The oral contraceptive pill, popularly called “the pill,” is a hormone-based method of preventing pregnancy. It can also help resolve painful or heavy periods, irregular menstruation, endometriosis, acne, and premenstrual syndrome (PMS).
Birth control pills prevents ovulation from taking place. Since no egg is produced, there would be none for the sperm to fertilize, hence preventing pregnancy.
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“The pill” has both advantages and disadvantages. People with different risk factors may be advised to use a particular kind of pill.
There are different types of contraceptive pills. They all contain synthetic forms of progesterone, hormones, or both. Synthetic progesterone is called progestin. Combination pills contain progestin and estrogen.
Monophasic pills contains all the same balance of hormones. With phasic pills, two or three different types of pill are taken monthly, each with a different balance of hormones.
Also, there is “everyday pills” and “21-day pills.” A pack of everyday pills lasts 28 days, but seven of the pills are inactive. The everyday pill may be easier to use suitably, as the routine is the same every day.
The pill is highly effective if used correctly, but because people make mistakes, it causes pregnancies to occur in some cases.
Note that birth control pills do not help in preventing (STDs). Only a condom can help prevent this type of infection.
Side effects of Birth Control Pills
- breast tenderness
- low libido
- intermenstrual spotting
- vaginal discharge
- headache and migraine
- weight gain
- mood changes
- missed periods
- changes to eyesight for those using contact lenses
- Breast tenderness
Breast tenderness may be experienced when on birth control pills. This normally resolves a few weeks after beginning the pill. Anyone who discovers a lump in the breast or who has persistent pain or tenderness or severe breast pain should see a doctor.
- Headaches and migraine
Headaches and migraines can occur when on birth control pills due to the hormones present. Pills with different types and doses of hormone may trigger different symptoms. Using a low-dose pill may reduce the incidence of headaches.
Symptoms usually improve over time, but if severe headaches begin after taking the pills, seek medical advice.
Mild nausea may be experienced when first taking the pill, but symptoms usually decrease after a while. Taking the pill with food or at bedtime may aid. If nausea persists for longer than 3 months, seek medical advice.
- Intermenstrual spotting
Vaginal bleeding is common between expected periods. This usually resolves within 3 months of starting to take the pill. During spotting, the pill is still effective, as long as it has been taken correctly and no doses are missed. If 5 or more days of bleeding is experienced while on active pills, or heavy bleeding for 3 or more days, health care professional should be contacted.
This bleeding may occur because the uterus is adjusting to having a thinner endometrial lining or because the body is adjusting to having different levels of hormones.
- Missed periods
A period may sometimes be missed even with proper use. Factors that can influence this include illness, stress, and hormonal or thyroid abnormalities. If a period is missed or is very light while using the pill, a pregnancy test is recommended before starting the next pack. It is common for a flow to be very light or missed altogether on occasion.
- Weight gain
Fluid retention may occur, especially around the breasts and hips when on birth control pills. According to one review, most studies have found an average weight gain of under 4.4 pounds (2 kilograms) at 6 or 12 months with progestin-only birth control. Some types of hormonal contraceptive have been connected to a decrease in lean body mass.
- Decreased libido
The hormone(s) in the contraceptive pill can greatly affect sex drive in some people. If decreased libido continues and is an issue of concern, see a doctor.
Birth control pill can increase libido, for example, by removing concerns about pregnancy and reducing the painful symptoms of menstrual cramping, premenstrual syndrome, uterine fibroids, and endometriosis.
- Mood changes
According to studies, oral contraceptives may affect the user’s mood and increase the risk of depression or other emotional changes. See your doctor if you are experiencing mood changes during the pill use.
- Vaginal discharge
Changes in vaginal discharge may occur when taking the pill. This may be an increase or a decrease in vaginal lubrication or a change in the nature of the discharge. If vaginal dryness occurs, added lubrication can help make sex enjoyable.
These changes are not usually harmful, but changes in color or odor could point to an infection. Anyone who is concerned about such changes should speak with their medical provider.
- Eye changes
The hormonal changes caused by the birth control pill have been connected to a thickening of the cornea in the eyes. Oral contraceptive use has not been associated with a higher risk of eye disease, but it may mean that contact lenses no longer fit comfortably.
Contact lens wearers should consult their ophthalmologist if they experience any changes in vision or lens tolerance during pill use.
The combined pill can increase the risk of cardiovascular problems, such as blood clots, deep vein thrombosis (DVT), a stroke, heart attack, or clot on the lung.
Birth control pills have also been linked with an increase in blood pressure, benign liver tumors, and some types of cancer.
Note: The pill should not be taken by group of persons listed below:
- Pregnant women
- smokers over the age of 35 years, or anyone who stopped smoking within the last year and is over 35 years old
- people with obesity
- people taking certain medications
- anyone who has or has had thrombosis, a stroke, or a heart problem
- anyone with a close relative who had a blood clot before the age of 45 years
- persons with stomach or abdominal pain
- people who have severe migraines, especially with an aura as the warning sign
- anyone who has or had had breast canceror disease of the liver or gallbladder
- anyone who has had diabetesfor at least 20 years or diabetes with complications
If any of the following occur, the user should see a doctor.
- chest pain, shortness of breath, or both
- severe headaches
- eye problems such as blurred vision or loss of vision
- swelling or aching in the legs and thighs
- redness, swelling or pain in the calf or thighs
Use of birth-control pills may increase the risk of long-term health problems.
Combination pills can slightly increase the risk of cardiovascular side effects, such as stroke, heart attack, and blood clots. These can all be fatal. The risk is higher with some pills. A doctor can advise on appropriate options.
Female hormones that occur naturally, such as estrogen may affect the chances of a woman developing some types of cancer. It is therefore possible that using a hormone-based method of birth control could have a similar effect.
Ovarian and endometrial cancer: These appear to be less likely among women who use the pill.
Breast cancer: There appears to be a slightly higher chance of breast cancer developing in women who have recently been using the contraceptive pill, and especially if they started using it during their teenage years. However, after 10 years of not using the pill, the risk appears to be the same as for someone who has never used it.
Other factors may play a role, such as a woman’s age at starting menopause and puberty, her age at her first pregnancy, and whether or not she has had children.
Cervical cancer: Long-standing use of the pill has been linked to a higher risk of cervical cancer, compared with those who have never used it. However, most types of cervical cancer are caused by the human papillomavirus (HPV). Whether HPV is connected to the use of oral birth control pills has not yet been established.
Liver cancer: Oral contraceptives have been linked to a higher chance of developing benign liver tumors, but these rarely become cancerous. Some studies have suggested that liver cancer risk is higher after using oral contraceptives for at least 5 years, but other studies have not had the same results.
Alternatives to Birth Control Pills
For those who cannot use or do not wish to the birth control pill, other options are available.
This is a barrier method of birth control that prevents sperm from coming into contact with egg cells. Male condoms are sheathes that are placed over the penis. A female condom is a pouch with a ring at each end. It is inserted into the vagina.
Condoms are widely available, but they are often made from latex, which can trigger an allergy in some persons. Alternative materials include polyurethane or lambskin.
This is a shallow, dome-shaped rimmed cup that is placed in the vagina to block the cervix. Used with spermicide, it prevents the sperm and egg from meeting.
Disadvantages include possible urinary tract infection and vaginal irritation. The irritation may stem from a reaction to the material the diaphragm is made from or the spermicide.
Between 6 and 12 pregnancies occur annually in every 100 women who use it, because of human error.
NuvaRing (vaginal ring)
This is a plastic ring that is inserted into the vagina, and it releases hormones to subdue ovulation. It is inserted for 3 weeks every month and removed for 1 week, during which menstruation occurs. These hormones are very similar to the pill, so similar side effects can occur.
Intrauterine devices (IUDs)
IUDs are small device made from plastic and copper. It is inserted into the uterus at the doctor’s office. IUDs can be hormonal or non-hormonal.
Hormonal IUDs thicken the cervical mucus and suppress ovulation. Non-hormonal IUDs produce an inflammatory response in the uterus that is toxic to sperm.
It lasts for up to 10 years and is almost 100 percent effective at preventing pregnancy.
This is a small, plastic rod is implanted into the upper arm during minor surgery. For the next 3 years, it releases a hormone to thicken cervical mucus, thin the endometrial lining and suppress ovulation.
Side effects are similar to those of the birth control pill. They include abdominal pain, back pain, and a higher risk of noncancerous ovarian cysts. Many women report missed periods after several months of use.
This procedure can be performed in both men and women. In men, surgery is performed to block or cut the tubes that transport sperm from the testicles to the penis. In the women, surgery blocks the fallopian tubes.