Birth control pills or oral contraceptive pills (OCPs) are a very effective, safe and reversible method of contraception. This makes them the most popular method of birth control in the United States, while the intrauterine device (IUD) is the most common contraceptive worldwide. One advantage of birth control pills is that they can also be used as emergency contraceptives (morning after pill) and to delay your period for vacations or special events.
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Written by Dr Kimberly Langdon, MD
Information last reviewed 06/21/19
Birth control pills are a type of oral contraceptive used primarily to prevent pregnancy. Aside from this, some birth control pills can also be used to delay your period, reduce period pain and as an emergency contraception. There are several types of birth control pill and it can take a while to find out which one works best for you.
You can get contraceptive pills online, from family planning clinics or from a doctor. According to the CDC, the contraceptive pill can be prescribed without needing any blood tests or physical examination other than a blood pressure check. The doctor will also ask if you experience migraines or if you have a family history of blood clots or certain cancers. This is so they can make sure that you get the safest contraceptive pill for you.
Combined hormonal contraceptives are predominantly used for preventing unwanted pregnancies but they also provide other benefits. Birth control methods like the combined pill, patch and vaginal ring are also used to regulate the menstrual cycle, make your periods lighter and less painful and ease premenstrual tension. Due to the control they give you over your cycle, you can also delay your period. This also makes them a good option for women who suffer from endometriosis. In this case, you would take the pill consistently for several months without the 7 day break.
If you suffer from acne, combined hormonal birth control methods can also help to decrease the appearance of spots and prevent new ones from forming.
Myth: The pill makes you gain weight.
Not really true. Some women think they gain weight while others only see monthly fluctuations. When women experience the estrogen-related side effects, they are more likely to have cyclic weight gain that goes away each month during and shortly after their periods. Higher estrogen content can increase nausea which can lead to more frequent eating and weight gain.
Depending on the type of progesterone used, the effect on weight will be different. For instance, desogestrel and norgestimate minimize weight gain whereas, levonorgestrel and norethindrone can increase appetite and weight gain.
The main reason OCPs are associated with weight gain is that teenagers and young women often go on them when their weight is increasing from the growth process itself. Weight usually stabilizes around the age of 25, but for the 10 years prior, there is linear weight gain regardless of the use of contraceptive hormones.
Myth: You need to take a break from the pill after a certain amount of time.
This is not true. The overall hormone production from the ovaries is suppressed by the hormones in OCPs. Women think that taking hormones raises their overall hormone level, but the ovaries produce a lot more. So, by suppressing ovulation, the overall effect is lower hormone exposure during each menstrual cycle and throughout your lifetime. Some women will stop having menses because the lining of the uterus is thin from oral contraceptives. This is perfectly safe and will change back to normal bleeding once they stop using The Pill. Taking a break will only increase your risk of getting pregnant.
Myth: All birth control pills are the same.
There are many different types of birth control pill. The active ingredients, type of progestin and the dosage of each hormone can all vary. In addition, some brands of the pill include placebo pills in the pack, to help you keep track of which pills to take on each day.
Progestin-only pills (the Mini Pill) or lower dose combined pills are often given to women who experience estrogen related side effects i.e. breast soreness, nausea, increased vaginal discharge or irritability.
Combined oral contraceptive pills (COCs): These pills contain synthetic versions of the female hormones, progestin and estrogen. Each pill contains the same dose of hormones (usually 35mcg of estrogen) and they are generally taken every day for 28 days, followed by a 1 week break. These pills can also be used for period delay and may be used as emergency contraceptives in some cases.
Progestin-only pills (POPs or Mini Pills): These pills are taken every day, without a break. The pills contain different doses of the active ingredient, depending upon when in your menstrual cycle they are taken. Progestin-only pills often have less side effects than combined pills. And therefore, unlike COCs, POPs can be taken by people who experience migraines. However, POPs are slightly less effective than combined pills, they need to be taken at the same time each day and many women will experience irregular periods or spotting when using POPs.
Contraceptive rings are small, soft plastic devices which are inserted into the vagina. They contain the same types of hormones as the combined pill, releasing them into the uterus and ovaries. Once inserted, each ring lasts for 21 days. After this, it is removed and then you wait 7 days until putting a new one in. You’ll still be protected against pregnancy during this time and this is when you have your monthly bleed. This is a good option if you struggle to remember to take the pill everyday.
Contraceptive patches are small, square patches which resemble plasters which are stuck onto the surface of your skin to release hormones into the bloodstream. They work in the same way as the combined pill, containing estrogen and progesterone hormones to stop ovulation from occurring, thickening the mucus around the cervix and thinning the uterine lining. Each patch should be left on for 7 days. After 3 weeks, remove the third one and wait 7 days before applying the next one.
There are many other types of birth control, including both long and short term options. These include:
Using hormonal birth control can cause side effects which includes mood changes. While not all women will experience this, depression is one of these mood related side effects. This can happen due to the hormonal changes within your body. The symptoms of depression include prolonged low mood, lack of energy or motivation and a loss of interest in your regular activities. If this continues, then you may wish to try a different type of pill or birth control.
It’s a common concern that hormonal birth control can cause weight gain. While this is listed as a possible side effect, in most cases the perceived weight gain is actually fluid retention which will subside after the first few months. The link between weight gain and birth control comes from older types of birth control pills which used to contain much higher levels of the estrogen hormone and as a result, did cause women to gain weight.
While many forms of birth control prevent ovulation, they do not necessarily stop your periods. With the combined pill, patch or ring you’ll have a 7 day break each month where your monthly bleed occurs. With the birth control shot, implant and hormonal IUD they can cause your periods to become irregular but for some women they may stop altogether.
There are several methods of birth control which are hormone free. These include male and female condoms, diaphragms and caps, sponges and the copper IUD. A diaphragm needs to be used with spermicide, a contraceptive gel, in order to be effective. The copper IUD is the most potent option, being over 99% effective at preventing pregnancy and lasts for ten years. None of these methods cause any unwanted side effects and can be used as often as needed.
Birth control pills contain lactose, which is a sugar found in cow’s milk. This means they are not technically vegan as they contain a form of animal produce. If you are vegan, it’s up to you whether you are happy to take birth control pills or not. There are other options like the patch or ring you can use instead. If you are severely lactose intolerant or have a rare condition called galactose intolerance then you may not be able to take birth control pills.
Oral contraceptive pills were invented in the 1950s, but were not released in the United States until 1962.
Annovera is a new hormonal contraceptive that lasts for one year. It is a ring that is inserted into the vagina for 3-4 weeks at a time, depending on whether a menstrual period is desired. The device is a flexible donut-like device that is washed with each removal [1,2,3].
An IUD is an intrauterine device. They are available in copper or hormonal varieties and they help to prevent pregnancy. An IUD is inserted into the uterus by a doctor and can be left in place for several years. Hormonal IUDs can last 3-6 years and non-hormonal IUDs for up to 12 years before they need replacing. This makes it a good option for someone who wants to prevent pregnancy long-term, and who also doesn’t want to have to take a pill everyday.
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