Contraceptives  ( Truths and Myths)

The combined oral contraceptive pill (COCP), that is quite often  referred to as the contraceptive pill (CP) or even more commonly known as ‘’the pill’’, is a method of contraception that combines in the same pill an  estrogen and  a progestogen.

The oral contraceptive pill  was approved for use for the first time in the USA in 1960, and is currently the most popular form of birth control. It is used by more than 100 million women worldwide and almost 12 million women in the USA alone.

Combined oral contraceptive pills must be taken at the same time daily. However if one or more tabs are forgotten for over 12 hours their contraceptive protection is drastically reduced. When taking an oral contraceptive that includes 21 pills, 1 pill is taken daily for three weeks followed by a week of not taking pills. Regarding the package of 28 pills, they are taken daily for 21 days followed by a week of placebo pills.

Effectiveness

The contraceptive efficacy of the pill is over 99% if taken according to the instructions.

The effectiveness of contraception may be affected by: 1) missing more than 1active ingredient pill, 2) when taking the 21 pack, a delay for more than 7 days of starting the new package. When using the 28 day package, a delay of more than one day, 3) Intestinal malabsorption due to emesis or diarrhea, 4) Interaction with other drugs that may reduce the serum levels of estrogen or progestogene. 

Contraceptive pills can also be used to treat  other conditions such as polysystic ovarian syndrome (PCOS), endometriosis, amenorrhea, uterine adenomyosis, heavy bleeding during menses , premenstrual syndrome and  acne.

It is a broadly accepted that fact that the dangers that contraceptives pose to a woman’s health are far less significant than those that she is exposed to during pregnancy and delivery as well as from an unwanted pregnancy.  

 Contra-indications for oral contraceptives use include the following:

• Cancerl  of the breast, uterus, ovaries
• Blood Clots/thrombofilia  or a history of blood clots / thrombofilia. The total possible risk of forming a blood clot out of every 100.000 women is about 60, in comparison to 30  for women not  taking OC.
• Diabetes type I or II for over 20 years
• Migraines that include an aura
• Serious disorders of the liver and the hepatic ducts
• History of Heart disease,  infarct, stroke
• Serious Hypertension
• Serious infectious disease such as HIV or TB
• Hypecholisterinaimia
• Smokers over 35 years of age.
• Increased risk for  venus thrombosis
• Hepatic function disorders 
• Reduced amount of blood during menstruation
• Breast tenderness
• Nausea
• Increased arterial blood pressure

Side effects that have been associated with the use of oral contraceptives include the following:

The above mentioned are rarely experienced when taking a low dose OC.

Myths and Reality

1. Association of Cancer and Contraceptive Pills

There is the general misconception that birth control pills may cause cancer, however most current studies have not shown an increased risk of ca for women taking OC. On the contrary, many studies have confirmed that long term use of OC protects women from ovarian and uterine cancer.

2. Contraceptives and Weight Gain

Most women believe that there is a link between OC and increased weight; however no study has validated such a link.