Controlling Birth

The Pill: what you need to know

THE conception of a new life is a wonderful blessing. And thanks to scientific advances, women are now in control of when they conceive, so that the arrival of a baby comes at the right time in their lives.

I always stress the importance of using proper birth control methods to prevent unplanned pregnancies. One of the most common and easy-to-use methods of contraception is the birth control pill.

Although it is usually referred to as the Pill, there are actually many different types to suit women’s different needs.

What’s in the Pill?

If you have never taken birth control pills before, you may be unsure about what it is or how it works.

It is actually very simple: the Pill contains synthetic hormones that prevent the release of eggs from your ovaries. As sperm is unable to meet with the egg to fertilise it, you will not conceive.

There are two types of birth control pills: combination and progestin-only pills.

There are two types of birth control pills: combination and progestin-only pills. Combination pills contain two types of hormones, which are oestrogen and progestin. Different brands of combination pills usually contain different types of progestin, but the same type of oestrogen.

Different brands also contain varying doses of the hormones. Discuss with your doctor or gynaecologist as to which is the most suitable pill for your cycle or needs.

There are some side-effects of taking birth control pills, but they are not serious and will go away on their own. They include mood changes, breast tenderness, sickness or vomiting, headaches, occasional water retention, and irregular vaginal bleeding.

Taking the Pill

You need to take the Pill every day for a cycle of 21 days. Then, there is a seven-day break in between cycles where you do not take the pill and you experience normal menstruation. Some pills are taken for 28 days straight, but during seven of those days, you take placebo pills instead.

It is important to take the pills at the same time every day, and without skipping any day in between. Ask your doctor what to do if you accidentally miss a day, as you are bound to forget once or twice!

Even though the Pill acts as birth control, it does not protect against HIV or other sexually transmitted diseases (STDs). You can only prevent against these STDs by using condoms during intercourse.

When you should not take the Pill

Birth control pills are perfectly safe for most women. However, under rare circumstances, some women may have pre-existing conditions that make the Pill unsafe for them. If you have a family history of venous thrombosis or pulmonary embolism, you may be at risk of developing blood clots. You should not take birth control pills because the hormones in the pill further increase your risk of getting blood clots in your legs or in your lungs. However, if you do not have a family history of developing blood clots, then you do not need to worry.

Another concern is for women who smoke. As it is, smoking already increases your risk of having a stroke; but if you are over 35 and a smoker, then taking the Pill at the same time will lead to an even greater chance of a stroke. I urge all women to stop smoking, of course, but particularly if you intend to start taking birth control pills.

This is why it’s important to get medical advice before starting on birth control pills, so that your gynaecologist can check out your medical history and health status.

Myths about the Pill

Some women are worried about the safety of birth control pills because they contain hormones. There are a few myths out there about the dangers of the Pill – but here are the real facts:

1. The Pill makes you gain weight

A lot of women worry about this, and I don’t blame them! But there is no scientific evidence to show that birth control pills cause weight gain. What may happen is that the hormones in the Pill cause water retention in your breasts, hips and thighs, causing a feeling of bloatedness. However, you are not gaining fat.

2. The Pill causes cancer

This is not true. But you’re probably worried about taking any form of hormones because some people say that oestrogen replacement treatment for post-menopause is linked to breast cancer. That’s a topic for another day, but for now, rest assured that the oestrogen in birth control pills are not linked to breast cancer. In fact, combination birth control pills may even prevent cancers of the ovary and uterus. For instance, the Pill can reduce your lifetime risk of ovarian cancer by about 50%.

3. The Pill causes birth defects

Lots of women have accidentally taken birth control pills during the early part of their pregnancy because they were unaware that they were pregnant. However, this has not been shown to cause birth defects. But we still advise women not to take the Pill if they are, or suspect that they are pregnant.

4. You should take a break from the Pill every once in a while

No, you don’t have to. A woman can be on the Pill for more than 15 straight years without any known increased risk. There is no extra benefit in stopping the Pill for a “break” – in fact, there is only the risk of an unplanned pregnancy.

5. You shouldn’t take birth control pills if you’re over 40

You can continue to take birth control pills until you reach menopause. However, there are some conditions: you should be healthy, have normal blood pressure, not be at increased risk of heart attack or stroke, and be on the low-dose pills.

6. The Pill causes infertility

This is untrue. In fact, you will find that you can conceive as soon as you stop taking the Pill.

The final myth is that the Pill is bad for your health in general. But why would your gynaecologist prescribe you a pill that is harmful for you? Birth control pills are a smart and safe way to practise family planning.

They also have some added health benefits, such as reducing the risk of ovarian and uterine cancers, ovarian cysts, acne, excess facial and body hair, regulating menstrual flow and reducing menstrual cramps.

Article by Dr Nor Ashikin Mokhtar, TheStar, Sunday September 16, 2007

v Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.