Combined Oral Contraceptive (COC) and
Progestin-only Oral Contraceptive (POC)

Description

COCs are pills comprised of the hormones estrogen and progestin. POCs are pills that contain only the hormone progestin. Both act to produce changes in the uterus making it inhospitable for implantation of an egg and difficult for sperm to move anywhere in the female reproductive system. Neither pill prevents the spread of STDs/STIs.

Effectiveness

One major attribute of the pill is that it is nearly 100% effective when used correctly. Real effectiveness is actually about 92-95% due to occasional misuse (i.e., forgetting to take it).

Directions

The pill is either administered on a 28-day or 21-day cycle. The 28-day pill is given for each day of the period, 7 of which are really just ‘filler’ pills (placebos) containing no hormones. The purpose of these placebos is to ensure the woman is maintaining the correct schedule of doses. In the 21-day pack, there are 7 days a month in which you do not take a pill and the woman must remember to resume the dose schedule after the 7-day break. If you wish to use the pill as an effective method of birth control then you must make it a part of your daily routine. Please see your physician to find out more on the pill and if it is right for you.

Benefits

There are many pleasant side effects to the pill. Menstruation is usually lighter, shorter and less painful. For most women the menstrual schedule becomes very predictable with menstruation occurring when there is a drop in hormones. It is even possible to change the day your period starts by stopping before the end of a package or adding pills to the end. Please consult your physician before you attempt to change the day your period starts. Studies have shown that those who take the pill have a decreased risk in developing anemia, pelvic inflammatory disease and cancer of the uterus and ovaries. Furthermore, it can help deal with problems such as cysts of the breasts or ovaries, acne, irregular bleeding and endometriosis.

Drawbacks

Consult your physician if you experience any negative side effects while taking the pill. It is important to note that all of the side effects caused by the pill are not yet known.

Short-term effects

Some women find that they experience occasional headaches, mood changes, breast tenderness, fatigue, and breakthrough bleeding in the first few months of using the pill. Spotting or breakthrough bleeding is due to a lack of estrogen in the first half of the cycle and a lack of progesterone in the second half. Bleeding normally stops without the need for treatment. However, if bleeding does continue, your physician will likely recommend that you change to a different brand. If you have been on the pill for several years and experience spotting then see your physician immediately to determine the cause. These effects will usually dissipate after two to three months of using the birth control pill.

Long-term effects

The birth control pill can cause a variety of long-term complications. It is important to identify, with a physician, if you are at risk.

Women who have had a history of circulatory disease should question their doctor about whether they are at serious risk because blood vessel and blood clotting disorders are more common in users of the birth control pill. Specifically, those women taking the pill have a higher risk of developing blood clots in the leg or pelvis, pulmonary embolism and heart attack or stroke.

Those who suffer from migraines should also question the use of the pill. If the migraines worsen during use of the pill, then usage should be discontinued.

The addition of hormones into the body will cause certain tumors to grow faster. Therefore, anyone with a known or suspected cancer should not take the pill. It is important to note that the pill decreases the risk of cancer of the ovaries and the endometrium by half. The effects of the pill on skin cancer and cancer of the cervix are currently unclear.

The addition of extra hormones will also cause an increase in breast size. Those women with benign breast disease (tender or lumpy breasts) may see an improvement in their condition while others may experience no significant change. The pill will also affect the breasts by decreasing the amount of breast milk produced; the quality of the breast milk is not significantly affected. Women who want to take the pill during breast-feeding should consult their doctor.

Women who have had liver damage should not take the pill. The pill causes a small increase in rare tumors of the liver. For diabetic women, the use of the birth control pill may change insulin needs and it may also change the results of the glucose tolerance test.

The pill has been linked to causing depression, irritability and/or tiredness in some women. This problem is usually not recognized until the discontinued use of the pill, when the woman gradually begins to feel better. The pill can adversely affect any of the prescription drugs that you may be required to take, so please consult a physician on the subject. The pill will increase the affect of some drugs (such as alcohol) and decrease the affects of other drugs (such as certain painkillers).

The pill may also cause some unwanted physical changes such as water retention; which in turn can cause bloating, irritability, leg cramps and nausea. If you suspect that this is a problem, you should ask your physician about changing the brand of pill that you use. Some women may have dark rings around their eyes due to the increased estrogen levels. A weaker brand of pill will normally correct these problems. Some women experience weight gain and an increased appetite that can be controlled by switching to a pill with a weaker progesterone level.