If you are thinking about birth control, the chances are good that you or your significant other will choose the birth control pill (also called OCP, for oral contraceptive pill) for pregnancy prevention, since it's the most frequently used form of reversible contraception in the United States. Indeed, more than 80 percent of American women use "the Pill" at one time or another in their lives. Today, approximately 26 percent of U.S. couples are using the Pill to help prevent an unintended pregnancy. The high popularity of the birth control pill continues despite the many myths allowed to circulate about this excellent contraceptive choice.
Is the Pill Safe?
OCPs are an extremely safe form of contraception. It is estimated that women who become pregnant will have more complications from the pregnancy compared to someone on the Pill. One estimate says that for every 100,000 women who carry a full-term pregnancy, 10 will die from the pregnancy, whereas two deaths might be attributable to the Pill. Put another way, Pill use decreases a sexually active fertile woman's chance of death fivefold compared to pregnancy. Interestingly, a woman who smokes has a 250 times greater chance of death from the negative cardiovascular effects resulting from cigarette smoking, and an eightfold greater risk of death by auto accident, than by Pill use. Most women who hear that OCP use is life-saving are astounded that these facts are not widely publicized.
Benefits
Women who use OCPs, when compared to their non-pill counterparts, have fewer occurrences of acne, cystic breasts, ovarian cysts, painful periods, lower occurrences of anemia, pelvic inflammatory disease, ectopic pregnancy, and osteoporosis.
The most controversial topic that concerns women is whether long-term use of hormones can cause cancer of the breast and uterus. The best evidence to date suggests that the Pill has been strongly associated with a decreased risk of cancers of the ovary and uterus. Cervical cancer is not increased in Pill users although some rare forms of endocervical cancer have been found to be more common. Breast cancer seems to be detected more often in women younger than the age of 35 years during the first five years of Pill use. Experts attribute this fact to Pill users having more frequent physical exams by their healthcare providers. The breast cancers found in these women were also easier to cure, due to their local occurrence and tendency not to spread. This fact is also consistent with no overall greater lifetime risk of breast cancers among Pill users.
Numerous studies have also confirmed that no overall risk of heart attack (myocardial infarction) or stroke is increased in OCP users -- unless they are smokers. Pill users occasionally experience higher rates of blood clots (thrombophlebitis), though pregnant women usually get them at a higher rate. The annual risk of blood clotting will be 50 percent lower in OCP users than in the pregnant patient who carries to term. Still, if you have a history of blood clots, you should not use OCPs.
Who Should Take the Pill?
The ideal candidate is any healthy, sexually active female-there is no age limit for Pill use. Currently available OCPs contain lower doses of the hormone estrogen compared with previous OCP formulations. If you are interested in reversible contraception and are willing to take a pill daily, then the birth control pill may be the ideal choice.
There are few women who would not be considered good candidates for the Pill. Patients who should not use combination pills under any condition are smokers older than the age of 35, those with a history of spontaneous estrogen-induced blood clotting, those with an estrogen-dependent malignancy, and those who are already pregnant.
Medical Conditions
Women with certain medical conditions may still be acceptable candidates for this form of contraception, since an unintended pregnancy often leads to a worsening of chronic diseases. Low-dose combination OCPs can be safely used if you have either diabetes or hypertension (high blood pressure), as long as you are willing to be monitored by your doctor and take the medications he/she has prescribed.
Women who are not allowed to take estrogen for medical reasons, or experience estrogen-induced headaches or severe breast tenderness, should not take the regular Pill, as estrogen is a main constituent present in combination OCPs. These women may elect to use mini-pills, which contain only progesterone.
Side Effects
Although not life-threatening in nature, the annoyances of breakthrough vaginal or menstrual bleeding, nausea, breast tenderness, and bloating can have a dramatic impact on how you feel about taking the Pill.
Weight gain is the number one concern expressed by patients. Some newer Pills studied do not cause significant weight gain in the first year of use. Some women have attributed weight gain to feeling hungrier and eating more while using the Pill. Raise your awareness to help avoid the temptation to eat more by teaching yourself to count calories. A consultation with a nutritionist and exercise trainer can help modify eating behaviors.
Unexpected breakthrough bleeding may occur in the first three months of Pill usage as your endocrine or hormone system adjusts to the circulation of Pill hormones, which signal the ovaries to halt ovulation for that cycle. Taking your Pill consistently at the same time each day eliminates this unexpected menstrual bleeding. If you choose ultra-low-dose Pills, you must try to take them at the same hour each day or you may experience light spotting, and may require the use of a panty liner.
Nausea and breast tenderness are caused by estrogens found in the Pill. Nausea is avoided by taking the Pill on a full stomach. Breast tenderness is usually decreased after two or three months, but if it persists, it can usually be eliminated by switching to a lower estrogen formulation.
Bloating is limited to the second half of the cycle and can be controlled, as you would with a natural menstrual cycle, by avoiding salty foods and keeping well-hydrated.
If you experience any of the above-mentioned minor side effects for more than three months, there are almost 100 other Pill formulations to consider.
Patients' Frequently Asked Questions
What day of the week should I start?
The best day to begin Pill use is the first Sunday after your last regular menstrual cycle. It is easier to track missed pills and ensures that most of the menstrual flow will stop before the weekend. You can also start the Pill on the first day of your normal menstrual cycle, but this will lead to more weekend flows and is less convenient for some.
When will it start protecting me from pregnancy?
Within the first week, if taken as directed after the last regular menses. Always use condoms during the first week.
What if I miss my Pill?
If you forget to take the Pill for one day, simply "double up" by taking two pills the next day. Be sure to take them on a full stomach, preferably several hours apart to prevent nausea and/or vomiting. If you have sex, use a condom as backup. The next day, resume taking your Pill on a daily basis. It is a good idea to continue using condoms until you have consistently used the Pill for one week. If you forget two days worth of Pills it is best to use a backup method such as condoms and start a new Pill pack to avoid confusion. Ask your healthcare provider for advice on this point, and keep using condoms as a backup for two weeks.
What is the lowest level of estrogen available?
Low-dose oral contraceptive pills generally contain 30 or 35 micrograms of estrogen, while those considered to be ultra-low-dose contain 20 micrograms of estrogen or less.
At what age must I stop using the Pill?
Due to the many health benefits and minimal serious side effects resulting from Pill use, nonsmokers who are older than 35 are allowed to use the Pill until menopause, which occurs around age 51. There is no limit to the number of years you can use the Pill. I have met many women who were told to stop using the Pill, without any good reason, as a sort of "Pill rest," who ended up becoming unintentionally pregnant.
If you forget to take the Pill for one day, simply "double up" by taking two pills the next day.
Not necessarily. Sometimes that's not healthy to do, but I'd have to get the information from my room before clarifying more.
Did you get this from somewhere, because it seems like something from a website, rather than something you simply typed up yourself.
~C
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