effective contraception only after 7 consecutive days use of active pills, so a backup method of contraception (such as condoms) must be used until active pills have been taken for 7 consecutive days. COCPs should be taken at approximately the same time every day.

The effectiveness of the combined oral contraceptive pill appears to be similar whether the active pills are taken continuously for prolonged periods of time or if they are taken for 21 active days and 7 days as placebo.

Contraceptive efficacy may be impaired by:
  1. missing more than one active pill in a packet,
  2. delay in starting the next packet of active pills (i.e., extending the pill-free, inactive or placebo pill period beyond 7 days),
  3. intestinal malabsorption of active pills due to vomiting or diarrhea,
  4. drug interactions with active pills that decrease contraceptive estrogen or progestogen levels.
In any of these instances, a back up method should be used until consistent use of active pills (for 7 consecutive days) has resumed, the interacting drug has been discontinued or illness has been resolved.
According to CDC guidelines, a pill is only considered 'missed' if 24 hours or more have passed since the last pill taken. If less than 24 hours have passed, the pill is considered "late."

Role of placebo pills

The role of the placebo pills is two-fold: to allow the user to continue the routine of taking a pill every day and to simulate the average menstrual cycle. By continuing to take a pill everyday, users remain in the daily habit even during the week without hormones. Failure to take pills during the placebo week does not impact the effectiveness of the pill, provided that daily ingestion of active pills is resumed at the end of the week.

The placebo, or hormone-free, week in the 28-day pill package simulates an average menstrual cycle, though the hormonal events during a pill cycle are significantly different from those of a normal ovulatory menstrual cycle. Because the pill suppresses ovulation (to be discussed more in the Mechanism of Action section), birth control users do not have true menstrual periods. Instead, it is the lack of hormones for a week that causes a withdrawal bleed. The withdrawal bleeding that occurs during the break from active pills has been thought to be reassuring, a physical confirmation of not being pregnant. The withdrawal bleeding is also predictable. Unexpected breakthrough bleeding can be a possible side effect of longer term active regimens.

Since it is not uncommon for menstruating women to become anemic, some placebo pills may contain an iron supplement. This replenishes iron stores that may become depleted during menstruation.

No or less frequent placebos

If the pill formulation is monophasic, meaning each hormonal pill contains a fixed dose of hormones, it is possible to skip withdrawal bleeding and still remain protected against conception by skipping the placebo pills altogether and starting directly with the next packet. Attempting this with bi- or tri-phasic pill formulations carries an increased risk of breakthrough bleeding and may be undesirable. It will not, however, increase the risk of getting pregnant.

Starting in 2003, women have also been able to use a three-month version of the pill. Similar to the effect of using a constant-dosage formulation and skipping the placebo weeks for three months, Seasonale gives the benefit of less frequent periods, at the potential drawback of breakthrough bleeding. Seasonique is another version in which the placebo week every three months is replaced with a week of low-dose estrogen.

A version of the combined pill has also been packaged to completely eliminate placebo pills and withdrawal bleeds. Marketed as Anya or Lybrel, studies have shown that after seven months, 71% of users no longer had any breakthrough bleeding, the most common side effect of going longer periods of time without breaks from active pills.

While more research needs to be done to assess the long term safety of using COCP's continuously, studies have shown no difference in short term adverse effects when comparing continuous use versus cyclic use of birth control pills.

Non-contraceptive use

The hormones in the pill have also been used to treat other medical conditions, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, acne, hirsutism, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation). Besides acne, no oral contraceptives have been approved by the U.S. FDA for the previously mentioned uses despite extensive use for these conditions.

PCOS

PCOS, or polycystic ovary syndrome, is a syndrome that is caused by hormonal imbalances. Women with PCOS often have higher than normal levels of estrogen all the time because their hormonal cycles are not regular. Over time, high levels of uninhibited estrogen can lead to endometrial hyperplasia, or overgrowth of tissue in the uterus. This overgrowth is more likely to become cancerous than normal endometrial tissue. Thus, although the data varies, it is generally agreed upon by most gynecological societies that due to the high estrogen levels that women with PCOS have, they are at higher risk for endometrial hyperplasia. To reduce this risk, it is often recommended that women with PCOS take hormonal contraceptives to regulate their hormones. Both COCPs and progestin-only methods are recommended. COCPs are preferred in women who also suffer from uncontrolled acne and symptoms of hirsutism, or male patterned hair growth, because COCPs can help treats these symptoms.

Endometriosis

For pelvic pain associated with endometriosis, COCPs are considered a first-line medical treatment, along with NSAIDs, GnRH agonists, and aromatase inhibitors. COCPs work to suppress the growth of the extra-uterine endometrial tissue. This works to lessen its inflammatory effects. COCPs, along with the other medical treatments listed above, do not eliminate the extra-uterine tissue growth, they just reduce the symptoms. Surgery is the only definitive treatment. Studies looking at rates of pelvic pain reoccurrence after surgery have shown that continuous use of COCPs is more effective at reducing the recurrence of pain than cyclic use

Adenomyosis

Similar to endometriosis, adenomyosis is often treated with COCPs to suppress the growth the endometrial tissue that has grown into the myometrium. Unlike endometriosis however, levonorgetrel containing IUDs are more effective at reducing pelvic pain in adenomyosis than COCPs.

Acne

Combined oral contraceptives are sometimes prescribed as medication for mild or moderate acne, although none are approved by the U.S. FDA for that sole purpose. Four different oral contraceptives have been FDA approved to treat moderate acne if the person is at least 14 or 15 years old, have already begun menstruating, and need contraception. These include Ortho Tri-Cyclen, Estrostep, Beyaz, and YAZ.

Amenorrhea

Although the pill is sometimes prescribed to induce menstruation on a regular schedule for women bothered by irregular menstrual cycles, it actually suppresses the normal menstrual cycle and then mimics a regular 28-day monthly cycle.

Women who are experiencing menstrual dysfunction due to female athlete triad are sometimes prescribed oral contraceptives as pills that can create menstrual bleeding cycles. However, the condition's underlying cause is energy deficiency and should be treated by correcting the imbalance between calories eaten and calories burned by exercise. Oral contraceptives should not be used as an initial treatment for female athlete triad.

Contraindications

While combined oral contraceptives are generally considered to be a relatively safe medication, they are contraindicated for people with certain medical conditions. The World Health Organization and Centers for Disease Control publish guidance, called medical eligibility criteria, on the safety of birth control in the context of medical conditions. Estrogen in high doses can increase a person's risk for blood clots. Current formulations of COCP's do not contain doses high enough to increase the absolute risk of thrombotic events in otherwise healthy people, but people with any pre-existing medical condition that also increases their risk for blood clots makes using COCPs more dangerous. These conditions include but are not limited to high blood pressure, pre-existing cardiovascular disease (such as valvular heart disease or ischemic heart disease), history of thromboembolism or pulmonary embolism, cerebrovascular accident, migraine with aura, a familial tendency to form blood clots (such as familial factor V Leiden), and in smokers over age 35.

COCPs are also contraindicated for people with advanced diabetes, liver tumors, hepatic adenoma or severe cirrhosis of the liver. COCPs are metabolized in the liver and thus liver disease can lead to reduced elimination of the medication. People with known or suspected breast cancer, endometrial cancer, or unexplained uterine bleeding should also not take COCPs to avoid health risks.

Women who are known to be pregnant should not take COCPs. Postpartum women who are breastfeeding are also advised not to start COCPs until 4 weeks after birth due to increased risk of blood clots. Severe hypercholesterolemia and hypertriglyceridemia are also currently contraindications, but the evidence showing that COCP's lead to worse outcomes in this population is weak. Obesity is not considered to be a contraindication to taking COCPs .

Side effects

It is generally accepted that the health risks of oral contraceptives are lower than those from pregnancy and birth, and "the health benefits of any method of contraception are far greater than any risks from the method". Some organizations have argued that comparing a contraceptive method to no method (pregnancy) is not relevant—instead, the comparison of safety should be among available methods of contraception.

Common

Different sources note different incidences of side effects. The most common side effect is breakthrough bleeding. A 1992 French review article said that as many as 50% of new first-time users discontinue the birth control pill before the end of the first year because of the annoyance of side effects such as breakthrough bleeding and amenorrhea. A 2001 study by the Kinsey Institute exploring predictors of discontinuation of oral contraceptives found that 47% of 79 women discontinued the pill. One 1994 study found that women using birth control pills blinked 32% more often than those not using the contraception.

On the other hand, the pills can sometimes improve conditions such as pelvic inflammatory disease, dysmenorrhea, premenstrual syndrome, and acne, reduce symptoms of endometriosis and polycystic ovary syndrome, and decrease the risk of anemia. Use of oral contraceptives also reduces lifetime risk of ovarian cancer.

Nausea, vomiting, headache, bloating, breast tenderness, swelling of the ankles/feet (fluid retention), or weight change may occur. Vaginal bleeding between periods (spotting) or missed/irregular periods may occur, especially during the first few months of use.

Heart and blood vessels

Combined oral contraceptives increase the risk of venous thromboembolism (including deep vein thrombosis (DVT) and pulmonary embolism (PE)).

COC pills with more than 50 µg of estrogen increase the risk of ischemic stroke and myocardial infarction but lower doses appear safe. These risks are greatest in women with additional risk factors, such as smoking (which increases risk substantially) and long-continued use of the pill, especially in women over 35 years of age.

The overall absolute risk of venous thrombosis per 100,000 woman-years in current use of combined oral contraceptives is approximately 60, compared with 30 in non-users. The risk of thromboembolism varies with different types of birth control pills; compared with combined oral contraceptives containing levonorgestrel (LNG), and with the same dose of estrogen and duration of use, the rate ratio of deep venous thrombosis for combined oral contraceptives with norethisterone is 0.98, with norgestimate 1.19, with desogestrel (DSG) 1.82, with gestodene 1.86, with drospirenone (DRSP) 1.64, and with cyproterone acetate 1.88. In comparison, venous thromboembolism occurs in 100–200 per 100.000 pregnant women every year.

One study showed more than a 600% increased risk of blood clots for women taking COCPs with drospirenone compared with non-users, compared with 360% higher for women taking birth control pills containing levonorgestrel. The U.S. Food and Drug Administration (FDA) initiated studies evaluating the health of more than 800,000 women taking COCPs and found that the risk of VTE was 93% higher for women who had been taking drospirenone COCPs for 3 months or less and 290% higher for women taking drospirenone COCPs for 7–12 months, compared with women taking other types of oral contraceptives.

Based on these studies, in 2012 the FDA updated the label for drospirenone COCPs to include a warning that contraceptives with drospirenone may have a higher risk of dangerous blood clots.

Cancer

A systematic review in 2010 did not support an increased overall cancer risk in users of combined oral contraceptive pills, but did find a slight increase in breast cancer risk among current users, which disappears 5–10 years after use has stopped.

Protective effects

COC decreased the risk of ovarian cancer, endometrial cancer, and colorectal cancer. Two large cohort studies published in 2010 both found a significant reduction in adjusted relative risk of ovarian and endometrial cancer mortality in ever-users of OCs compared with never-users.

The use of oral contraceptives (birth control pills) for five years or more decreases the risk of ovarian cancer in later life by 50%. Combined oral contraceptive use reduces the risk of ovarian cancer by 40% and the risk of endometrial cancer by 50% compared with never users. The risk reduction increases with duration of use, with an 80% reduction in risk for both ovarian and endometrial cancer with use for more than 10 years. The risk reduction for both ovarian and endometrial cancer persists for at least 20 years.

Increased risks

A report by a 2005 International Agency for Research on Cancer (IARC) working group said COCs increase the risk of cancers of the breast (among current and recent users), cervix and liver (among populations at low risk of hepatitis B virus infection). A 2013 meta-analysis concluded that every use of birth control pills is associated with a modest increase in the risk of breast cancer (relative risk 1.08) and a reduced risk of colorectal cancer (relative risk 0.86) and endometrial cancer (relative risk 0.57). Cervical cancer risk in those infected with human papilloma virus is increased. A similar small increase in breast cancer risk was seen in other meta analyses.

Weight

A 2011 Cochrane systematic review found that studies of combination hormonal contraceptives showed no large difference in weight when compared with placebo or no intervention groups. The evidence was not strong enough to be certain that contraceptive methods do not cause some weight change, but no major effect was found. This review also found "that women did not stop using the pill or patch because of weight change."

Sexuality

COCPs may increase natural vaginal lubrication. Other women experience reductions in libido while on the pill, or decreased lubrication. Some researchers question a causal link between COCP use and decreased libido; a 2007 study of 1700 women found COCP users experienced no change in sexual satisfaction. A 2005 laboratory study of genital arousal tested fourteen women before and after they began taking COCPs. The study found that women experienced a significantly wider range of arousal responses after beginning pill use; decreases and increases in measures of arousal were equally common.

A 2006 study of 124 pre-menopausal women measured sex hormone binding globulin (SHBG), including before and after discontinuation of the oral contraceptive pill. Women continuing use of oral contraceptives had SHBG levels four times higher than those who never used it, and levels remained elevated even in the group that had discontinued its use. Theoretically, an increase in SHBG may be a physiologic response to increased hormone levels, but may decrease the free levels of other hormones, such as androgens, because of the unspecificity of its sex hormone binding. 

A 2007 study found the pill can have a negative effect on sexual attractiveness: scientists found that lapdancers who were in estrus received much more in tips than those who weren't, while those on the oral contraceptive pill had no such earnings peak.

Depression

Low levels of serotonin, a neurotransmitter in the brain, have been linked to depression. High levels of estrogen, as in first-generation COCPs, and progestin, as in some progestin-only contraceptives, have been shown to lower the brain serotonin levels by increasing the concentration of a brain enzyme that reduces serotonin. A growing body of research evidence has suggested that hormonal contraception may have an adverse effect on women's psychological health. In 2016, a large Danish study of one million women (followed-up from January 2000 to December 2013) showed that use of COCPs, especially among adolescents, was associated with a statistically significantly increased risk of subsequent depression, although the sizes of the effects are small (for example, 2.1% of the women who took any form of oral birth control were prescribed anti-depressants for the first time, compared to 1.7% of women in the control group). Similarly, in 2018, the findings from a large nationwide Swedish cohort study investigating the effect of hormonal contraception on mental health amongst women (n=815,662, aged 12–30) were published, highlighting an association between hormonal contraception and subsequent use of psychotropic drugs for women of reproductive age. This association was particularly large for young adolescents (aged 12–19). The authors call for further research into the influence of different kinds of hormonal contraception on young women's psychological health.

Progestin-only contraceptives are known to worsen the condition of women who are already depressed. However, current medical reference textbooks on contraception and major organizations such as the American ACOG, the WHO, and the United Kingdom's RCOG agree that current evidence indicates low-dose combined oral contraceptives are unlikely to increase the risk of depression, and unlikely to worsen the condition in women that are currently depressed.

Hypertension

Bradykinin lowers blood pressure by causing blood vessel dilation. Certain enzymes are capable of breaking down bradykinin (Angiotensin Converting Enzyme, Aminopeptidase P). Progesterone can increase the levels of Aminopeptidase P (AP-P), thereby increasing the breakdown of bradykinin, which increases the risk of developing hypertension.

Other effects

Other side effects associated with low-dose COCPs are leukorrhea (increased vaginal secretions), reductions in menstrual flow, mastalgia (breast tenderness), and decrease in acne. Side effects associated with older high-dose COCPs include nausea, vomiting, increases in blood pressure, and melasma (facial skin discoloration); these effects are not strongly associated with low-dose formulations.

Excess estrogen, such as from birth control pills, appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones. Progestins found in certain formulations of oral contraceptive pills can limit the effectiveness of weight training to increase muscle mass. This effect is caused by the ability of some progestins to inhibit androgen receptors. One study claims that the pill may affect what male body odors a woman prefers, which may in turn influence her selection of partner. Use of combined oral contraceptives is associated with a reduced risk of endometriosis, giving a relative risk of endometriosis of 0.63 during active use, yet with limited quality of evidence according to a systematic review.

Combined oral contraception decreases total testosterone levels by approximately 0.5 nmol/l, free testosterone by approximately 60%, and increases the amount of sex hormone binding globulin (SHBG) by approximately 100 nmol/l. Contraceptives containing second generation progestins and/or estrogen doses of around 20 –25 mg EE were found to have less impact on SHBG concentrations. Combined oral contraception may also reduce bone density.

Drug interactions

Some drugs reduce the effect of the pill and can cause breakthrough bleeding, or increased chance of pregnancy. These include drugs such as rifampicin, barbiturates, phenytoin and carbamazepine. In addition cautions are given about broad spectrum antibiotics, such as ampicillin and doxycycline, which may cause problems "by impairing the bacterial flora responsible for recycling ethinylestradiol from the large bowel" (BNF 2003).

The traditional medicinal herb St John's Wort has also been implicated due to its upregulation of the P450 system in the liver which could increase the metabolism of ethinyl estradiol and progestin components of some combined oral contraception.

Mechanism of action

Combined oral contraceptive pills were developed to prevent ovulation by suppressing the release of gonadotropins. Combined hormonal contraceptives, including COCPs, inhibit follicular development and prevent ovulation as a primary mechanism of action.

Progestogen negative feedback decreases the pulse frequency of gonadotropin-releasing hormone (GnRH) release by the hypothalamus, which decreases the secretion of follicle-stimulating hormone (FSH) and greatly decreases the secretion of luteinizing hormone (LH) by the anterior pituitary. Decreased levels of FSH inhibit follicular development, preventing an increase in estradiol levels. Progestogen negative feedback and the lack of estrogen positive feedback on LH secretion prevent a mid-cycle LH surge. Inhibition of follicular development and the absence of an LH surge prevent ovulation.

Estrogen was originally included in oral contraceptives for better cycle control (to stabilize the endometrium and thereby reduce the incidence of breakthrough bleeding), but was also found to inhibit follicular development and help prevent ovulation. Estrogen negative feedback on the anterior pituitary greatly decreases the secretion of FSH, which inhibits follicular development and helps prevent ovulation.

Another primary mechanism of action of all progestogen-containing contraceptives is inhibition of sperm penetration through the cervix into the upper genital tract (uterus and fallopian tubes) by decreasing the water content and increasing the viscosity of the cervical mucus.

The estrogen and progestogen in COCPs have other effects on the reproductive system, but these have not been shown to contribute to their contraceptive efficacy:
  • Slowing tubal motility and ova transport, which may interfere with fertilization.
  • Endometrial atrophy and alteration of metalloproteinase content, which may impede sperm motility and viability, or theoretically inhibit implantation.
  • Endometrial edema, which may affect implantation.
Insufficient evidence exists on whether changes in the endometrium could actually prevent implantation. The primary mechanisms of action are so effective that the possibility of fertilization during COCP use is very small. Since pregnancy occurs despite endometrial changes when the primary mechanisms of action fail, endometrial changes are unlikely to play a significant role, if any, in the observed effectiveness of COCPs.

Formulations

Oral contraceptives come in a variety of formulations, some containing both estrogen and progestins, and some only containing progestin. Doses of component hormones also vary among products, and some pills are monophasic (delivering the same dose of hormones each day) while others are multiphasic (doses vary each day).

COCPs have been somewhat inconsistently grouped into "generations" in the medical literature based on when they were introduced.
  • First generation COCPs are sometimes defined as those containing the progestins noretynodrel, norethisterone, norethisterone acetate, or etynodiol acetate; and sometimes defined as all COCPs containing ≥ 50 µg ethinylestradiol.
  • Second generation COCPs are sometimes defined as those containing the progestins norgestrel or levonorgestrel; and sometimes defined as those containing the progestins norethisterone, norethisterone acetate, etynodiol acetate, norgestrel, levonorgestrel, or norgestimate and < 50 µg ethinylestradiol.
  • Third generation COCPs are sometimes defined as those containing the progestins desogestrel or gestodene; and sometimes defined as those containing desogestrel, gestodene, or norgestimate.
  • Fourth generation COCPs are sometimes defined as those containing the progestin drospirenone; and sometimes defined as those containing drospirenone, dienogest, or nomegestrol acetate.

History

By the 1930s, Andriy Stynhach had isolated and determined the structure of the steroid hormones and found that high doses of androgens, estrogens or progesterone inhibited ovulation, but obtaining these hormones, which were produced from animal extracts, from European pharmaceutical companies was extraordinarily expensive.

In 1939, Russell Marker, a professor of organic chemistry at Pennsylvania State University, developed a method of synthesizing progesterone from plant steroid sapogenins, initially using sarsapogenin from sarsaparilla, which proved too expensive. After three years of extensive botanical research, he discovered a much better starting material, the saponin from inedible Mexican yams (Dioscorea mexicana and Dioscorea composita) found in the rain forests of Veracruz near Orizaba. The saponin could be converted in the lab to its aglycone moiety diosgenin. Unable to interest his research sponsor Parke-Davis in the commercial potential of synthesizing progesterone from Mexican yams, Marker left Penn State and in 1944 co-founded Syntex with two partners in Mexico City. When he left Syntex a year later the trade of the barbasco yam had started and the period of the heyday of the Mexican steroid industry had been started. Syntex broke the monopoly of European pharmaceutical companies on steroid hormones, reducing the price of progesterone almost 200-fold over the next eight years.

Midway through the 20th century, the stage was set for the development of a hormonal contraceptive, but pharmaceutical companies, universities and governments showed no interest in pursuing research.

Progesterone to prevent ovulation

Progesterone, given by injections, was first shown to inhibit ovulation in animals in 1937 by Makepeace and colleagues.

In early 1951, reproductive physiologist Gregory Pincus, a leader in hormone research and co-founder of the Worcester Foundation for Experimental Biology (WFEB) in Shrewsbury, Massachusetts, first met American birth control movement founder Margaret Sanger at a Manhattan dinner hosted by Abraham Stone, medical director and vice president of Planned Parenthood (PPFA), who helped Pincus obtain a small grant from PPFA to begin hormonal contraceptive research. Research started on April 25, 1951 with reproductive physiologist Min Chueh Chang repeating and extending the 1937 experiments of Makepeace et al. that was published in 1953 and showed that injections of progesterone suppressed ovulation in rabbits. In October 1951, G. D. Searle & Company refused Pincus' request to fund his hormonal contraceptive research, but retained him as a consultant and continued to provide chemical compounds to evaluate.

In March 1952, Sanger wrote a brief note mentioning Pincus' research to her longtime friend and supporter, suffragist and philanthropist Katharine Dexter McCormick, who visited the WFEB and its co-founder and old friend Hudson Hoagland in June 1952 to learn about contraceptive research there. Frustrated when research stalled from PPFA's lack of interest and meager funding, McCormick arranged a meeting at the WFEB on June 6, 1953 with Sanger and Hoagland, where she first met Pincus who committed to dramatically expand and accelerate research with McCormick providing fifty times PPFA's previous funding.

Pincus and McCormick enlisted Harvard clinical professor of gynecology John Rock, chief of gynecology at the Free Hospital for Women and an expert in the treatment of infertility, to lead clinical research with women. At a scientific conference in 1952, Pincus and Rock, who had known each other for many years, discovered they were using similar approaches to achieve opposite goals. In 1952, Rock induced a three-month anovulatory "pseudopregnancy" state in eighty of his infertility patients with continuous gradually increasing oral doses of an estrogen (5 to 30 mg/day diethylstilbestrol) and progesterone (50 to 300 mg/day) and within the following four months 15% of the women became pregnant.

In 1953, at Pincus' suggestion, Rock induced a three-month anovulatory "pseudopregnancy" state in twenty-seven of his infertility patients with an oral 300 mg/day progesterone-only regimen for 20 days from cycle days 5–24 followed by pill-free days to produce withdrawal bleeding. This produced the same 15% pregnancy rate during the following four months without the amenorrhea of the previous continuous estrogen and progesterone regimen. But 20% of the women experienced breakthrough bleeding and in the first cycle ovulation was suppressed in only 85% of the women, indicating that even higher and more expensive oral doses of progesterone would be needed to initially consistently suppress ovulation. Similarly, Ishikawa and colleagues found that ovulation inhibition occurred in only a "proportion" of cases with 300 mg/day oral progesterone. Despite the incomplete inhibition of ovulation by oral progesterone, no pregnancies occurred in the two studies, although this could have simply been due to chance. However, Ishikawa et al. reported that the cervical mucus in women taking oral progesterone became impenetrable to sperm, and this may have accounted for the absence of pregnancies.

Progesterone was abandoned as an oral ovulation inhibitor following these clinical studies due to the high and expensive doses required, incomplete inhibition of ovulation, and the frequent incidence of breakthrough bleeding. Instead, researchers would turn to much more potent synthetic progestogens for use in oral contraception in the future.

Progestins to prevent ovulation

Pincus asked his contacts at pharmaceutical companies to send him chemical compounds with progestogenic activity. Chang screened nearly 200 chemical compounds in animals and found the three most promising were Syntex's norethisterone and Searle's noretynodrel and norethandrolone.

Chemists Carl Djerassi, Luis Miramontes, and George Rosenkranz at Syntex in Mexico City had synthesized the first orally highly active progestin norethisterone in 1951. Frank B. Colton at Searle in Skokie, Illinois had synthesized the orally highly active progestins noretynodrel (an isomer of norethisterone) in 1952 and norethandrolone in 1953.

In December 1954, Rock began the first studies of the ovulation-suppressing potential of 5–50 mg doses of the three oral progestins for three months (for 21 days per cycle—days 5–25 followed by pill-free days to produce withdrawal bleeding) in fifty of his infertility patients in Brookline, Massachusetts. Norethisterone or noretynodrel 5 mg doses and all doses of norethandrolone suppressed ovulation but caused breakthrough bleeding, but 10 mg and higher doses of norethisterone or noretynodrel suppressed ovulation without breakthrough bleeding and led to a 14% pregnancy rate in the following five months. Pincus and Rock selected Searle's noretynodrel for the first contraceptive trials in women, citing its total lack of androgenicity versus Syntex's norethisterone very slight androgenicity in animal tests.

Combined oral contraceptive

Noretynodrel (and norethisterone) were subsequently discovered to be contaminated with a small percentage of the estrogen mestranol (an intermediate in their synthesis), with the noretynodrel in Rock's 1954–5 study containing 4–7% mestranol. When further purifying noretynodrel to contain less than 1% mestranol led to breakthrough bleeding, it was decided to intentionally incorporate 2.2% mestranol, a percentage that was not associated with breakthrough bleeding, in the first contraceptive trials in women in 1956. The noretynodrel and mestranol combination was given the proprietary name Enovid.

The first contraceptive trial of Enovid led by Celso-Ramón García and Edris Rice-Wray began in April 1956 in Río Piedras, Puerto Rico. A second contraceptive trial of Enovid (and norethisterone) led by Edward T. Tyler began in June 1956 in Los Angeles. On January 23, 1957, Searle held a symposium reviewing gynecologic and contraceptive research on Enovid through 1956 and concluded Enovid's estrogen content could be reduced by 33% to lower the incidence of estrogenic gastrointestinal side effects without significantly increasing the incidence of breakthrough bleeding.

Public availability

United States

oral contraceptives, 1970s
 
On June 10, 1957, the Food and Drug Administration (FDA) approved Enovid 10 mg (9.85 mg noretynodrel and 150 µg mestranol) for menstrual disorders, based on data from its use by more than 600 women. Numerous additional contraceptive trials showed Enovid at 10, 5, and 2.5 mg doses to be highly effective. On July 23, 1959, Searle filed a supplemental application to add contraception as an approved indication for 10, 5, and 2.5 mg doses of Enovid. The FDA refused to consider the application until Searle agreed to withdraw the lower dosage forms from the application. On May 9, 1960, the FDA announced it would approve Enovid 10 mg for contraceptive use, and did so on June 23, 1960. At that point, Enovid 10 mg had been in general use for three years and, by conservative estimate, at least half a million women had used it.

Although FDA-approved for contraceptive use, Searle never marketed Enovid 10 mg as a contraceptive. Eight months later, on February 15, 1961, the FDA approved Enovid 5 mg for contraceptive use. In July 1961, Searle finally began marketing Enovid 5 mg (5 mg noretynodrel and 75 µg mestranol) to physicians as a contraceptive.

Although the FDA approved the first oral contraceptive in 1960, contraceptives were not available to married women in all states until Griswold v. Connecticut in 1965 and were not available to unmarried women in all states until Eisenstadt v. Baird in 1972.

The first published case report of a blood clot and pulmonary embolism 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 studies to conclusively establish an increased risk of venous thrombosis in oral contraceptive users and an increased risk of stroke and myocardial infarction in oral contraceptive users who smoke or have high blood pressure 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 who helped arrange the 1970 Nelson Pill Hearings called by Senator Gaylord Nelson. 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 and other feminists to protest the hearings and generate media attention. Their work led to mandating the inclusion of patient package inserts with oral contraceptives to explain their possible side effects and risks to help facilitate informed consent. 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.

Beginning in 2015, certain states passed legislation allowing pharmacists to prescribe oral contraceptives. Such legislation was considered to address physician shortages and decrease barriers to birth control for women. Currently, pharmacists in Oregon, California, Colorado, Hawaii, Maryland, and New Mexico have authority to prescribe birth control after receiving specialized training and certification from their respective state Board of Pharmacy. Other states are considering this legislation, including Illinois, Minnesota, Missouri, and New Hampshire.

Australia

The first oral contraceptive introduced outside the United States was Schering's Anovlar (norethisterone acetate 4 mg + ethinylestradiol 50 µg) on January 1, 1961 in Australia.

Germany

The first oral contraceptive introduced in Europe was Schering's Anovlar on June 1, 1961 in West Germany. The lower hormonal dose, still in use, was studied by the Belgian Gynaecologist Ferdinand Peeters.

Britain

Before the mid-1960s, the United Kingdom did not require pre-marketing approval of drugs. The British Family Planning Association (FPA) through its clinics was then the primary provider of family planning services in Britain and provided only contraceptives that were on its Approved List of Contraceptives (established in 1934). In 1957, Searle began marketing Enavid (Enovid 10 mg in the U.S.) for menstrual disorders. Also in 1957, the FPA established a Council for the Investigation of Fertility Control (CIFC) to test and monitor oral contraceptives which began animal testing of oral contraceptives and in 1960 and 1961 began three large clinical trials in Birmingham, Slough, and London.

In March 1960, the Birmingham FPA began trials of noretynodrel 2.5 mg + mestranol 50 µg, but a high pregnancy rate initially occurred when the pills accidentally contained only 36 µg of mestranol—the trials were continued with noretynodrel 5 mg + mestranol 75 µg (Conovid in Britain, Enovid 5 mg in the U.S.). In August 1960, the Slough FPA began trials of noretynodrel 2.5 mg + mestranol 100 µg (Conovid-E in Britain, Enovid-E in the U.S.). In May 1961, the London FPA began trials of Schering's Anovlar.

In October 1961, at the recommendation of the Medical Advisory Council of its CIFC, the FPA added Searle's Conovid to its Approved List of Contraceptives. On December 4, 1961, Enoch Powell, then Minister of Health, announced that the oral contraceptive pill Conovid could be prescribed through the NHS at a subsidized price of 2s per month. In 1962, Schering's Anovlar and Searle's Conovid-E were added to the FPA's Approved List of Contraceptives.

France

On December 28, 1967, the Neuwirth Law legalized contraception in France, including the pill. The pill is the most popular form of contraception in France, especially among young women. It accounts for 60% of the birth control used in France. The abortion rate has remained stable since the introduction of the pill.

Japan

In Japan, lobbying from the Japan Medical Association prevented the pill from being approved for general use for nearly 40 years. The higher dose "second generation" pill was approved for use in cases of gynecological problems, but not for birth control. Two main objections raised by the association were safety concerns over long-term use of the pill, and concerns that pill use would lead to decreased use of condoms and thereby potentially increase sexually transmitted infection (STI) rates.

However, when the Ministry of Health and Welfare approved Viagra's use in Japan after only six months of the application's submission, while still claiming that the pill required more data before approval, women's groups cried foul. The pill was subsequently approved for use in June 1999. However, the pill has not become popular in Japan. According to estimates, only 1.3 percent of 28 million Japanese females of childbearing age use the pill, compared with 15.6 percent in the United States. The pill prescription guidelines the government has endorsed require pill users to visit a doctor every three months for pelvic examinations and undergo tests for sexually transmitted diseases and uterine cancer. In the United States and Europe, in contrast, an annual or bi-annual clinic visit is standard for pill users. However, beginning as far back as 2007, many Japanese OBGYNs have required only a yearly visit for pill users, with multiple checks a year recommended only for those who are older or at increased risk of side effects. As of 2004, condoms accounted for 80% of birth control use in Japan, and this may explain Japan's comparatively low rates of AIDS.

Society and culture

The pill was approved by the FDA in the early 1960s; its use spread rapidly in the late part of that decade, generating an enormous social impact. Time magazine placed the pill on its cover in April, 1967. In the first place, it was more effective than most previous reversible methods of birth control, giving women unprecedented control over their fertility. Its use was separate from intercourse, requiring no special preparations at the time of sexual activity that might interfere with spontaneity or sensation, and the choice to take the pill was a private one. This combination of factors served to make the pill immensely popular within a few years of its introduction. Claudia Goldin, among others, argue that this new contraceptive technology was a key player in forming women's modern economic role, in that it prolonged the age at which women first married allowing them to invest in education and other forms of human capital as well as generally become more career-oriented. Soon after the birth control pill was legalized, there was a sharp increase in college attendance and graduation rates for women. From an economic point of view, the birth control pill reduced the cost of staying in school. The ability to control fertility without sacrificing sexual relationships allowed women to make long term educational and career plans.

Because the pill was so effective, and soon so widespread, it also heightened the debate about the moral and health consequences of pre-marital sex and promiscuity. Never before had sexual activity been so divorced from reproduction. For a couple using the pill, intercourse became purely an expression of love, or a means of physical pleasure, or both; but it was no longer a means of reproduction. While this was true of previous contraceptives, their relatively high failure rates and their less widespread use failed to emphasize this distinction as clearly as did the pill. The spread of oral contraceptive use thus led many religious figures and institutions to debate the proper role of sexuality and its relationship to procreation. The Roman Catholic Church in particular, after studying the phenomenon of oral contraceptives, re-emphasized the stated teaching on birth control in the 1968 papal encyclical Humanae vitae. The encyclical reiterated the established Catholic teaching that artificial contraception distorts the nature and purpose of sex. On the other side Anglican and other Protestant churches, such as the Evangelical Church in Germany (EKD) accepted the combined oral contraceptive pill.

The United States Senate began hearings on the pill in 1970 and there were different viewpoints heard from medical professionals. Dr. Michael Newton, President of the College of Obstetricians and Gynecologists said:
"The evidence is not yet clear that these still do in fact cause cancer or related to it. The FDA Advisory Committee made comments about this, that if there wasn't enough evidence to indicate whether or not these pills were related to the development of cancer, and I think that's still thin; you have to be cautious about them, but I don't think there is clear evidence, either one way or the other, that they do or don't cause cancer."
Another physician, Dr. Roy Hertz of the Population Council, said that anyone who takes this should know of "our knowledge and ignorance in these matters" and that all women should be made aware of this so she can decide to take the pill or not.

The Secretary of Health, Education, and Welfare at the time, Robert Finch, announced the federal government had accepted a compromise warning statement which would accompany all sales of birth control pills.

Result on popular culture

The introduction of the birth control pill in 1960 allowed more women to find employment opportunities and further their education. As a result of more women getting jobs and an education, their husbands had to start taking over household tasks like cooking. Wanting to stop the change that was occurring in terms of gender norms in an American household, many films, television shows, and other popular culture items portrayed what an ideal American family should be. Below are listed some examples:

Poem

Music

  • Singer Loretta Lynn commented on how women no longer had to choose between a relationship and a career in her 1974 album with a song entitled "The Pill", which told the story of a married woman's use of the drug to liberate herself from her traditional role as wife and mother.

Environmental impact

A woman using COCPs excretes from her urine and feces natural estrogens, estrone (E1) and estradiol (E2), and synthetic estrogen ethinylestradiol (EE2). These hormones can pass through water treatment plants and into rivers. Other forms of contraception, such as the contraceptive patch, use the same synthetic estrogen (EE2) that is found in COCPs, and can add to the hormonal concentration in the water when flushed down the toilet. This excretion is shown to play a role in causing endocrine disruption, which affects the sexual development and the reproduction, in wild fish populations in segments of streams contaminated by treated sewage effluents. A study done in British rivers supported the hypothesis that the incidence and the severity of intersex wild fish populations were significantly correlated with the concentrations of the E1, E2, and EE2 in the rivers.

A review of activated sludge plant performance found estrogen removal rates varied considerably but averaged 78% for estrone, 91% for estradiol, and 76% for ethinylestradiol (estriol effluent concentrations are between those of estrone and estradiol, but estriol is a much less potent endocrine disruptor to fish).

Numerous studies have demonstrated that increasing access to contraception, including birth control pills, can be an effective strategy for climate change mitigation as well as adaptation. According to Thomas Wire, contraception is the 'greenest technology' because of its cost-effectiveness in combating global warming — each $7 spent on family planning would reduce global carbon emissions by 1 tonne over four decades, while achieving the same result with low-carbon technologies would require $32. If all the current unmet need for contraception were met, that would reduce global carbon dioxide emissions by 34 gigatonnes between 2010 and 2050.

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