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CONTRACEPTIVES

ORAL CONTRACEPTIVES

What are Birth Control Pills?

Oral contraceptives, known as “The Pill”, contain two synthetic female hormones (estrogen and progesterone) which prevent pregnancy by inhibiting the monthly release of the “egg” from the ovaries. These are the same female hormones you normally produce. Oral contraceptives are almost 100% effective when taken correctly. To be absolutely safe, you should use a second form of contraception the first seven days of the first cycle.

 Birth control pills do not completely protect a woman from getting sexually transmitted diseases.

 How are they available?

  • Combination Pill : Here the pills contain both the female hormones in various combinations.

  • Minipill: These contain only progesterone. 

 There has been tremendous change in the usage of Oral Contraceptives, over a period of time. The newer Oral Contraceptive pills available are extremely safe and highly effective, if taken correctly. The various brand names available in Indian markets are Triquflar, Ovaral –G, Femilon, and Novelon. Your medical practitioner is the ideal person to advise you which one to choose. 

All birth control pill cycles are three weeks of active hormone pills (21 tablets) followed by one week of no hormones. Some pills, called “everyday” version have additional 7 pills of a different colour for the 4th week. The fourth week of pills are just “reminder” pills and do not contain hormones. You either take them or just use them for counting. When you get to the fourth week of pills, you should have a menstrual period. 

How to take them?

 When starting for the first time or changing from other methods of contraception to hormonal method or one brand to another there are a number of ways to start oral contraceptives.

  • We most commonly start on day of menses, one pill each day, regularly at a particular time of day preferably after dinner or in the morning with your breakfast.

  • If you forget to take your pills take immediately as soon as you remember.

  • If you forget to take for more than 12 hours, take immediately or use additional back up method of contraception for another week. 

  • If you forget to take two or more pills, you must use another birth control (back up method) for the remaining days of your cycle.

  • With packets of 21 pills, you take 1 pill every night for 3 weeks. After 1-week pill free interval, you start the next packet. 

  • For everyday version, after the last week of placebo (do not contain hormones) pills you start immediately with a new packet (no gap).

At times, for a woman, there may be no menstrual bleeding while using birth control pills. 

  • If you miss one menstrual period and have taken the tablets exactly as directed, continue as usual with your next cycle. 

  • If you have not taken them correctly and miss a period you should be evaluated for pregnancy. 

  • If two consecutive menstrual periods are missed you should be evaluated for pregnancy. It is not a health hazard to miss your menstrual period when you are on birth control pills.

Some drugs such as antibiotics, anti-convulsants, anti-tuberculous drugs can interfere in the effectively of birth control pills. Confirm the same with the Health Care Provider. You may need to use an additional form of birth control while you are taking antibiotics.

Side Effects

Occasionally experience side effects, which are usually temporary and may disappear in the first three to four cycles. We encourage you to remain on the pill for at least three cycles so that we can evaluate how you are adjusting. If symptoms persist longer than three months, consult your medical practitioner who may be able to solve the problem by changing the type of pill you are taking.

  • Some women experience slight nausea, which may be relieved by taking the pill along with a snack just before going to sleep or with a meal.
  • Breakthrough bleeding (bleeding in between the menses): If this bleeding is heavier than light flow or lasts more than a few days, you should contact your practitioner.
  • Your breasts may enlarge or become somewhat tender.

Complications

  • If you have special health problems, such as fibrous growths of the uterus, heart or kidney disease, depression, diabetes, thyroid disease, migraine headaches, or epilepsy, you should inform your practitioner of these or any other problems. 
  • If you have a history of blood clots anywhere in your body, cancer of the breast or uterus, or liver disease, you may not be able to use the pill.

Important:

Most women taking oral contraceptive have few or no problems. But do call your practitioner if you notice any of the following symptoms:

A- abdominal pain (severe)
C - chest pain (severe), shortness of breath, or coughing up blood
H- headaches (severe)
E -eye problems like blurred vision, flashing lights
S -severe leg pain (calf or thigh)

Benefits:

This includes a reduced incidence of benign ovarian cysts, ectopic pregnancy, pelvic inflammatory disease, anaemia, rheumatoid arthritis, and most importantly, endometrial cancer and ovarian cancer.

  • Most successful means of contraception if used properly. The failure rate is less than 1%.
  • It is of great social advantage for working and educated women as withdrawal bleeding is predictable. One can postpone the same safely by taking more pills continually for even one month or so.
  • Cures painful menses and the mid cycle ovulation pain.
  • Oral contraception decreases the amount of bleeding and can be used in women having heavy and prolonged regular menses.
  • Oral contraception protects against ovarian and endometrial cancer. The effect lasts for many years. Benign breast diseases, functional ovarian cyst, fibroid of the uterus are reduced in pill users.
  • Oral contraception protects against ectopic pregnancy, pelvic inflammatory diseases, anaemia and malnutrition, endometriosis, hirsutism, acne and oily skin.

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