contraceptive-pill

Contraceptive Pill

Contraceptive pills have been available and used since the 1960’s. Between 2006 and 2010, according to the Center of Disease Control and Prevention, two thirds of women, in the reproductive age, use some type of contraception, and 17% of these women use oral contraceptive pills (OCP).

It is important to know how the OCP works, how to use it, and the side effects in order to decide the best option for you.

Medication

What are Contraceptive Pills?

Contraceptive Pills are one of the most effective methods to prevent pregnancy. If you are a sexually active woman, you should consider the possibility to use birth control pills. There are different kinds of methods, but the most common is the combined pill, which is the combination of two female hormones, progesterone and estrogen. These pills contains artificial versions of female hormones, which prevent the release of an egg (called ovulation) and tries to keep apart the sperm and the egg in order for the woman to not get pregnant. 

Which types can you find in the market?

Combination Pills

Combination Pills, as mentioned before, have progesterone and estrogen. Usually most of the pills are active, which means they contain hormones. The remaining pills are not active, which means they do not contain hormones.

There are several kind of brands of the combination pills, made up of four types:

Monophasic 21-day pill

This is the most common type and has the same level of hormone in each pill. This is a monthly cycle and you need to take every day, at the same time of the day, one pill for 21 days. Then you do not take pills for seven days. During this time your menstruation cycle will start. Yasmine, Cilest, Marvelon, Mocrogynon, Yaz,  and Ocella are some examples of this kind of pill.

Phasic 21-day pill

This type of pill has two of three section of different amount of hormones. It is also a one-month cycle and you should take one pill, every day, at the same time of the day for 21 days. This kind of pill is important and crucial to take in a correct order because each section has a different amount of hormones. Then you do not take pills for 7 days and have your period. Logynon is an example of this kind of pill. 

Every day (ED) pill

This type of pill have 21 active pills and 7 inactive (dummy) pills in one-month pack. You will take the pills for 28 days with no break between the packets of pills. This kind of pill is also important and crucial to take in a correct order to avoid the medicine to be less effective. Microgynon ED is an example of this kind of pill. 

Progesterone-only pill

This kind of pill contains only progesterone without estrogen and it is called also minipill. This type is recommended for women in which estrogen is contraindicated. All the pills are active and you will not have your period while taking progestin-only pills. Aygestin, Camila, Ortho Micronor, Lyza and Errin are some examples of this kind of pill.

How Combined Pills and Progesterone-only Pills work?

Combined pills work preventing the ovaries to release an egg each month. They thicken the cervical mucus preventing sperm from reaching the uterus.

The progesterone-only pill works in a different way: they can also prevent the ovulation and they can make the cervical mucus thicken and make the endometrium more thin. Endometrium is the lining in your uterus, when it is thin, it makes it harder for an egg to implant itself, which makes harder to have a pregnancy.

How can you use it?

Monophasic and Phasic (21-day) pills:

You need to take the first pill from the packet,  marked in the correct day of the week. Keep taking the pill for 21 days at the same time of the day, every day. Stop taking the pills for 7 days. In this period, your menstrual cycle will start. Start the next pack on the eighth day, whether you are still bleeding or not. Please pay attention that the day of the week will be the same you took your first pill. 

Every day pills:

Take the first pill from the section which has a marked “start”: this is an active pill. Then keep taking the pills, every day, at the same time of the day for 28 days. The lasts 7 pills are dummy pills and your period should start. Then start the next pack of pills after you finished the first one, even if you are still bleeding. 

Progesterone-only pill

With this method you take the pills for 28 days at the same time of the day and start the next pack of pills after you finished the first one.  With this method, you will not have your period. 

When should you start the combined pill?

Most women can start the combined pill at any time in their menstrual cycle. You just need to pay attention if you just have had a baby, a miscarriage or an abortion. There is a special guidance for those cases, so make sure you contact a doctor before starting to take these pills.

Starting the pill in your first day of your menstrual cycle

If you start taking the pill in your first day of your period, you do not need any other kind of protection from pregnancy. The effect starts right away.

Starting  the pill on the fifth day of your cycle or before

If you start taking the pills on the fifth day of your cycle or before, you do not need any other kind of protection from pregnancy. The effect starts right away. Unless you have a short period cycle, which is 23 days or less. If you have a short period cycle, you should use another kind of contraception, such as condoms, until you will take the pills for 7 days. After this, you will be protected only using the combined pill.

If you start taking the pill after the fifth day of your cycle

If you start taking the pill after the fifth day of your cycle, you should use another kind of contraception, such as condoms, until you will take the pills for 7 days. When you start taking the pill after the fifth day, make sure you will not put yourself in risk of pregnancy since your last period. To avoid this problem, you can take a pregnant test after 3 days you had unprotected sex. 

What can happen if you forget a pill?

If you forget one or more pills or if you took it late, you can decrease the effectiveness of the pill and can get pregnant. The risk of getting pregnant depends on how many pills you missed, and the time of your cycle you missed.

If you forget one pill or started the new pack one day late, you are still protected against pregnancy and you should:

  • Take the pill immediately when you remember even if you need to take 2 pills at the same time;
  • Keep taking the next days as normal;
  • If you are in an everyday pill, take the inactive pills as usual or if you forgot to take the   the seven-day pill, keep taking them as usual.
  • You do not need to use another kind of contraception;

If you forget two or more pills or started the new pack two or more days late, you should:

  • Take the pill immediately when you remember even  if you need to take 2 pills at the same time;
  • Do not use the earlier missed pills;
  • Keep taking the next days as usual;
  • You need to use another kind of contraception for the next seven days;

The effectiveness of birth control pills

If you take the pill (combination pill and progestin-only pill) every day correctly, the pill is around 9% to have a failure in typical use.  This means that  nine women in 100, who are using these pills have a chance to get pregnant in one year. For the progestin-only pill to be fully effective, you should take the pill every day in three-hour period difference. The combination pill is more flexible and you should take the pill every day in 12-hour period time for it to be fully effective.

Please pay attention that there are some medicines that can decrease the effectiveness of  birth control pills, as follow:

  • Some antibiotics, for example : rifampicin;
  • HIV and epilepsy medicines;
  • St. John’s wort;

The complete list of medicines, which can interact with birth control pills and reduce the effectiveness, can be given by your GP or a pharmacist. They should recommend you another kind of contraception during the time you are using the medicine. Please also pay attention if you are vomiting or having diarrhea. If you have a stomach illness, you should always ask your doctor if you have the risk of pregnancy. 

Which are the advantages to use birth control pills?

There are several benefits for Combined Pills and Progestin-only Pills, as follow:

  • The effectiveness is high andthe are better than most other birth control options;
  • You do not need to interrupt sex;
  • If you have PMS ( premenstrual syndrome), painful or heavy periods, they can help you;
  • You can stop taking it any time, and your cycle will return as normal and you can become pregnant;

Some types of combined pills can also have other protections against, as follow:

  • Ovarian and endometrial cancer;
  • Acne;
  • Thinning bones;
  • Several menstrual cramps;

The Progestin-only Pill can also be better for woman who:

  • Smoke and  are older than 35;
  • Can not tolerate estrogen therapy;
  • Want to breastfeed;
  • Have history of blood clots;

Which are the disadvantages of using birth control pills?  What are the side- effects?

There are some disadvantages of Combined Pills and Progestin-only Pills. You are not protected against sexually transmitted infections and you need to remember every day to take it.

Some women have different reactions to the hormones in birth control pills, which can be:

  • You can feel at first headaches, nausea  and mood swings;
  • It can increase your blood pressure;
  • It can be linked with some conditions such as breast cancer and thrombosis (blood clots);
  • It can decrease your sex drive;
  • You can have bleeding between the periods;
  • You can have breast tenderness;

Play attentionto these side effects, because they  should happen just for a few months. If the continue, stop taking them and talk to you doctor, so that he suggest another type of birth control method.

What are the risks of taking birth control pills?

There are some risks of using birth control pills, especially Combined Pills that can increase the chance to have blood clots and lead to:

  • Heart attacks;
  • Strokes;
  • Pulmonary embolism;
  • Deep vein thrombosis;

Even if there is the possibility of increasing the chance of having blood clots by using birth control, the risk is very small. According to the American College of Obstetricians and Gynecologist, from 10,000  women, less than 10 will develop  blood clots in a year using birth control pills.

However, if  you have one of the risk factors below, you should talk to your doctor and analyze about the risks to use the birth control pills, as follow:

  • If you have 35 years old or more;
  • If you smoke or have quit smoking in less than one year ago;
  • If you are overweight;
  • Have a blood clot or stroke in the past;
  • If you have longer periods of immobilization;

Which one is the best option for you?

Nowadays, there are in the market, many different types of birth control pills, which will fit you. The important thing is always consult your doctor and be sure that you’re taking them every day correctly, accordingly to the side effects and the risks factors mentioned above. It is also important to ask your doctor if you are using the best option for you. If you are using some medicine, you always need to say to your doctor and make sure that this medicine will not affect the effectiveness of the birth control pill, and if this happens, which option do you have to avoid an unplanned pregnancy.

Sources

  • https://www.healthline.com/health/birth-control-pills#side-effects-and-risks
  • https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/