Contraceptive Pill

About Oral contraception

Oral contraception, also known as ‘the pill’ is a tablet taken by women to prevent pregnancy. There are many different types of the pill, which use synthetic hormones, such as oestrogen and progesterone to prevent pregnancy. This can be in 1 of 3 ways:

• ✅ They stop ovulation, so an egg is not released from the ovaries
• ✅ They thicken a woman’s cervical mucus, making it harder for the sperm to reach the egg
• ✅ They make a woman's womb inhospitable to stop a fertilised egg from attaching to the lining of the uterus.

What is a Contraceptive pill?

A contraception pill is a hormonal birth control method that changes your menstrual cycle. There are 2 types of contraception pills; Combined pills and progestogen-only pills.

Combined pill

Combination birth control pills, such as Yasmin, Logynon, Marvelon, and Microgynon, contain synthetic versions of two female hormones: estrogen and progestogen (a synthetic form of progesterone).

These oral contraceptives are formulated to mimic the hormonal changes that occur during the menstrual cycle. They prevent pregnancy by inhibiting ovulation, thickening cervical mucus to hinder sperm movement, and thinning the uterine lining.

Regular monitoring of blood pressure and BMI is advised for those taking these pills to manage potential risks and ensure their effectiveness.

Benefits of combination birth control pills:

• ✅ Highly effective: When taken correctly, combination pills are over 99% effective at preventing pregnancy
• ✅ Reversible: You can stop taking the pills at any time and your fertility will return to normal, But this can take time.
• ✅ More benefits: Combination pills can also regulate your periods, reduce period pain, improve acne, and protect against ovarian and endometrial cancer.

How combined pill works?

Combined pill works by preventing pregnancy. The pill prevents pregnancy in 3 ways;

1. Thinning of the womb to prevent implantation of the fertilized egg in the womb
2. Thickening the mucus in the womb prevents the sperm from penetrating the womb and reaching the egg
3. It prevents ovulation from taking place. Ovulation is the release of an egg every month

Types of combined pill

• Monophasic 21-day pills: Monophasic is the most common type of combined pill. It is taken for 21 consecutive days and next, no pills should be taken for 7 days. The pills in the pack contain similar types of hormones. Examples of monophasic 21-day pills include Yasmin,marvelon, and Microgynon.
• Phasic 21-day pills: The pill is divided into 2 or 3 sections and each section contains a different hormone. The pills should be taken for 21 days consecutively and afterward, you are expected to take a 7-day rest without taking any pill. An example of a phasic pill is Logynon.
• EveryDay pills: This type of combined pill contains 21 active pills and 7 inactive pills. You should take the pills for 28  days consecutively as instructed by your pharmacist, doctor, or nurse. An example of an everyday pill is Microgynon ED.

How you take it?

To take combined contraceptive pills, you typically have several options:

Standard 21-Day Regimen:

• Take one pill every day for 21 days.
• Then, have a pill-free break of 4 or 7 days.
• During the pill-free week, you usually experience a withdrawal bleed or 'period'.

Extended Regimen:

• Take one pill every day for 9 weeks (63 days).
• Followed by a 4 or 7-day break.
• This option allows for fewer withdrawal bleeds or periods.

Continuous Use:

• Take one pill every day continuously, without breaks.
• This option eliminates withdrawal bleeds altogether.

Flexible Use:

• Take the pill every day for at least 21 days.
• Followed by a 4 or 7-day break.
• If you experience heavy bleeding, painful periods, headaches, or mood swings during the break, you can skip it.

Who can use the combined pill?

It's important to talk to a pharmacist first before taking a combined pill. Below is a group of people who should not take the combined pill.

• Pregnant women 
• People prescribed to take specific medicines 
• Overweight individuals 
• Individuals who smoke and are 35 years and above 
• Individuals who stopped smoking 1 year ago and are 35 years and above.

The combined pill should also not be taken by people with the following medical conditions.

• Heart disease and high blood pressure 
• Stroke 
• Diabetes 
• Gallbladder or liver disease
• Migraines 
• Breast cancer 
• Blood clots in the veins or family history of members who have had a blood clot under 45 years.

Low-dose combined

Low-dose combined pills, like Gedarel, contain both progestogen and estrogen, but with lower levels of estrogen compared to regular combined pills. This reduction in estrogen can lead to a decrease in some side effects.

How to take most low-dose combined pills?

With most low-dose combined pills, you take one pill daily for 21 days, followed by a pill-free break of 4 or 7 days. During this break, you typically experience a withdrawal bleed or 'period'. If you experience heavy or painful bleeding, headaches, or mood swings on pill-free days, you have the option to skip the break.

Possible side effects of low-dose pills

With low-dose pills like the mini pill, you might experience irregular bleeding and a rise in blood pressure. Before starting, check your blood pressure at home or in a pharmacy. Have it checked yearly while taking the pill.

The mini pill (progestogen-only pill or POP)

The mini pill, also known as the progestogen-only pill or POP, such as Cerazette and Cerelle (or the generic version Desogestrel), contains only the hormone progestogen. It can be a suitable option for individuals who:

• Cannot take the combined pill
• Are overweight
• Have a history of blood clots
• Have high blood pressure

How to take Mini-Pill

To take the mini pill, you consume one pill daily at the same time each day. Unlike combined pills, there is no pill-free break. Consistency in timing is crucial for its effectiveness.

Possible side effects of mini pills

The most common side effect of the mini pill is irregular bleeding, which often improves within three months of starting the pill. Unlike combined pills, there's no requirement for blood pressure or BMI checks with the mini pill.

Contraceptive patch and vaginal ring

Both the contraceptive patch and vaginal ring contain synthetic versions of the hormones progestogen and estrogen, similar to the combined pill. However, they deliver these hormones into the body through different methods.

Contraceptive Patch (Evra):

• Wear the patch on clean, dry skin anywhere on your body.
• Change it once a week, replacing it with a new patch.
• Typically, use the patch for 21 days, followed by a 4- or 7-day break for withdrawal bleeding.

Vaginal Ring (NuvaRing):

• Self-insert the ring into your vagina, which is easy to do
• Change the ring every 3 weeks, on the same day and time.
• Similarly, use the ring for 21 days, followed by a 4- or 7-day break for withdrawal bleeding.

Both methods also offer alternative usage options:

• Use for 9 weeks followed by a 4- or 7-day break.
• Use continuously, without any breaks.

It's essential to follow the instructions provided with each method and consult a healthcare provider for personalized guidance.

How reliable are the vaginal ring and contraceptive patch?

The contraceptive patch and vaginal ring are highly reliable when used correctly, with a 99% effectiveness rate. Unlike pills, they are not affected by stomach upsets, and you don't need to remember to take a pill daily.

However, there is a small risk of the patch becoming unstuck or the ring becoming dislodged. Regular checks are recommended, and if either happens, replacing it promptly should maintain protection.

Possible side effects

As for side effects, most people do not experience any. However, common side effects may include headaches, skin irritation, nausea, and tender breasts.

Additionally, there is a slightly higher risk of blood clots associated with the use of these methods. It's essential to be aware of these potential side effects and consult a healthcare provider if any concerns arise.

There are 5 types of oral contraception:

Monophasic 21-day contraceptive pills - They contain oestrogen and progesterone. They are taken for 21 days followed by a 7 day break, then the cycle starts again.

Monophasic 28-day preparations - They contain oestrogen and progesterone. They are taken continuously. The first 21 days will be an ‘active’ pill, and the last 7 days are ‘inactive’ pills. You will take tablets for 28 days, then you should start a new pack for another 28 days.

Phasic 21 day preparations - They contain oestrogen and progesterone. They are taken for 21 days followed by a 7 day break, then the cycle starts again. These contain different levels of each hormone depending on which day's pill you are taking.

Phasic 28-day preparations - They contain oestrogen and progesterone. They are taken continuously. The first 21 days will be an ‘active’ pill, and the last 7 days are ‘inactive’ pills. You will take tablets for 28 days, then you should start a new pack for another 28 days.These contain different levels of each hormone depending on which day's pill you are taking.

Progesterone-only pill - They contain progesterone only. These pills must be taken continuously everyday at the same time within a 3 hour window each day. Each pack contains 28 tablets, and each new pack should be taken back to back.

Choosing the best contraceptive pill

Oral contraception is prescribed by your doctor. Deciding on which contraceptive pill you should take should be a joint decision between you and your doctor.

You should disclose your full medical history to ensure that you get a suitable pill. Different contraceptive pills are suitable for different situations, so you should never start taking a contraceptive pill without the advice of your doctor.

Contraceptive pill general information

Oral contraceptive pills are normally taken once daily at the same time each day. For the pill to have maximum effect, it must be taken at the same time each day.

This is particularly important for certain contraceptive pills, which must be taken in a 3 hour window for them to be effective at all.

Most contraceptive pills involve a 21 day period of taking the pill, followed by a 7 day break. Whereas others are taken continuously.

You should never take a contraceptive pill that has not been prescribed for you by your doctor, and you must have a pill review at least once a year, which includes a blood pressure test.

Here at Ashcroft Pharmacy, we are able to supply repeat oral contraception to women that have had the same contraception previously prescribed for them.

Alternative medication

There are many different types of contraception available other than the contraceptive pill. These include:

• The implant
• A progesterone only injection
• Contraceptive patches
• Inter-uterine Devices (IUD)
• Vaginal rings
• Condoms
• Dams
• Caps

Side effects of oral contraception

Side effects can often occur with oral contraception, but most of the time these effects are mild and go away with continued use of the pill. Common side effects include:

• Nausea
• Weight gain
• Sore, swollen breasts
• Spotting between periods

With more severe side effects, you should stop taking the pill and consult your doctor. These include:

• Abdominal pain
• Severe headaches
• Blurry vision
• Swelling or aching in the legs