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Oral Contraceptives Pills (Birth Control Pill)

What are oral contraceptives or the birth control pill?

Medicine contains hormones that can prevent pregnancy.

  • Combined oral contraceptive pills which contain two female sex hormones, oestrogen and progestogen.
  • Progestogen-only pills which contain only one type of female sex hormone, progestogen.

How does the pill work?

  • Works mainly by changing the body’s hormone balance by inhibiting the release of egg by stopping it maturing
  • Preventing the sperm reaching the egg
  • Changing the lining of the uterus and making it less suitable for implantation.

What are the advantage of the pill?

  • Reliable method of contrecption, failure rate 1% if use correctly.
  • Reversible birth control method. Easy to discontinue use when planning a pregnancy, enabling women to control their reproductive cycles.
  • Have non contraceptive medical uses. Can prevent or reduce conditions such as irregular menstrual periods and acne

How effective is the pill?

  • 99% effective if used correctly but does not protect against sexually transmitted infection (STI) including HIV/AIDS.
  • Correct use means not missing any pills, and taking extra contraceptive precautions when necessary.

Who should not take the pill?

Most women can take the pill. If you are healthy, not overweight, do not smoke and have no medical reasons for you not to take the pill, you can take it until your menopause. Women using the pill will need to change to another method of contraception at the age of 50 years.

Your doctor will discuss any current and past diseases that you have had. Some diseases cause an increased risk or other problems with taking the pill. Therefore, the pill will not be prescribed to some women with a certain diseases. For example hepatitis or breast cancer, or if you are taking certain medicines.

Please tell your doctor or pharmacist if you have ever had any of these conditions. They might recommend an alternative method of birth control

  • A history of heart attack or stroke
  • Blood clots in the legs, lungs, or eyes
  • A history of blood clots in the deep veins of your legs
  • Chest pain
  • Known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina
  • Unexplained vaginal bleeding
  • Yellowing of the whites of the eyes or of the skin (jaundice) during pregnancy or during previous use of the pill
  • Liver tumor (benign or cancerous)
  • Known or suspected pregnancy

Be aware of these signs and symptoms while taking the pills

Do consult your doctor if you notice any of the following signs and symptoms:

  • Vision disturbance, blurred vision, flashing lights
  • Headache (severe)
  • Unusual leg pain (calf or thigh)
  • Chest pain (severe), shortness of breath, or coughing up blood
  • Abdominal pain (severe)

How do I take the pill?

There are different brands of pill which contain varying amounts and types of oestrogen and progestogen. There is usually a leaflet inside the packet of pills. Read the leaflet carefully and make sure you understand how to take the pill and what to do in special situations such as if you miss a pill or vomit.

Dosage:
One tablet orally and should be taken at approximately same time each day. Take with food or immediately after food to prevent stomach upset

Points To Remember When First Starting On The Pill :

  1. Be sure to read the enclosed leaflet
    • Before taking your pills
    • Anytime you are not sure what to do
  2. Decide what time of day to take the pill.
    • Take the pill every day at the same time
    • Missed pill could lead to pregnancy. The more pills you miss, the more likely you would get pregnant.
  3. Look at the pill, whether it has 21 or 28 pills
    • The 21-pill packet has 21 active pills to be taken for three weeks, followed by one week without pills
    • The 28-pill packet has 21 active pills to be taken for three week, followed by one week of non-active pills
  4. Decide:
    • Where on the packet to start taking the pill
    • The order of taking the pill. Many of the packets on which the day of the week or a consecutive number is written on them.
  5. Many women experiencing spotting light bleeding, or have stomach ache during the first 1 – 3 packet of pills
    • If you have stomach ache, do not stop taking the pill. The stomach ache will usually go away. If it does not, please consult your doctor.
  6. Vomiting, diarrhea and some medicines may reduce the effectiveness of the pill. You are recommended to use other method of contraceptives (such as condoms or others)

What sholud I do if I miss a pill?

Missed pills advice differs and depends on the brand used, and the number of pills missed. Refer to the product leaflet for advice on missed pills.

Are there anyside-effects when taking the pill?

The following are some common side effects from oral contraceptive use:

  • Vaginal bleeding
    Irregular vaginal bleeding or spotting may occur while you are taking the pill which may vary from slight staining between menstrual periods to breakthrough bleeding which is a flow much like a regular period. Irregular bleeding occurs most often during the first few months of oral contraceptive use, but may also occur after you have been taking the pill for some time. Such bleeding may be temporary and usually does not indicate any serious problems. It is important to continue taking your pills on schedule. If the bleeding occurs in more than one cycle or lasts for more than a few days, talk to your doctor or health care provider.
  • Contact lenses
    If you wear contact lenses and notice a change in vision or an inability to wear you lenses, contact your doctor.
  • Fluid retention
    Oral contraceptives may cause edema (fluid retention) with swelling of the fingers or ankles and may raise your blood pressure. If you experience fluid retention, contact your doctor.
  • Melasma
    A spotty darkening of the skin is possible, particularly of the face, which may persist.
  • Other side effects
  • Other side effects may include nausea and vomiting, change in appetite, headache, nervousness, depression, and dizziness, loss of scalp hair, rash, and vaginal infections.

If any of these side effects bother you, call your doctor.

Will other medicines affect the way oral contraceptives or the birth control pill work?

Certain medicines may interact with birth control pills to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such medicines include:

  • Tubercolisis Medication (Rifampicin)
  • Drugs used for epilepsy/ seizure such as barbiturates, carbamazepine phenytoin, primidone, topiramate
  • Antibiotics such as tetracyclines, ampicilin, amoxycillin, ampicillin ,erythromycin
  • Migraine medications

You may need to use additional contraception when you take drugs that can make oral contraceptives less effective.

It is important to always let your doctor and pharmacist know that you are taking oral contraceptives so they can appropriately instruct you.

Warning

  • Smoking may increase the risk of serious side effects from oral contraceptives, including heart attacks, blood clots and strokes. The risk is higher for women over 35 years old and heavy smokers (15 or more cigarettes per day).

Storage conditions

  • Keep out of reach of children.
  • Store at room temperature, away from moisture and sunlight.
Last reviewed : 20 April 2012
Writer : Siti Aisah bt. Bahari
Reviewer : Norhayati bt. Yaacob