10 Benefits Of Combined Oral Contraceptive Pills

Having discussed the various side effects and contraindications of the combined oral contraceptive pills in previous posts, it's time now to say some nice things about combined pills. Read on to know the benefits of the combined oral pills. Details regarding the component, mode of action and dosage of combined oral pills as well as the caution required while using them is discussed in the previous post, Types of oral contraceptive pills-A comparison. 


Benefits Of Combined Oral Pills


1. One of the most effective method of birth control. Failure rate of only 0.1% which is lowest among the contraceptives in use today.


2. With the use of combined pills the menstruation occurs at regular intervals.


3. Bleeding during menstrual periods becomes scanty, thus it is useful for the women having profuse flow during periods.


4. Prevents anemia by reducing the amount of blood flow during menses.


5. Reduced risk of ovarian cancer


6. Reduced risk of endometrial cancer/uterine cancer (endometrium is the inner lining of the uterus or womb)


7. Since the progestogen component of the pill makes the cervical mucus thick and somewhat impermeable to the infective organisms, thus the risk of pelvic inflammatory disease (PID) is reduced. (But not as much as with the use of condom or other barrier methods)


8. Reduced risk of ectopic pregnancy due to suppression of ovulation and lowered chances of PID i.e. pelvic inflammatory disease.


9. Use of combined pills is also said to have a protective action against rheumatoid arthritis.


10. It also reduces the incidence of benign breast diseases.

Read the previous posts:

1. 12 Contraindications To The Use Of Oral Contraceptive Pills

2. 12 Side Effects Of Oral Contraceptive Pills

3. 10 Indications To Stop The Use Of Oral Pills

4. Types Of Oral Contraceptive Pills - A Comparison

Minipill - Benefits Drawbacks and Contraindications

This is in continuation with the previous post - Types Of Oral Contraceptive Pills - A comparison in which we learnt about the three different types of oral pills namely monophasic combined pills, triphasic combined pills and the progestogen only pill or minipill. Let's see what the advantages of minipill over combined pills are, its drawbacks and contraindications.


Advantages of Minipill/POP


1. Since it does not contain the hormone oestrogen therefore the side effects related to oestrogen hormone are not present. Therefore it can be used by the women in whom combined pills are contraindicated. So, it can be used by women having:

• High blood pressure
• Fibroid
• Diabetes
• Epilepsy
• Smoking
• History of thromboembolism (clot formation in a blood vessel)

2. It can be given to the lactating women since it does not suppress milk production. Hence the name given 'Lactation Pill'


Disadvantages of Minipill/POP


Some drawbacks may be associated with the use of Minipill such as:

• Irregular bleeding
• Amenorrhoea or absence of menstruation
• Ectopic pregnancy i.e. when the fertilized ovum in implanted a site other than the uterus.
• Headache
• Increased weight gain
• Failure rate is somewhat higher than combined pills

Contraindications to the use of Minipill

• Previous ectopic pregnancy
• Ovarian cyst
• Breast cancer
• Genital cancers
• Abnormal bleeding from vagina
• Liver disease
• Porphyria i.e a metabolic disorder
• With the use of certain drugs

Also read:


Types Of Oral Contraceptive Pills - A Comparison

Types Of Oral Contraceptive Pills - A Comparison

Hormonal contraceptives are used by many women for birth control. A little awareness about the pills and other methods of contraception helps you select the method or type of pill that suits you the best. Prior knowledge of the side effects and contraindications is also necessary. These have been discussed in previous posts. Today we'll see what the different types of oral contraceptive pills are and compare them.

1. Combined Oral Pills (Monophasic)

These contain a mixture of the two female hormones oestrogen and progesogen. All tablets of the pack contain the two hormones in the same amount.

Dose -

• Starting from the 5th day of the cycle, tablets are taken for 21 days.
• New pack is started after a gap of seven days.
• In some brands you will get a pack of 28 tablets instead of 21 tablets.
• This is because they include iron tablets i.e. the 7 tablets of different colour in the pack.
• This is done in order to make the use of tablets simple for the women.
• Tablets are to be taken at a fixed time of the day, preferably after a meal.

Mode Of Action

• It suppresses the FSH and LH hormones released from the pituitary gland and consequently prevent ovulation.
• Progestogen causes atrophic changes in the inner lining of the womb or uterus and thus prevents implantation.
• Progestogen also makes the cervical mucus thick and therefore impermeable to the sperms.

Faliure rate

Faliure rate is only 0.1% which is lowest among all contraceptives in use today.

Caution required

• During the first cycle, use of an additional method of birth control is advised since ovulation may not be suppressed by then.
• However starting the pill on the first day of the cycle reduces this risk.
• If you forget to take a tablet once, then take two tablets on the next day.
• If you forget to take the tablet twice or more then you are no longer protected and must use a barrier method like condom for that cycle.

Side effects and contraindications

Read the previous posts:

1. 12 Contraindications To The Use Of Oral Contraceptive Pills

2. 12 Side Effects Of Oral Contraceptive Pills

3. 10 Indications To Stop The Use Of Oral Pills

2. Triphasic Combined Pills

Pills contain a combination of oestrogen  and progestogen  in three sets of combination ratio.

• During first six days 30 micro gram oestrogen (EE2 = ethinyloestradiol) + 50 micro gram progestogen (LNG=levonorgestrel)
• Next five days 40 micro gram oestrogen + 75 micro gram progestogen
• Last ten days 30 micro gram oestrogen + 125 micro gram progestogen

Dose -

Same as monophasic combined pills

Failure rate -

These are as effective as the monophasic combined pills.

Advantage over monophasic pills

Triphasic pills do not have a bad effect on the carbohydrate and lipid metabolism like monophasic pills and therefore can be used by the diabetic women.

Disadvantage over monophasic pills

While monophasic pills also control the amount of flow during periods and therefore useful in women with menorrhagia i.e. with excessive bleeding during menses, same is not possible with the triphasic pills.

3. Progestogen-Only Pill (POP)/Minipill

These contain only progestogen and no oestrogen.

Dose -

• Tablet is taken daily without a break.
• Pill should be started within 5 to 7 days of menstruation

Caution required -

• Pill should be taken at a fixed time daily +/- three hours.
• If you forget to take the pill as mentioned above, use additional method like condom for 48 hours and continue taking the pill as before.
• Additional method is also advised in the first 48 hours of the first cycle or pack.

Failure rate -

Failure rate is 2-3% i.e. higher than combined pill.

Advantage over combined pills

Mini pill does not have the side effects related to oestrogen.

I'll discuss more about the advantages, drawbacks and contraindications of minipill in the next post, Minipill - Benefits Drawbacks and Contraindications

Please Note: This post is informative in nature and cannot replace a face to face consultation with your doctor. Therefore, use of any contraceptive with the advice of the gynecologist is recommended.

10 Indications To Stop The Use Of Oral Pills

If you use oral contraceptive pills as a method of birth control, you should be aware of the side effects of the pills, which have been discussed in a previous post - 12 Side Effects Of Oral Contraceptive Pills. This post provides another important information for the pill users. While using pills you should not ignore certain symptoms which indicate the withdrawal of the pills. Read on to find what are these symptoms.


Symptoms Which Indicate Withdrawal Of Oral Pills


#1- Severe migraine i.e. periodic attacks of one sided headache usually associated with digestive disturbances.


#2- Visual disturbances


#3- Sudden pain in the chest


#4- Severe cramps in the legs


#5- Excessive weight gain


#6- Symptoms of depression such as:

• Feeling sad daily
• Loss of interest in all activities
• Lowered appetite
• Sleeplessness or excessive sleepiness
• Suicidal thoughts

#7- Six weeks before surgery in order to minimize the chances of vascular complications after the surgery


#8- Planning pregnancy in near future. Use of pills suppresses ovulation and it may take a few months before you'll be able to conceive after the withdrawal of pills. Return of fertility after pills is discussed in the post - Return Of Fertility After Contraceptives - How Long Does It Take?


#9- Use of pills beyond the age of 35 years should be done under regular medical supervision.


#10- Early symptoms of cervical cancer discussed in detail in the post Early Detection Of Cervical Cancer - Identify The Warning Signs


Also read:


12 Contraindications To The Use Of Oral Contraceptive Pills

See list of all articles on Birth Control

12 Side Effects Of Oral Contraceptive Pills

In previous post I discussed the factors which contraindicate the use of oral contraceptive pills. Today, let's see what are the possible side effects that you may have due to the use of pills. Combined pills contain the two female hormones estrogen and progesterone and prevent pregnancy by suppressing ovulation and producing atrophic changes in the inner lining of the uterus. They also cause thickening of the cervical mucus thus preventing the entry of the sperms. However, these hormones may cause some side effects in your body and it's important that you are aware of these before adopting pills as a method of birth control.


Side effects of combined oral pills


#1- You may have spotting between periods specially in the first three months of pill use.


#2- Amount of flow during periods reduces and bleeding may become very scanty.


#3- You become prone to monilial vaginitis.


#4- Long term use of oral contraceptive pills increases the risk of cervical cancer.


#5- Use of pills in nulliparous women (who have not borne children) less than 24 years of age may increase the risk of breast cancer.


#6- Milk production is suppressed in lactating mothers and therefore use of pills is not recommended while you are breast feeding your baby.


#7- You may have nausea and vomiting


#8- Liver and gall bladder may be affected.


#9- Use of pills may reduce carbohydrate tolerance and therefore contraindicated in diabetic women.


#10- Due to the effect of progestogen, you may have:

• Headache
• Irritability
• Tired feeling
• Increase in weight

#11- Increased risk of thromboembolism due to increase in clotting mechanism of blood.

#12- Oedema and irritation of eyes may occur in women who use contact lenses.

Also read:

12 Contraindications For Oral Contraceptive Pills

See list of all articles on Birth Control

12 Contraindications For Oral Contraceptive Pills

Oral contraceptive pills serve as an effective method of contraception and are used by many women for preventing unwanted pregnancy. However, before selecting pills as a method of birth control you should be aware of the contraindications and side effects of these hormonal contraceptives. In this post I'll discuss the contraindications to the use of oral contraceptive pills.

Combined oral pills are not recommended for you-

#1- If  you have hypertension or you have a tendency for high blood pressure.

#2- If you suffer from heart disease.

#3- If you have diabetes.

#4- If you have suffered in the past from any of these conditions:

• Thrombosis i.e. formation of a blood clot within a blood vessel
• Sickle cell anemia
• Severe migrane

#5- If you suffer from a chronic liver disease.

#6- If you have thyroid disease.

#7- If you have breast cancer.

#8- If you are obese or overweight.

#9- If you are lactating or breastfeeding milk to your baby.

#10- If you are using drugs which induce enzyme production, e.g.

• Rifampicin
• Antiepileptic drugs except sodium valproate

#11- If you are going to have a surgery within 4 to 6 weeks.

#12- If you are more than 45 years of age. You can use pills for several years up to the age of 35 and after that till the age of 45 if you are healthy and do not smoke. However, regular checkups and pap smears are recommended to detect cervical cancer in early stages. 

• Long term use of oral contraceptive pills is one of the risk factors for cervical cancer.

I'll discuss more about the side effects of pills in the next post.

Also read:

10 Contraindications To The Use Of Cu T and Nova T

See list of all articles on Birth Control

10 Contraindications To The Use Of Copper T and Nova T

While selecting a method of contraception which suits you the most, several factors should be considered. One such factor is its contraindications. This post deals with the conditions which contraindicate the use of Copper T and Nova T, commonly used intrauterine contraceptive devices (IUDs) containing copper. This includes Paraguard which is Cu T 380A.  

Copper IUDs are not recommended for you -

#1- If you have become pregnant

#2- If you suffer from abnormal bleeding from vagina e.g. excessive or irregular bleeding.

#3- If you suffer from lower genital tract infection or pelvic inflammatory disease (PID) now or in the past.

#4- If bearing child in future is absolutely necessary for you.

#5- If any of your previous pregnancies was abnormally located i.e. ectopic pregnancy where the fertilized ovum is implanted at a site other than the uterus.

#6- If you suffer from moderate to severe pain during your menstrual periods.

#7- If you have fibroids in the uterus.

#8- If you have iron deficiency anemia.

#9- If you suffer from heart disease.

#10- If you are a patient of Wilson's disease. It is a hereditary disorder in which increased intestinal absorption of copper results in accumulation of copper in various organs like brain, liver, kidney and cornea.

 Also read-

Return of fertility after contraceptives - How long does it take

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Return Of Fertility After Contraceptives - How Long Does It Take?

If you want to adopt a temporary method of birth control, so that you may plan pregnancy in future, read this very carefully. Fertility does not return immediately after discontinuation of every contraceptive. It's important for you to know about the time interval after which fertility returns on stopping the use of a particular contraceptive, before selecting it as a method of birth control.

1. The Barrier Methods

These methods include the mechanical devices or chemical agents, which prevent the entry of sperms in the uterus. Popular barrier methods of contraception are:

• Male Condom
• Female Condom (Fem Shield)
• Diaphragm
•  Vaginal Contraceptive Sponge (Today)

Return of fertility after withdrawal

Fertility returns immediately after stopping the use of barrier methods.

2. Oral Contraceptive Pills

These are steroidal contraceptives, which prevent pregnancy in the following ways:

• Inhibit ovulation
• Cause regression of the endometrial glands
• Make the cervical mucus thick and scanty, so that sperms cannot penetrate
• Alters fallopian tube's motility

Return of fertility after withdrawal

Usually, fertility returns within 3 months after stopping the pills. However, in some women, it may take as long as 6 months or more.

3. Depot Injections

These are injectable steroids, which prevent pregnancy in the same way as the oral contraceptive pills. Commonly used preparations include:

• DMPA (Depo Provera)
• NETO

Intramuscular injections of depo provera are given in a dose of 150 mg every three months or 300 mg every six months; NETO is given in a dose of 200 mg, at two months interval.

Return of fertility after withdrawal

Most women are able to conceive within one year, after stopping the use of depo provera. However, with NETO, fertility returns earlier.

4. Intra Uterine Contraceptive Device (I.U.D)

Intra uterine contraceptive devices prevent pregnancy by producing biochemical changes and inflammatory reaction in the uterine cavity. Commonly used I.U.D include:

• Cu T 200
• Cu T 380A
• Multiload 250
• Multiload 375
• Progestasert
• LNG-IUS

Return of fertility after withdrawal

Fertility returns immediately after removal of Intrauterine Contraceptive Devices.

Conclusion

Before adopting any method of birth control, you should know about the time interval after which pregnancy is possible on its withdrawal. Fertility returns soon after the withdrawal of barrier methods of contraception and intrauterine contraceptive devices. However, steroidal contraceptives, like oral pills and depot injections may delay fertility for three to twelve months.

Please Note: It's always better to consult your doctor before adopting any method of contraception and ask about their side effects too.

Also read:

5 Ways To Avoid Pregnancy Naturally

5 Ways To Avoid Pregnancy Naturally

A woman is fertile only for a few days in a month. Correct knowledge of this 'fertile period' and abstinence during this phase will serve as a natural method of birth control or contraception. Here are five most effective ways to prevent pregnancy naturally by predicting those few days of a woman's menstrual cycle when there is a risk of getting pregnant.

1. The Calendar Method

Any woman having a regular menstrual cycle can rely on this method to predict her 'fertile period'. First and last day of the 'fertile period' or 'risk period' is calculated by using this simple formula:

• First day of the 'fertile period' = Shortest cycle - 20 

• Last day of the 'fertile period' = Longest cycle - 10

Example: A woman having a regular 28 to 30 days cycle

• First day of her 'fertile period' = Shortest cycle - 20 = 28 - 20 = 8th day of her cycle

• Last day of her 'fertile period' = Longest cycle - 10 = 30 - 10 = 20th day of her cycle 

For achieving birth control without using mechanical means, she will have to abstain from 8th to 20th day of her cycle.

[PS: First day of the cycle = First day of the menstrual period, that is, the day when the period starts.]

2. The Temperature Method

• To predict the 'fertile period' by using this method a woman is required to measure the vaginal temperature daily, on awakening in the morning, before she starts any physical activity. 

• An abrupt rise of about 0.3 to 0.4 Degree Celsius will be noticed after the day of ovulation and the temperature remains at this level for the rest of the cycle. 

• Abstinence is required until the third day of the rise of temperature.

• However, it is more effective when used in combination with the calendar method.

3. Combined Temperature and Calendar Method

• This method is more effective than the calendar or temperature method used alone. 

• In this method the first day of the 'fertile period' is determined using the calendar method and the last day is predicted using the temperature method.

4. The Cervical Mucus (Billings) Method

• To predict the 'fertile period' using this method, a woman is required to observe the consistency of the cervical mucus daily. 

• Mucus is detected several days before ovulation and then it gradually increases in quantity and becomes more thin and slippery until a 'peak' is reached, at about the time of ovulation. 

• After that mucus becomes scanty, thicker and opaque. Abstinence is required since the day mucus is detected until fourth day after the 'peak day'.

• This method is as effective as the combined temperature and calendar method.

5. Combined Mucus, Temperature and Calendar Method

• Most effective and reliable natural birth control method is the combined mucus, temperature and calendar method. 

• The first day of abstinence is determined using the calendar method or the first day the mucus is detected, whichever comes first. 

• The last day is predicted using the temperature method.

Conclusion

Abstinence during the 'fertile period' can be safely used as the natural method of birth control by women having menstrual cycles at regular intervals. Period of abstinence can be predicted using either the calendar, temperature or the cervical mucus method. However, most effective is the joint method, in which first day is predicted either by using calendar or the mucus method and the last day is predicted using the temperature method.

Please Note: Though these methods are safe if used properly, but in case pregnancy occurs, there is a risk of congenital abnormality of the baby, because of the union of aging sperm and ovum.


Also read:
Return Of Fertility After Contraceptives - How Long Does It Take?
How To Know If You Are Pregnant? - 5 Early Signs
How And When To Do Pregnancy Test At Home

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