Questions and Answers: Oral Contraceptives

Oral contraceptives, commonly known as "the pill," are synthetic (or artificial) hormones. They are similar to the hormones produced by a woman's ovaries. These hormones prevent the release of eggs from the ovary. They are the most commonly used form of birth control in the United States. More than 16 million women in the United States and approximately 60 million women worldwide use oral contraceptives.

Every woman's cycle is different. So, your doctor will prescribe the brand of oral contraceptive that best suits your particular needs. Two major kinds of oral contraceptives are available:

• Minipills (these pills contain only the hormone progestin)
• Combination pills (these pills contain both progestin and estrogen)

Why Are Oral Contraceptives Prescribed? Oral contraceptives are considered to be an effective form of birth control. It is very important to note, however, that using oral contraceptives does not protect individuals from HIV, AIDS, or any other sexually transmitted disease. Your doctor also may prescribe oral contraceptives for a number of other reasons:

• To regulate irregular or missing menstrual cycles
• To decrease premenstrual symptoms for those who suffer from painful menstrual cycles
• To treat conditions such as endometriosis or polycystic ovary syndrome

Some brands of oral contraceptives also are used to treat acne by decreasing the amounts of certain natural substances that may cause acne.

Studies have shown that the use of oral contraceptives may provide certain other health benefits to some patients. They may lower the risk of cancer of the ovaries or uterus, as well as pelvic inflammatory disease.

Who Should Not Take Oral Contraceptives?

Women who have or have had certain medical conditions should not use the pill. It is important to inform your doctor if any of the following are true:

• You have had a stroke or heart attack
• You have had blood clots
• You have had chest pain
• You have had breast cancer or cancer of the uterus or cervix
• You have active liver disease
• You are having abnormal bleeding from the uterus without a known cause
• You are pregnant or think that you may be

Women who take oral contraceptives and smoke cigarettes increase their risk of developing heart attacks, blood clots, and strokes.Women who are heavy smokers and women who are over 35 years of age have a higher risk of developing these conditions.

What Else Should Be Considered Before Taking the Pill?

You also should inform your doctor if you have any of the following:

• Diabetes
• High cholesterol
• High blood pressure
• A seizure disorder
• Depression
• Headaches or migraines
• Irregular menstrual cycles

Women with these conditions will need to be checked often by a doctor if they take oral contraceptives.

How Are Oral Contraceptives Taken?

Your doctor will direct you when you should start taking your pills. Some women are instructed to start taking their pills on the first Sunday after their cycle. Other women start taking their pills on the first or fifth day of their cycle. Others may be told by their physician to start immediately. It is important to follow the directions given to you by your doctor. You should always talk to your physician or your pharmacist if you have any other questions or concerns.

You should take the pill at the same time every day to maintain hormone levels. Therefore, pick a time of day that is convenient for you to remember. Your doctor also may recommend that you use another method of birth control for a period of time for added protection.

Before starting oral contraceptives, you should inform your doctor of any allergies or preexisting medical conditions. Many medications can make oral contraceptives less effective. So, it also is very important to tell your health care provider about all the other medications you are taking. Include prescription drugs, nonprescription or over-the-counter drugs, vitamins, and herbal medications, such as St. John's wort.

What If a Dose Is Missed?

Every brand of oral contraceptive contains a patient information packet. The packet includes specific directions to follow if a dose is missed. It is important that you carefully follow these instructions. If you have any questions, always contact your doctor or your pharmacist for instructions. As an added precaution, you should use another method of contraception as well.

What Side Effects Are Associated with the Use of Oral Contraceptives?

As with any medication, it is crucial that you thoroughly understand how to take these pills correctly. You also need to be aware of the potential risks and side effects associated with their use. The majority of women who take oral contraceptives do not typically experience many side effects while taking the pill. Yet, it is very important to contact your physician if you do have any problems.

The most common side effects are breast tenderness and nausea. Some women may experience spotting between menstrual cycles after their first oral contraceptive regimen. Other potential side effects can include fluid retention, oily skin or acne, depression, and fatigue.

You should contact your physician immediately if you experience any of the following other side effects:

• Pain or swelling in the leg
• Shortness of breath
• Chest pain
• Severe headaches
• Double vision or loss of vision
• Severe stomach pain
• Breast lumps

For more information on oral contraceptives, always seek the advice of your physician or your pharmacist.

Ms. Terrie is a clinical pharmacy writer based in Haymarket,Va.