Oral Contraceptives Health Article

Definition

Oral contraceptives are medicines taken by mouth to help prevent pregnancy. They are also known as the Pill, OCs, or birth control pills.

Purpose

Oral contraceptives, also known as birth control pills, contain artificially made forms of two hormones produced naturally in the body. These hormones, estrogen and progestin, regulate a woman's menstrual cycle. When taken in the proper amounts, following a specific schedule, oral contraceptives are very effective in preventing pregnancy. Studies show that less than one of every one hundred women who use oral contraceptives correctly becomes pregnant during the first year of use.

These pills have several effects that help prevent pregnancy. For pregnancy to occur, an egg must become mature inside a woman's ovary, be released, and travel to the fallopian tube. A male sperm must also reach the fallopian tube, where it fertilizes the egg. Then the fertilized egg must travel to the woman's uterus (womb), where it lodges in the uterus lining and develops into a fetus. The main way that oral contraceptives prevent pregnancy is by keeping an egg from ripening fully. Eggs that do not ripen fully cannot be fertilized. In addition, birth control pills thicken mucus in the woman's body through which the sperm has to swim. This makes it more difficult for the sperm to reach the egg. Oral contraceptives also change the uterine lining so that a fertilized egg cannot lodge there to develop.

Birth control pills may cause good or bad side effects. For example, a woman's menstrual periods are regular and usually lighter when she is taking oral contraceptives, and the pills may reduce the risk of ovarian cysts, breast lumps, pelvic inflammatory disease, and other medical problems. However, taking birth control pills increases the risk of heart attack, stroke, and blood clots in certain women. Serious side effects such as these are more likely in women over 35 years of age who smoke cigarettes and in those with specific health problems such as high blood pressure, diabetes, or a history of breast or uterine cancer. A woman who wants to use oral contraceptives should ask her physician for the latest information on the risks and benefits of all types of birth control and should consider her age, health, and medical history when deciding what to use.

Precautions

No form of birth control (except not having sex) is 100% effective. However, oral contraceptives can be highly effective when used properly. Discuss the options with a health care professional.

Oral contraceptives do not protect against AIDS or other sexually transmitted diseases. For protection against such diseases, use a latex condom.

Oral contraceptives are not effective immediately after a woman begins taking them. Physicians recommend using other forms of birth control for the first 1–3 weeks. Follow the instructions of the physician who prescribed the medicine.

Smoking cigarettes while taking oral contraceptives greatly increases the risk of serious side effects. Women who take oral contraceptives should not smoke cigarettes.

Seeing a physician regularly while taking this medicine is very important. The physician will note unwanted side effects. Follow his or her advice on how often you should be seen.

Anyone taking oral contraceptives should be sure to tell the health care professional in charge before having any surgical or dental procedures, laboratory tests, or emergency treatment.

This medicine may increase sensitivity to sunlight. Women using oral contraceptives should avoid too much sun exposure and should not use tanning beds, tanning booths, or sunlamps until they know how the medicine affects them. Some women taking oral contraceptives may get brown splotches on exposed areas of their skin. These usually go away over time after the women stop taking birth control pills.

Oral contraceptives may cause the gums to become tender and swollen or to bleed. Careful brushing and flossing, gum massage, and regular cleaning may help prevent this problem. Check with a physician or dentist if gum problems develop.

Women who have certain medical conditions or who are taking certain other medicines may have problems if they take oral contraceptives. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to estrogens or progestins in the past should let her physician know before taking oral contraceptives. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

PREGNANCY. Women who become pregnant or think they may have become pregnant while taking birth control pills should stop taking them immediately and check with their physicians. Women who want to start taking oral contraceptives again after pregnancy should not refill their old prescriptions without checking with their physicians. The physician may need to change the prescription.

BREASTFEEDING. Women who are breastfeeding should check with their physicians before using oral contraceptives. The hormones in the pills may reduce the amount of breast milk and may cause other problems in breastfeeding. They may also cause jaundice and enlarged breasts in nursing babies whose mothers take the medicine.

OTHER MEDICAL CONDITIONS. Oral contraceptives may improve or worsen some medical conditions. The possibility that they may make a condition worse does not necessarily mean they cannot be used. In some cases, women may need only to be tested or followed more closely for medical problems while using oral contraceptives. Before using oral contraceptives, women with any of these medical problems should make sure their physicians are aware of their conditions:

• Female conditions such as menstrual problems, endometriosis, or fibroid tumors of the uterus. Birth control pills usually make these problems better, but may sometimes make them worse or more difficult to diagnose.
• Heart or circulation problems; recent or past blood clots or stroke. Women who already have these problems may be at greater risk of developing blood clots or circulation problems if they use oral contraceptives. However, healthy women who do not smoke may lower their risk of circulation problems and heart disease by taking the pills.
• Breast cysts, lumps, or other noncancerous breast problems. Oral contraceptives generally protect against these conditions, but physicians may recommend more frequent breast exams for women taking the pills.
• Breast cancer or other cancer (now or in the past, or family history). Oral contraceptives may make some existing cancers worse. Women with a family history of breast cancer may need more frequent screening for the disease if they decide to take birth control pills.
• Migraine headaches. This condition may improve or may get worse with the use of birth control pills.
• Diabetes. Blood sugar levels may increase slightly when oral contraceptives are used. Usually this increase is not enough to affect the amount of diabetes medicine needed. However, blood sugar will need to be monitored closely while taking oral contraceptives.
• Depression. This condition may worsen in women who already have it or may (rarely) occur again in women who were depressed in the past.
• Gallbladder disease, gallstones, high blood cholesterol, or chorea gravidarum (a nervous disorder). Oral contraceptives may make these conditions worse.
• Epilepsy, high blood pressure, heart or circulation problems. By increasing fluid build-up, oral contraceptives may make these conditions worse.