The contraceptive Pill is today the favored method of contraception in many parts of the world, and has been used by more than 60 million women worldwide. It has proved to be, in the opinion of many, the most socially significant medical advance of the century.

What is the Pill ? How does it work ?
Advantages
Drawbacks
Contraindications
Where can I get the Pill?
What if I had sex and forgot my Pill?
What if I want to become pregnant?

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What is the Pill? How does it work?

The Pill, or combined oral contraceptive pill, is a birth control pill which contain two hormones, an estrogen and a progestin. The estrogen prevents pregnancy primarily by stopping the development of the egg in the ovary. The progestin changes the mucus in the cervix and helps prevent the sperm from reaching the egg. Also, the lining of the uterus does not become fully developed so that there is little likelihood that a fertilized egg will become implanted in the uterus.

These hormone pills are usually available in packs of 21 or 28 pills. Hormone pills are taken every day for 21 days, then a sugar or dummy pill in the 28 day pack is taken for the next 7 days, or no pill for 7 days in the 21 day pack.

Advantages

   Pills are safe for most women
   Pills are convenient to use and do not interrupt sex
   Pills decrease a woman's risk for cancer of the ovary and cancer of the lining of the uterus (endometrial cancer).
   Pills also lower the risk of developing benign breast masses (breast masses which are NOT cancer) and ovarian cysts.
   They decrease menstrual cramping and pain.
   Combined pills reduce menstrual blood loss and the risk for anemia.
   Acne often improves in women taking combined birth control pills. One pill, Tricyclen, is formally approved for the treatment of acne.
   Many women enjoy sex more when taking birth control pills because they know they are less likely to get pregnant.

Drawbacks

   Pills do not protect you from HIV or other infections. Use a condom if you may be at risk.
   You have to remember to take one pill every day.
   Nausea and/or spotting are two problems women may have the first month on pills.
   Pills tend to make periods short and scanty. You may see no blood at all. Most women like this when they understand it is common.
   Some women taking combined pills may experience side effects such as headaches, depression or decreased enjoyment of sex.
   Serious complications such as blood clots may occur but are very rare.
   Pills require a prescription and can be expensive.
   Pills may promote growth of breast cancer but probably do not cause breast cancer. They may lead to higher rates of one type of cervical cancer (adenocarcinoma of the cervix).

Problems you may have while you are taking birth control pills include:

   Irregular bleeding for the first few months after starting birth control pills
   Increased appetite
   Depression or moodiness
   Headaches and/or dizziness
   Nausea and vomiting
   Scant or missed periods
   Weight change
   High blood pressure
   Breast tenderness

Contraindications

Women with any of the following conditions should NOT take the Pill:

   Thrombophlebitis or thromboembolic disorder or a history of them (blood clots);
   Cerebrovascular accident or a history of it ((stroke);
   Coronary artery or ischemic heart disease or a history of it (angina, heart attack, or congestive heart failure, valvular heart disease);kidney failure or other serious disease;
   History of, known, or strongly suspected breast cancer or other estrogen-dependent cancer of reproductive organs; pregnancy; liver tumor, cancer or acute stages of hepatitis.

Women in the following situations should be evaluated before starting to take Pills:

   A current smoker over 35 years of age (particularly 15 or more cigarettes a day);
   Migraine headaches that start after initiation of oral contraceptives;
   High blood pressure; some women with diabetes;
   Major surgery requiring immobilization in the next four weeks;
   Undiagnosed abnormal vaginal/uterine bleeding;
   Sickle cell disease or sickle C disease;
   Breast-feeding women; gestational diabetes (symptoms of diabetes during pregnancy);
   Active gallbladder disease or disease with jaundice;
   Women over 50;
   Completion of term pregnancy within the past 10-14 days;
   Heart or kidney disease or history, or family history of death of parent or sibling (especially mother or sister) due to heart disease before age 50;
   Family history of hyperlipidemia (blood fats); or
conditions such as mental retardation, psychiatric illness, alcoholism or chemical abuse or other conditions which make it difficult to take the medication correctly and consistently.

Where can I get the Pill?

Pills require a prescription. You can get pills from your doctor, nurse practitioner, nurse midwife, health department, or family planning clinic.

What if I had sex and forgot to take my Pill?

When taking the Pill, you must take one every day in order to be protected.

   If you forget to take one pill at your usual time, take a pill as soon as you remember.
   If you miss two consecutive pills, take two pills each day for two days and then go back to your regular schedule.
   If you miss three consecutive pills, begin a new pack 7 days after the last pill was taken and use an additional method of contraception until your next period.

For up to 72 hours AFTER unprotected sex, you can take emergency contraceptive pills (see article at left margin) to avoid becoming pregnant.

For up to 7 days AFTER unprotected sex, you can have an IUD put in. Not all physicians know about emergency contraception. If you want more information or would like the phone numbers of clinicians near you who prescribe emergency birth control, call the Emergency Contraceptive Hotline at 1-888-NOT-2-LATE or 1-800-584-9911.

What if I want to become pregnant?

Simply stop taking pills after a cycle.

The Pill revisited: Benefits beyond birth control  PlannedParenthood.org: Birth Control Methods FAQ on Contraception : presents and explains several methods of contraception: the Pill, condoms, Morning After Pill, Diaphragm, IUCD, etc. Protecting Against Unintended Pregnancy: A Guide to Contraceptive Choices A Woman's Guide to Contraception and Responsible Sex Emergency Contraception