The Pill, or Oral Contraceptive Pill (OCP), is a hormonal contraception, used by women to inhibit fertility. It was developed in the USA and approved for use in 1960, and has since found universal application due to its efficacy. Even though it is over 99% effective, it has always been a controversial choice because of its numerous side effects and associated health risks. These include an increased risk of cervical and breast cancer, particularly in some user groups. It also has raised concerns regarding fertility, especially if taken for an extended time.
How the Pill works
The contraceptive Pill uses a combination of the hormones oestrogen and progestogen to stop ovulation. These synthesised i.e. artificial, hormones halt the production of an egg by the female ovaries. Without an egg for male sperm to fertilise conception is not possible. The Pill interrupts the normal menstrual cycle, which is replaced by a withdrawal bleed, which can be much lighter and shorter than a period. The hormones also act to thicken the mucus in the cervix, making the passage of male sperm more difficult, and therefore reducing the likelihood of fertilisation. In addition, the hormones thin the lining of the uterus making it less likely for a fertilised egg to implant there.
For the Pill to be effective it must be taken at its prescribed dose at the same time every day. Missing the Pill for 24 hours or more will lead to a return in fertility and pregnancy could result, assuming no other contraception is utilised. There is also a mini-pill, which only contains progestogen, commonly prescribed in women who are breastfeeding or who experience nausea with estrogen. It is slightly less effective (95%) than the standard or combined Pill.
Benefits of the Pill
Studies have shown that the hormones contained in the Pill can have the following positive side effects for some women:
- lighter periods
- milder menstrual cramps
- improved acne
- May protect against cancers of the ovary, womb and some pelvic infections
- May protect against certain types of breast disease, ovarian cysts, anemia, and uterine cancer
Side effects
Some women are uncomfortable with the concept of interrupting their natural body processes and/or the side effects of the sustained intake of artificial hormones. Side effects, particularly in the first three months, are not uncommon and include:
- nausea
- breast tenderness
- headaches
- water retention - this can often be reduced by switching to a lower dose pill
- weight gain - progestogen in the Pill can increase appetite
- mood changes/depression - the Pill may reduce levels of serotonin in the body
- thrombosis/blood clots - blood clots which can block a vein and cause a heart attack or stroke, particularly in women over 35 who smoke
- breakthrough bleeding - unexpected bleeding on pill-taking days
Early versions of the Pill had high doses of hormones, which led to associated health risks. Women who take the combined oral contraceptive pill show an increased risk of cervical cancer but a direct causal link has not been established. There is also a small increased risk of breast cancer in some Pill users. Modern versions of the Pill have reduced doses which have reputedly diminished these risks.
High risk groups
The pill may be unsuitable if you:
* Are already pregnant
* Are a smoker who is over 35, or are over 35 and stopped smoking less than a year ago
* Overweight
* Take certain medicines
* Have had a previous thrombosis (blood clot)
* Have a heart abnormality, circulatory disease or high blood pressure
* Suffer from severe migraines
* Have breast cancer now or within the last five years
* Have active liver or gall bladder disease
* Have diabetes with complications
Some alternatives...
Natural Family Planning - Not using any contraception is an option, and is particularly attractive to established couples. Predicting the optimum period of fertility and then either abstaining or having sex is the key to this technique. There is however no protection against sexually transmitted diseases, and predicting the cycle accurately is not guaranteed.
Naturopathy - Herbs and other supplements can also be used very effectively to help balance hormone levels, improve fertility, ease and prevent muscle cramps and reduce mental and emotional strain and irritability. Evening primrose oil is a popular choice, which acts as an anti-inflammatory that counters the hormones causing period pain. Other alternatives include: sage tea, agnus castus/chaste berry or any vitamin B complex supplement. Supplementing the body with natural progesterone may also help to reduce hormonal imbalances.
Before choosing a contraceptive solution consult your doctor, accredited naturopath or fertility clinic.
Site Resources
References
http://www.bbc.co.uk/health/sexual_health/contr_combpill.shtml
http://www.sciencedaily.com/releases/2008/01/080126194137.htm
Originally published on Apr 18, 2009
