Oral contraceptives (OCs) are very effective, with a risk of pregnancy of 6-8% with typical use and of about 1% with perfect use. Normally a combination of estrogen and progesterone.
Uses of oral contraceptive pills include :
-birth control
-control of dysmenorrhea and menorrhagia
-control of acne
-hirsuitism
-reduced hot flashes in perimenopausal women
-decreased risk of endometrial cancer, ovarian cancer, ovarian cysts, and fibroids, with possibly decreased risk of osteoporosis, endometriosis, and colorectal cancer
When Selecting the product:
Combined OCs contain two hormones - estrogen and progestin. Estrogen is usually ethinyl estradiol (EE) at a dose of 20-50 ug. Nausea or breast tenderness may be reduced by using a low-dose EE pill.
Progestin-only contraceptives contain norethindrone. They are useful when estrogen is contraindicated, for example in smokers over 35, in breastfeeding women, or in women with hypertension, migraine + aura, or a history of DVT.
Starting the pill:
There are a number of ways of beginning OC. It may be started immediately in the office after ruling out pregnancy, on the first day of the cycle, or the fifth day of the cycle. If the pill is started after the fifth day, alternative contraception must be used for 7 days.
Systematic plan for taking medicine:
Pills may be taken on 21 or 28 day cycles. In the case of 28 day cycles, the last 7 days are sugar or 'dummy' pills, used to maintain consistency in a woman's routine.
Continuous use is also feasible, and is often done for women who have dysmenorrhea, mood swings, or would like to avoid periods. Breakthrough bleeding often occurs, but decreased over time.
Progestin only pills need to be taken at the same time daily, are taken consistently, and often are accompanied by irregular bleeding.
Missed pills:
If a woman misses one pill, it should be taken as soon as possible, and the next pill taken at the normal time. If two consecutive days are missed during the 1st or 2nd week, take 2 pills daily for 2 days, then return to one pill daily. Use back-up contraception for one week.
If two consecutive days are missed during the third week, or if three or more pills are missed at any time, discard the pack and immediately start a new pack. Use back-up contraception for one week.
