Birth Control Pill

Aug 21, 2004 Viewed: 1082


THE BASICS
“The Pill” is the common name for oral contraception. There are two basic types -  combination pills and progestin-only pills. Both are made of hormones like those made by a woman’s ovaries. Combination pills contain both estrogen and progestin. Both kinds of pills require a medical evaluation and prescription.

Both pills can prevent pregnancy. But they work differently. Combination pills usually work by preventing a woman’s ovaries from releasing eggs (ovulation). Progestin-only pills also can prevent ovulation. But they usually work by thickening the cervical mucus. This keeps sperm from joining with an egg. Combination pills also thicken cervical mucus.
Taking the Pill daily maintains the level of hormone that is needed to prevent pregnancy.

EFFECTIVENESS
The Pill is one of the most effective reversible methods of birth control. Of 100 women who use the Pill, only

eight will become pregnant during the first year of typical use.* Fewer than one out of 100

women will become pregnant with perfect use.**

* “Typical use” refers to failure rates for use that is not consistent or always correct. 
** “Perfect use” refers to failure rates for use that is consistent and always correct.

Certain herbs and medicines, including the antibiotic rifampin, certain drugs used to control seizures, anti-fungals (for yeast infections), or anti-HIV protease inhibitors may make the Pill less effective. Vomiting and diarrhea may also keep the Pill from working. Ask your clinician for advice. Until you are sure, use an additional method of birth control.

It is very important to remember that the Pill does not protect against sexually transmitted infections. Use a latex or female condom along with the Pill for protection against infection.

GETTING THE RIGHT PILL 
You must see a clinician to tell whether you can take the Pill and what dosage is right for you. The clinician will discuss your medical history with you, check your blood pressure, and give you any other medical exam that may be needed.

If the Pill is right for you, you likely will be given the lowest amount of hormone needed to protect you against pregnancy. Your clinician will adjust the prescription if you continue to experience side effects after a few months. Be sure to have checkups at least once a year. Your prescription may need to be changed as your health needs change. See your clinician right away if any problem develops.
Remember to tell any other clinician you may see that you take the Pill.

SOME BENEFITS
Taking the Pill is simple, safe, and convenient.
Many women who take the Pill have more regular, lighter, and shorter periods.
The Pill does not interfere with having sex. Many women say the Pill has improved their sex lives. They say they are free to be more spontaneous and do not have to worry about becoming pregnant.
The Pill offers many health benefits, including some protection against

  • infection of the fallopian tubes (pelvic inflammatory disease), which often leads to infertility
  • ectopic pregnancy
  • noncancerous breast growths
  • ovarian cysts
  • cancer of the ovaries
  • cancer of the lining of the uterus
  • troublesome menstrual cramps
  • iron deficiency anemia that results from heavy menses
  • acne
  • premenstrual symptoms, as well as related headaches and depression
  • excess body hair
  • vaginal dryness and painful intercourse related to menopause

 
In fact, protection against developing cancer of the ovary or the lining of the uterus (endometrium) can last up to 30 years after stopping the Pill. Protection against both of these types of cancer increases with each year of use:

  • Eight years of pill use reduces the risk of endometrial cancer by up to 80 percent

  • Ten years of pill use reduces the risk of ovarian cancer by up to 80 percent

    The Pill may offer some protection against osteoporosis.
     
    SOME RISKS
    As with all drugs, there may be some undesirable side effects for some women taking the Pill. However, the Pill is much safer than pregnancy and childbirth for healthy women? except among smokers age 35 and older.
    Some side effects that usually clear up after two or three months of use include

    • bleeding between periods
    • weight gain or loss
    • breast tenderness
    • nausea ? rarely, vomiting
    • changes in mood    

    Nausea and vomiting often can be reduced or eliminated by taking the Pill with the evening meal or at bedtime. (Do not stop taking the Pill if you feel sick to your stomach.) Irregular spotting and bleeding happen more frequently with progestin-only pills than with combination pills.
    Other possible side effects include

    • headache
    • change in sexual desire
    • depression

    Serious problems do not occur very often. Pill users have a slightly greater chance of certain major disorders than nonusers. The most serious is the possibility of blood clots in the legs, lungs, heart, or brain. Women on the Pill who undergo major surgery seem to have a greater chance of having blood clots. Blood clots in the legs occur with increased frequency for women and men who

    • have one or both legs immobilized
    • are confined to their beds

    It is important to stop taking the Pill about four weeks before a scheduled major operation.
          Do not start again while recuperating or while a leg or arm is in a cast.

    Rarely, women who take the Pill develop high blood pressure. Very rarely,liver tumors, gallstones, and jaundice (yellowing of the skin or eyes) occur in women who take the

      Pill. More detailed information about the use and risks of the Pill is provided in an insert included with each pill pack.
     
    THE PILL AND BREAST CANCER

    Most experts agree that taking the Pill does not increase the overall risk of developing breast cancer? no matter how long a woman takes the Pill or even if she has a close relative with breast cancer.
    You should not take the Pill if you

    • smoke more than 15 cigarettes a day and are 35 or older
    • have uncontrolled high blood pressure
    • have a history of blood clots or vein inflammation
    • have unexplained bleeding in your vagina
    • have had an abnormal growth or cancer of the breast or uterus
    • have a severe liver disease or have had growths of the liver
    • have certain conditions associated with diabetes mellitus
    • think you might be pregnant
    • have a history of heart attack or stroke
    • have a history of migraine headaches plus aura

    Some women can take the Pill under close medical supervision if they are very overweight or have

    • a high risk for heart disease
    • slightly High cholesterol or slightly increased blood pressure
    • a seizure disorder that requires taking anticonvulsant medication  
    • a certain cancer of the nervous system called meningioma

    For most women with these conditions, the risks of pregnancy are more dangerous than those of the Pill.
    Women with a history of depression may not be able to continue to take the Pill if it worsens the problem.
       
    EARLY WARNING SIGNS
    Serious problems usually have warning signs. Watch for them. If one occurs, report it to your clinician as soon as possible. These warning signs include

    • sudden or constant pain or redness and swelling in the leg
    • pain in the abdomen, chest, or arm
    • sudden shortness of breath or spitting up blood
    • eye problems such as blurred or double vision
    • worsening depression
    • yellowing of the skin or eyes (jaundice)


     
    PREGNANCY AND THE PILL
    There is a very slight chance that you will become pregnant even if you take the Pill.
    However, a missed period does not always mean you are pregnant, especially if you have not skipped any pills. But see your clinician if you miss a second period.
     
    It is unlikely that taking the Pill during early pregnancy will increase the risk of defects in the fetus. However, the likelihood of tubal pregnancy is greater if you become pregnant while taking the progestin-only pill.
    If you want to become pregnant, stop taking the Pill. If you want to plan the timing of your pregnancy, use another form of birth control until your period becomes regular. It usually takes about one to three months for your period to return to the cycle you had before taking the Pill.
    After childbirth, your clinician can help you decide when to take the Pill again.
    Progestin-only pills will not affect your milk during nursing. Combination pills may reduce the amount and quality of milk in the first six weeks of breastfeeding.
    Also, the milk will contain traces of the Pill’s hormones. It is unlikely that these hormones will have any effect on your child.

    Oral contraceptives available in the United states

    Alesse
    Alesse usually contains two types of hormones, estrogens (ES-troh-jenz ) and progestins ( proh-JES-tins) and, when taken properly, prevents pregnancy. It works by stopping a woman’s egg from fully developing each month.

    Mircette
    Mircette is a “biphasic” oral contraceptive pill indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. The efficacy of these contraceptive methods, except sterilization, depends upon the reliability with which they are used.

    Nordette 28
    Nordette is used to prevent pregnancy or to regulate your menstrual cycle.

    Yasmin
    Yasmin is a medication that is used to prevent pregnancy in women.
    Yasmin is a prescription medication that you will take orally once a day, generally at the same time everyday so that you are best protected against getting pregnant and having children when you are not ready or don’t want children.

    Triphasil
    Triphasil is an oral contraceptive (commonly known as “the Pill”) containing two active ingredients (levonorgestrel and ethinyloestradiol) that are similar to hormones that your body naturally produces.
    Triphasil is a pill that you will take orally once a day so that you don’t get pregnant. If you are looking to protect your future and not have children at right now, Triphasil is a medication that you should consider.

    Seasonale
    SEASONALE ® is the FDA-approved extended-cycle birth control pill for the prevention of pregnancy that reduces your monthly periods to just 4 times a year.

    Ortho Tri-Cyclen
    ORTHO TRI-CYCLEN is a birth control pill that is taken orally. In addition to preventing pregnancy, Ortho Tri-Cyclen may also be used to regulate the menstrual cycle or treat symptoms of menopause.

    Ortho Evra Patch
    Ortho Evra Patch is an estrogen and progestin combination used to prevent pregnancy. It may also be used to treat other conditions as determined by your doctor.

    Johns Hopkins patient information

    Last revised:

    Diseases and Conditions Center

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