Question

Oral Pills As Contraception - Myths & Facts!

Dr.Hema Jajoo · Accepted Answer

Oral contraceptives (the pill) are hormonal pills which are usually taken by women on a daily basis for contraception. They contain either two hormones combined (progestogen and estrogen) or a single hormone (progestogen).

When to start? - Usually from 1st or 5th day of menses.

How to take Pills? - Needs to be taken for 21 to 24 days in a month with 4 to 7 days pill-free period. It has to be taken daily at the same time each day preferably at night. If one pill is missed then it should be taken as soon as one remembers and the next pill should be taken at the scheduled time. If one misses two pills consecutively then there is a possibility of breakthrough bleeding in between and one should use other methods like condoms to prevent pregnancy in that particular month.

How do Pills act? - By suppressing ovulation (prevents the release of the egg which normally occurs every month), thickening of cervical mucus and blocking sperm penetration. Effectiveness of Pills - 92 to 99 %

USES - Mainly for contraception.

Other uses -

1. Regularizing periods
2. In painful periods
3. In heavy menstrual periods
4. In PCOD & Endometriosis
5. In Premenstrual syndrome (PMS) etc.

Common side effects

1. Nausea; Usually, it disappears after a few days.

2. Headache

3. Breast pain and heaviness

4. Breakthrough bleeding

5. Weight gain in some cases. But nowadays pills are available which does not increase weight.

6. Very rarely, it can lead to serious health risks (e.g. blood clots, heart attack, and stroke).

Risks are higher for women over 35 years who smoke. Nowadays as we are using very low dose pills this risk has become very negligible. Again the risk is much less as compared to the complications which can occur during pregnancy and after delivery.

Long-term non-contraceptive health benefits of using pills :

1. Protect against cancer of the lining of the uterus (endometrial cancer)
2. Protect against cancer of the ovaries
3. Protect against symptomatic pelvic inflammatory disease
4. Protect against ovarian cysts
5. Protect against iron-deficiency anaemia
6. Reduce menstrual cramps
7. Reduce menstrual bleeding problems
8. Reduce excess hair on face or body
9. Reduce symptoms of polycystic ovarian syndrome
10. Reduce symptoms of endometriosis

A word of caution - The pill does NOT protect against sexually transmitted infections (STIs, including HIV). To protect against STIs, a male or female condom must be used.

Myths and facts about OCPs -

Myth: Cancer- Pills cause cancers such as breast cancer, uterine cancer, and ovarian cancer.
Fact: The use of pills is proven to decrease the risk of two gynaecological cancers (ovarian and endometrial ie uterine).

Myth: Pills use lead to the general ill-health of women.
Fact: A woman may experience short term side effects associated with the use of pills, including changes in bleeding patterns, headaches, and nausea. However such side effects are not a sign of illness, and usually, stop within the first few months of using pills. For a woman whose side-effects persist, different pill formulations can be tried. In women who are otherwise well, pill use may be continued for many years as there are no adverse effects related to long-term use. In fact, there are also long-term non-contraceptive health benefits of using pills as described above.

Myth: Infertility/Return to Fertility: Using pills will cause a long delay in conceiving or prevent them from being able to have children in the future.
Fact: Pills does not cause infertility. There is no evidence that pills delay a woman's return to fertility after she stops taking them. Women who stop using pills can become pregnant as quickly as women who stop using nonhormonal methods.

Myth: Pill Absorption: Belief that pills accumulates in the body and cause diseases and tumours, or get stored in the stomach, ovaries, or uterus and form stones.
Fact: After the pills are swallowed, they dissolve in the digestive system, and the hormones they contain are absorbed into the bloodstream. After they produce their contraceptive effect, the hormones are metabolised in the liver and gut and are then eliminated from the body. They do not accumulate in the body anywhere.

Myth: Promiscuity: Pill encourages infidelity, promiscuity, or prostitution in women.
Fact: There is no evidence that pills affect women s sexual behaviour. The evidence on contraception in general shows that sexual behaviour is unrelated to contraceptive use. In fact, using contraception shows responsible behaviour in order to avoid unintended pregnancy.

Myth: Sexual Desire and Sexual Pleasure: Pill reduces sexual pleasure or interest in sex (loss of libido) or that they cause frigidity in women.
Fact: There is no evidence that pills affect a woman's sex drive.

Myth: Weight Changes: Pills cause women to gain or lose weight.
Fact: Most women do not gain or lose weight as a result of pill use. A woman's weight may fluctuate naturally due to changes in age or life circumstance. Because changes in weight are common, many women attribute their natural weight gain or loss to the use of pills. Although a very small number of pill users may report weight change, studies have found that, on average, pills do not affect weight. A few women experience sudden changes in weight when using pills. These changes reverse after they stop taking pills.

Myth: Body needs a break from OCPs at least once a year.
Fact: On the contrary, it may increase the risk of unwanted pregnancy.

Myth: There is no need to take the pill at the same time daily.
Fact: The pill has to be taken at the same time daily for:

Maximum effectiveness
Decrease the chances of side effects e.g. bleeding between periods
Myth: In the case of bleeding/spotting between periods, one must stop using the pill.
Fact: This is temporary and no cause to worry and one should not stop using the pill.

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