Contraceptive pill
DEFINITION
The Pill is the common name given to the oral contraceptive
pill.
pill.
DESCRIPTION
There are two main types of oral contraceptive pills: the
combined pill and the progestogen-only pill. The Pill consists of a
combination of hormonal drugs which help to prevent pregnancy.
There are many brands of Pill available and many different
formulae.
combined pill and the progestogen-only pill. The Pill consists of a
combination of hormonal drugs which help to prevent pregnancy.
There are many brands of Pill available and many different
formulae.
The combined oral contraceptive (COC) contains two hormones,
oestrogen and progestogen. There are combined Pills which provide a
constant daily dose of hormones (monophasic) or two (biphasic) or
three (triphasic) varied doses over the menstrual cycle. In these
types of Pill, the amount of oestrogen and progestogen is gradually
increased over 21 days.
oestrogen and progestogen. There are combined Pills which provide a
constant daily dose of hormones (monophasic) or two (biphasic) or
three (triphasic) varied doses over the menstrual cycle. In these
types of Pill, the amount of oestrogen and progestogen is gradually
increased over 21 days.
The COCs are taken every day for three weeks with no active
tablets taken in the fourth week. The menstrual period should occur
between 2 and 5 days after each course of 21 active pills has been
finished. Some women may not have a period at all while on the
Pill. This does not mean that they are at an increased risk of
becoming pregnant. Packs containing either 21 or 28 tablets of COCs
are available. Both contain 21 hormone pills but the 28-day pack
also contains 7 inactive sugar pills which help to maintain the
daily routine of taking one tablet per day.
tablets taken in the fourth week. The menstrual period should occur
between 2 and 5 days after each course of 21 active pills has been
finished. Some women may not have a period at all while on the
Pill. This does not mean that they are at an increased risk of
becoming pregnant. Packs containing either 21 or 28 tablets of COCs
are available. Both contain 21 hormone pills but the 28-day pack
also contains 7 inactive sugar pills which help to maintain the
daily routine of taking one tablet per day.
The progestogen-only Pill provides a small, daily dose of
synthetic progestogen. This Pill (referred to as the minipill) is
usually prescribed for women who are breastfeeding, for non-insulin
dependent diabetics, migraine sufferers, heavy smokers more than 35
years of age, those with poor circulation and those who suffer from
oestrogen side effects.
synthetic progestogen. This Pill (referred to as the minipill) is
usually prescribed for women who are breastfeeding, for non-insulin
dependent diabetics, migraine sufferers, heavy smokers more than 35
years of age, those with poor circulation and those who suffer from
oestrogen side effects.
The Pill needs to be taken at a regular time each day to ensure
effective protection. If a Pill is missed or is taken more than 3
hours late the missed Pill must be taken immediately and the next
one must be taken at the usual time. If vomiting or severe
diarrhoea occurs within 3 hours of taking the Pill another one will
need to be taken. If either of these disturbances occur, it is a
good idea to use another method of contraception for the next two
days e.g., condoms, as an added precaution. The Pill should be
taken at the same time each day. If a woman is 24 hours late taking
the Pill, two Pills should be taken together and extra
contraception (such as condoms) used for seven days. If there are
fewer than seven active pills left, the next pack of active pills
should be started immediately without the usual 7 day
break.
effective protection. If a Pill is missed or is taken more than 3
hours late the missed Pill must be taken immediately and the next
one must be taken at the usual time. If vomiting or severe
diarrhoea occurs within 3 hours of taking the Pill another one will
need to be taken. If either of these disturbances occur, it is a
good idea to use another method of contraception for the next two
days e.g., condoms, as an added precaution. The Pill should be
taken at the same time each day. If a woman is 24 hours late taking
the Pill, two Pills should be taken together and extra
contraception (such as condoms) used for seven days. If there are
fewer than seven active pills left, the next pack of active pills
should be started immediately without the usual 7 day
break.
Full contraceptive protection cannot be guaranteed if a dose
is missed for more than 12 hours after the regular dose time e.g.,
if the Pill is usually taken in the morning, this would give a
woman 12 waking hours to remember to take her dose. If the Pill is
usually taken at night and a woman forgets to take The Pill, then,
assuming she has slept for eight hours, she only has four waking
hours to remember to take her dose.
is missed for more than 12 hours after the regular dose time e.g.,
if the Pill is usually taken in the morning, this would give a
woman 12 waking hours to remember to take her dose. If the Pill is
usually taken at night and a woman forgets to take The Pill, then,
assuming she has slept for eight hours, she only has four waking
hours to remember to take her dose.
If more than twelve hours have passed since the dose was
missed other forms of contraception e.g., condoms and spermicidal
jellies should be used until another 7 active tablets have been
taken. Do this even if this means using other forms of
contraception for an additional 7 days while the inactive pills are
finished and seven active tablets have been taken from the new
pack.
missed other forms of contraception e.g., condoms and spermicidal
jellies should be used until another 7 active tablets have been
taken. Do this even if this means using other forms of
contraception for an additional 7 days while the inactive pills are
finished and seven active tablets have been taken from the new
pack.
TREATMENT OPTIONS
Your Doctor is the only person to prescribe the Pill. Your
Doctor may give you a physical examination that will include a
breast examination and pap smear before prescribing the Pill. Your
Doctor will be able to answer any queries you may have about the
Pill and possible alternatives. Contact a Doctor if any of the
following is experienced: sudden, severe chest pain or headache,
sudden loss of vision or blurred vision, swelling of one leg or
severe pain in the calf. These symptoms may indicate that a blood
clot has become lodged in a blood vessel which could result in a
medical emergency. See the Blood Clots topic.
Doctor may give you a physical examination that will include a
breast examination and pap smear before prescribing the Pill. Your
Doctor will be able to answer any queries you may have about the
Pill and possible alternatives. Contact a Doctor if any of the
following is experienced: sudden, severe chest pain or headache,
sudden loss of vision or blurred vision, swelling of one leg or
severe pain in the calf. These symptoms may indicate that a blood
clot has become lodged in a blood vessel which could result in a
medical emergency. See the Blood Clots topic.
DIET HINTS
- Taking the Pill may increase the body’s requirements for
vitamin A, vitamin C and vitamins B6 and B12. Most fruits and
vegetables are high in these vitamins, especially those which are
orange, yellow and dark green in colour. Dairy products are rich in
vitamin B12 as are organ meats e.g., liver and kidneys, which are
also good sources of vitamin B6. - The body’s ability to properly absorb and use folic acid may
also be reduced by taking the Pill. Dark green leafy vegetables
e.g., spinach, root vegetables, brown rice, salmon and brewers’
yeast are rich in folic acid and should be included regularly in
the diet.
INTERACTIONS
- The oral contraceptive pill may react with certain antibiotics
therefore it is important to inform your medical practitioner if
taking the pill when prescribed a course of antibiotics. - Some antibiotics interfere with liver enzymes which then
increase the rate of metabolism of both oestrogen and
norethisterone, thus lowering circulating concentrations of active
hormones. - Griseofulvin, an anti fungal agent, also has the ability to
interact with antibiotics through liver activity. Check with your
Pharmacist or medical practitioner. - Some anti-epileptic medications can reduce effectiveness of
hormones through increased liver activity.
The following herbal medicines may interfere with the oral
contraceptive pill:
contraceptive pill:
- Vitex agnus-castus (chaste tree) should not be taken with the
pill or hormone replacement therapy. - Liquorice combined with the Pill increases risks of
hypertension, fluid retention and potassium loss. - St. John’s Wort may lead to break-through bleeding.
- Dong Quai may lead to oestrogen excess.
- Vitamin C may increase the amount of circulating oestrogen in
women who are taking the two concurrently. This actually increases
the effectiveness of the Pill in preventing conception. Problems
may arise, however, when very large doses of Vitamin C are stopped
suddenly and circulating oestrogen levels also drop. This can be
avoided by gradually tapering the dosage of Vitamin C down over
several days.
VITAMINS/MINERALS/HERBS
- Vitamin E may reduce side effects of progesterone (e.g.
breakthrough bleeding). - As the Pill is metabolised by the liver, liver support
supplements such as milk thistle may be beneficial. - Ginseng may be used to reduce fluid retention and improve
general well-being.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints.
- Let your Doctor know if any side effects occur. If you are
suffering from excess bleeding or nausea it is advisable to see a
Doctor immediately. You may be allergic to the ingredients in the
Pill and your Doctor may need to prescribe a different type. If you
have any queries about the medication, ask your Pharmacist. - Ask your Pharmacist about any special instructions with regard
to the brand of Pill you have been prescribed. Remember, the Pill
must be taken every day and preferably at the same time each
day.