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. The quantities in the pill are less than what your body would produce if you were pregnant. 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 controll pills do not protect a woman from getting sexually transmitted diseases.

How to Take Them:

There are a number of ways to start oral contraceptives. We most commonly have you start the pills on the Sunday after your normal menstrual period begins. If your period begins on Sunday, then start the pills on that Sunday. Take one pill at about the same time each day so you will not forget them. Keeping the pills with your toothbrush is one way to remember. They are least likely to cause nausea if taken with dinner or along with a snack before going to bed. If you forget one pill, take it as soon as you remember. If you do not remember untill the next day, then take two pills that day. If you miss two pills, take two pills a day for two days. If you miss three or more pills, call the clinic for instructions.

IMPORTANT: If you miss more than one pill in a row, you need to use a backup method for one week to prevent pregnancy that cycle.

All birth contril pill cycles are three weeks of active hormone pills followed by one week of no hormones. The fourth week of pills are just "reminder" pills and do not contain hormones. You may either take them or just use them for counting. When you get to the fourth week of pills, you should have a menstrual period. Always start a new packet every fourth week, the next day after completing the last pack regardless of your menstrual flow.

At times, and for some women, 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.

If you are not happy with the pills you are using, discuss this with your practitioner rather than giving up and stopping them. There are many kinds of pills and one may be more closely related to your normal hormonal pattern than another.

Always make an appointment well before you run out of pills so there is no scheduling difficulty and you have the pills when you need them.

Side Effects:

When taking the pill, some women occasionally experience side effects which are annoying, but will not damage their health. These changes 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 your pill.

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 (spotting between periods) may occur while taking the three weeks of active hormone pills and is not serious. Continue your pills as instructed and you will continue to be protected. This is not unusual and most commonly occurs during the first two or three cycles. If this bleeding is heavier than light flow or lasts more than a few days, you should contact your practitioner.

Emotional changes can be due to life stressors, birth control pills, or a combination of both. In some cases depression or loss of interest in sex may occur. Excercise and a healthy diet and lifestyle can be helpful, but sometimes a change of pills may be needed. A few women may develop freckling of the skin or acne, although in most cases pre-existing acne is improved by oral contraceptives. 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.

There is a small risk of benign liver tumors which can be serious among pill users. The pill slightly increases the incidence of gallbladder disease. If you are prescribed antibiotics for a serious infection, there is a possible risk of reduced effectiveness of birth control pills. The data is limited and unclear. If taking antibiotics, to be absolutely safe, you could use an additional backup method of birth control with the remainder of that cycle of pills. Rifampin, an antibiotic for treatment of tuberculosis and meningitis prophylaxis, reduces effectiveness and another method would be advised. Certain medications to treat seizure disorders and sedatives may also reduce effectiveness slightly. Your practitioner will guide you if you have any questions.

Important:

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

• vision disturbance, blurred vision, flashing lights
• headaches (severe)
• unusual leg pain (calf or thigh)
• chest pain (severe), shortness of breath, or coughing up blood
• abdominal pain (severe)

Benefits:

There are numerous benefits from the use of oral contraceptive pills and, in fact, for most women they significantly outweigh any risks. These include a reduced incidence of benign ovarian cysts, ectopic pregnancy, pelvic inflammatory disease, anemia, rheumatoid arthritis, and most importantly, endometrial cancer and ovarian cancer. Periods are usually lighter, shorter, and occur every 28 days. Decreased menstrual cramping is another benefit of the pill. Birth control pills do not decrease a woman's chance of getting pregnant once she has stopped them. Oral contraceptives continue to be one of the most effective reversible methods of birth control.

Please contact the Health Center if you have questions about or problems with your birth control pills.