Birth Control: How the Pill Works

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The birth control pill, or "the Pill," is a very effective method of birth control — almost as effective as sterilization, in fact — assuming full compliance. Basically, the active ingredients in the Pill are the same hormones that a woman’s body uses to regulate her menstrual cycle. Today’s lower doses greatly reduce the side effects, and do a great job of preventing unintended pregnancy if you remember to take the Pill regularly. It does not, however, protect against STDs.

These days, the Pill comes in two types:

  • Combination pills, which contain both estrogen and progestin, keep the ovaries from releasing eggs.

  • The so-called mini-pills contain only progestin.

The Pill can prevent ovulation, but the primary way it prevents conception is by thickening the cervical mucus so the sperm can’t penetrate it. The Pill also makes the uterine lining less receptive to the implantation of sperm.

If you use the Pill, you must remember to take it every day, and preferably at the same time of the day — say, every morning — for the hormones to work best. (When using the combination pill, the woman goes off the hormones for seven days a month to allow for withdrawal bleeding, which simulates normal menstrual flow. In most cases, however, she continues to take placebo pills during this time to enforce the habit.)

The failure rate of the Pill relates closely to compliance, so if you are on the Pill and don’t want to become pregnant, make sure that you follow to the letter the directions that your doctor gives you.

Advantages of the Pill

Besides preventing pregnancy, the Pill has several advantages, including

  • More regular periods

  • Less menstrual flow

  • Less menstrual cramping

  • Less iron deficiency anemia

  • Fewer ectopic pregnancies (pregnancies that occur outside the uterus)

  • Less pelvic inflammatory disease

  • Less acne

  • Less premenstrual tension

  • Less rheumatoid arthritis

  • Less ovarian cyst formation

  • Protection against endometrial and ovarian cancer, two of the most common types of cancer in women

When you start taking the Pill, you may experience a little bleeding between periods, which is usually a temporary phenomenon.

The birth control pill now offers another potential advantage, the end of monthly periods. The only reason placebos were included in a woman’s monthly allotment of pills was to allow her to have a period. Now the FDA has decided to allow pharmaceutical companies to sell brands of pills that will either lessen or completely suppress a woman’s periods. Lybrel is the first extended-use brand of oral contraceptive that women can take every day, thus suppressing their periods for as long as they take the drug. Yaz and Loestrin 24 reduce a woman’s period to only three days a month. And women who take two brands of pills, Seasonale and Seasonique, only have their periods four times a year.

Some women fear that the Pill may cause cancer of the breast or uterus because the hormones used have been linked to these cancers in animal studies. Whether or not such a risk once existed, no scientific evidence indicates that this is the case at the doses presently prescribed. In fact, the Pill has been shown to reduce the risk of cancer of the ovary or endometrium.

Disadvantages of the Pill

Just about every woman of child-bearing age can take the Pill, except those women who are smokers over the age of 35. These women should refrain from taking the Pill because it can cause some risks to the cardiovascular system. Further studies have found this increased risk to the cardiovascular system to be somewhat higher than previously believed, though exactly what those risks involve remains unclear. Some other physical conditions, such as diabetes or a history of blood clots, can make the Pill unsuitable for a woman.

Because of these risks, a physician must prescribe the Pill for you. Because the medical world seems to release a new study every day, keeping up with all the latest information is difficult. So, if you’re considering using the Pill, definitely have a talk with your gynecologist so you can be confident that your choice is the right one.

The initial doctor’s visit usually costs between $35 and $175, though the cost can be less if you visit a clinic. The pills themselves cost between $15 and $35 per month, though again the cost may be lower at a clinic or through Planned Parenthood. Medicaid may cover these costs, as may a private health insurance carrier.

The Pill offers absolutely no protection against AIDS or any other sexually transmitted disease, and you must use the Pill in conjunction with a condom if any risk exists that you may catch a disease from your partner.

If you use other drugs — including antibiotics — while you’re on the Pill, check with your doctor to make sure that these medications won’t interfere with your method of birth control. In many cases, your doctor will advise you to use an additional form of protection at this time.

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