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Oral Contraceptives

Oral contraceptives (birth control pills) are medications that prevent pregnancy. They are one method of birth control. Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin (progesterone) or progestin alone (mini-pill). 

Combinations of estrogen and progestin prevent pregnancy by inhibiting the release of hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland in the brain. LH and FSH play key roles in the development of the egg and preparation of the lining of the uterus for implantation of the embryo. Progestin also makes the uterine mucus that surrounds the egg more difficult for sperm to penetrate and, therefore, for fertilization to take place. In some women, progestin inhibits ovulation (release of the egg).

Other uses

Some brands of oral contraceptives are also used to treat acne in certain patients. Oral contraceptives treat acne by decreasing the amounts of certain natural substances that can cause acne.

Some oral contraceptives are also used to relieve the symptoms of premenstrual dysphoric disorder (physical and emotional symptoms that occur before the menstrual period each month) in women who have chosen to use an oral contraceptive to prevent pregnancy.

How should this medicine be used?

Oral contraceptives come in packets of 21, and 28 tablets to take by mouth once a day, every day or almost every day of a regular cycle. 

Oral contraceptives come in many different brands. Different brands of oral contraceptives contain slightly different medications or doses, are taken in slightly different ways, and have different risks and benefits. 

If you have a 21-tablet packet, take 1 tablet daily for 21 days and then none for 7 days. Then start a new packet.

If you have a 28-tablet packet, take 1 tablet daily for 28 days in a row in the order specified in your packet. Start a new packet the day after you take your 28th tablet. The tablets in most 28-tablet packets may have different colours. Many 28-tablet packets have certain colour tablets that contain different amounts of estrogen and progestin, but also may have other colour tablets which contain an inactive ingredient or a folate supplement.

Oral contraceptives are usually started on the first or fifth day of your menstrual period or on the first Sunday after or on which bleeding begins. Your doctor will also tell you whether you need to use another method of birth control during the first 7 to 9 days that you take your oral contraceptive and will help you choose a method. Follow these directions carefully.

You will probably experience withdrawal bleeding similar to a menstrual period while you are taking the inactive tablets or the low dose estrogen tablets or during the week that you do not take your oral contraceptive.

If you are taking the type of packet that only contains active tablets, you will not experience any scheduled bleeding, but you may experience unexpected bleeding and spotting, especially at the beginning of your treatment. Be sure to start taking your new packet on schedule even if you are still bleeding.

Oral contraceptives will work only as long as they are taken regularly. Continue to take oral contraceptives every day even if you are spotting or bleeding, have an upset stomach, or do not think that you are likely to become pregnant. Do not stop taking oral contraceptives without talking to your doctor.

Non-contraceptive use

The hormones in the pill have also been used to treat other medical conditions, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, acne, hirsutism, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation).

PCOS

PCOS, or polycystic ovary syndrome, is a syndrome that is caused by hormonal imbalances. Women with PCOS often have higher than normal levels of estrogen all the time because their hormonal cycles are not regular.  it is often recommended that women with PCOS take hormonal contraceptives to regulate their hormones. Both COCPs and progestin-only methods are recommended. COCPs are preferred in women who also suffer from uncontrolled acne and symptoms of hirsutism, or male patterned hair growth, because COCPs can help treat these symptoms.

Endometriosis

For pelvic pain associated with endometriosis, COCPs are considered a first-line medical treatment, along with NSAIDs, GnRH agonists, and aromatase inhibitors.COCPs work to suppress the growth of the extra-uterine endometrial tissue. This works to lessen its inflammatory effects.

Also read: Oral Contraceptive Pills For Endometriosis

Next read: Endometriosis: What Can You Do For Yourself When You Have Period Pain

Acne

Combined oral contraceptives are sometimes prescribed as medication for mild or moderate acne, Four different oral contraceptives have been clinically approved to treat moderate acne if the person is at least 14 or 15 years old, have already begun menstruating, and need contraception. 

Amenorrhea

Although the pill is sometimes prescribed to induce menstruation on a regular schedule for women bothered by irregular menstrual cycles, it actually suppresses the normal menstrual cycle and then mimics a regular 28-day monthly cycle.

Take your oral contraceptive as advised. Follow the directions on your prescription label carefully, and do not take more or less of it, take it more often, or take it for a longer time than prescribed by your doctor.

Oral contraceptives are a very effective method of birth control, but they do not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases.

Also read: Contraception & Family Planning – What you need to know

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