Contraceptive Pills (OC Pills)

Combined Oral Contraceptive Pill

The pill works mainly by changing the body's hormone balance so that a woman does not ovulate (do not release an egg each month). In addition, it causes the mucus made by the cervix to thicken. This makes it difficult for sperm to enter the uterus (womb) to fertilize an egg. The pill also makes the lining of the uterus thinner so that fertilized egg does not attach to the womb.

Advantages
- It is over 99% effective if used correctly
- Does not interfere with sex.
- Periods are often lighter, less painful, and more regular.
- May relieve pre-menstrual tension.
- Helps to protect against some benign (non cancerous) breast disease.
- Reduces the risk of developing certain types of cyst in the ovary.
- Reduces the risk of developing cancers of the ovary and uterus (womb).
- Reduces the risk of pelvic infection (as the 'mucus plug' may prevent bacteria as well as sperm getting into the uterus).

Disadvantages/ Side effects

Most women who take the pill do not develop any side effects. For most women the benefits far outweigh the disadvantages, as the risks are small.
Some women develop nausea headaches, or sore breasts. These usually go away within days or weeks of starting the pill.
Uncommon side effects include: tiredness, change in sex drive, skin changes, and mood changes.
Sometimes causes a rise in blood pressure.
Breastfeeding women should not take the pill as it can reduce the amount of milk.
Small increased risk of breast cancer in women who use the pill.
The risk of thrombosis (blood clot in the blood vessel) is more in women in the following situations:
- Previous history of thrombosis
- Severe obesity
- Immobility (e.g. wheelchair bound)
- Severe varicose veins
- Poorly controlled diabetes
- High blood pressure
- Close family member who has had a thrombosis, heart attack, or stroke before the age of 45
- Severe migraine
- Smoking - particularly if woman is over 35

Method of taking pills

There are different brands of pill, which contain varying amounts and types of estrogen and progestogen. The following gives a general guideline.

Brands with 21-day pills
Take the first pill on the first day of next period. A woman will be protected against pregnancy from then on. Take the pill at about the same time each day for the 21 days. Then have a break of seven days before starting next pack. A Woman will usually have some bleeding (like a period) in the seven-day break. Woman will be protected from pregnancy during the seven-day break provided she has taken pills correctly. Start the next pack on time. Start the next pack after the seven-day break whether still bleeding or not. If the pill is taken correctly, first pill of each pack will be on the same day of the week.

Brands with everyday pills (28 day pills)
These contain 21 active and seven 'dummy' pills. Instead of a seven-day break, carry on taking the dummy pills. The idea is to get in a routine of taking a pill everyday. The pills have to be taken in the correct order.

Precautions/ Additional information
- Missing or forgetting to take one or more pills Ovulation (and therefore pregnancy) may occur if the pills are missed, particularly if the missed pills are at the end or beginning of the packet. If unsure the pills are taken correctly, then use other forms of contraception (such as condoms) and seek advice from a doctor.
- Interference of other medicines with the pill
Some medicines may interfere with the pill. In particular, many types of antibiotics can stop the pill from working properly. In short - before taking any other medicines, ask your doctor whether they stop the pill from working properly.
- Vomiting or Diarrhoea
If vomiting occurs within 2-3 hours of taking a pill, the pill will not get absorbed. Take another pill as soon as possible. If vomiting continues even after taking the second pill, then it is the same as 'missing pills'
- Mild diarrhoea does not affect the absorption of the pill. Very severe diarrhoea may do so; consider this as the same as 'missing pills'
- No Period
It is normal to have period like bleeding during the seven-day break between pill packs (or during the dummy pills everyday pills. However, there may not be any bleeding between pill packs. In such a situation start the next pack after the usual seven-day break and continue to take pill as usual. Consult doctor if no bleeding occurs after the next pack (two packs in total). A pregnancy test may be advised.
- Bleeding whilst on the pill (breakthrough bleeding)
During the first few months woman may have some vaginal bleeding in addition to the usual bleeding between packs. This is not serious. It may vary from 'spotting' to a heavier loss like a light period. Do not stop taking pill. This problem settles after the first 2-3 months. If it persists, see your doctor.