The appearance of the first contraceptive pill in the early 1960s became one of the pillars of the sexual revolution that was beginning at that time. Such methods are still used willingly and widely today, but not everyone is well aware of what they actually do. Let's take a look at the principles of their action and potential benefits and contraindications.
How does hormonal contraception work?
The principle of hormonal contraception is quite simple. The monthly cycle is controlled by specific hormones. Contraceptive pills contain their synthetic equivalents that allow for manipulation of the cycle. They allow the ovaries to suspend their activity, which due to the action of hormones will not release an egg - taking contraceptive pills therefore equals a lack of ovulation. In addition, hormonal pills affect the mucus produced by the cervix, which becomes thicker, which additionally makes it difficult for sperm to travel.
Oral hormonal contraception is generally divided into single-component tablets (the so-called mini-pill) and two-component tablets. The first contain only progestogen, the second – in addition to progestogen – also estrogen. Mini-pills have a slightly different mechanism of action and are usually prescribed to breastfeeding women or in the case of contraindications related to the two-component pill. Two-component tablets, on the other hand, are characterized by slightly greater effectiveness and a faster intervention time, and younger people usually feel better on them than when using the mini-pill.
You can learn about other methods of contraception in the articles:All contraceptive methods and The morning-after pill .
Is hormonal contraception effective?
The effectiveness of contraceptive pills is very high. How do we know this? This is indicated by the Pearl Index, which allows us to determine how many people using a chosen contraceptive method have become unplanned pregnant. We can say that methods are assessed on a scale from 0 to 100, because the result is given as the number of pregnancies per 100 examined over a year of intercourse. The Pearl Index for contraceptive pills is from 0.1 to 0.9 (this difference results from studies conducted on different populations), which puts them in first place in the ranking of the effectiveness of contraceptive methods - this means that among people using hormonal contraception, only a few in a thousand of the examined get pregnant. For comparison, the result for a condom is from 3 to 7 (i.e. from 3 to 7 people per 100 examined), the hormonal coil - 1, copper - 3, and the total lack of contraception was valued at 90.
How to choose contraceptive pills?
Choosing the right contraceptive pills is a task for a doctor. There are various types of hormonal contraception on the market, but in Poland they are only available by prescription. It is very important to undergo the necessary tests before starting to use them, thanks to which it will be possible to choose the means for individual needs. After all, hormonal balance does not only concern the issue of fertility - hormonal fluctuations can be easily observed, for example, based on observations of weight, skin condition or emotional reactions. Hormonal pills can also react with other medications taken, which is why a medical consultation is crucial when we want to ensure effective and safe contraception. During the visit, we will learn the detailed rules for using the pills, so we will find out when to start taking them and what to do if we happen to forget to take them.
What happens to your cycle if you use hormonal contraception?
Contraceptive pills work based on the natural menstrual cycle . The average cycle of a healthy person lasts 28 days and this is the number that hormonal contraception is based on. As we already know, taking contraceptive pills puts the ovaries into hibernation mode and stopsovulation . However, this does not mean that the entire cycle stops. Usually, pills are taken for 21 days (although there are 24+4 pills), after which there is a break or a change from "real" contraceptive pills to placebo, so as not to fall out of rhythm ;) During the week-long break, so-called withdrawal bleeding occurs, which may be associated with a period, but it is not. During withdrawal bleeding, much less blood appears than during menstruation, because contraception in the form of pills limits the growth of the mucous membrane - the same one whose shrinkage is associated with bleeding during natural menstruation.
Withdrawal bleeding – does it always occur and how long does it last?
Withdrawal bleeding occurs as a result of a break in the use of oral hormonal contraception. If we take it without taking a break between series (or the prescribed type of contraception is taken without breaks), bleeding will not occur. Irregular bleeding or its complete absence at the beginning of taking the pills should not be a cause for concern - the body is just adjusting to the new situation and it will take several cycles before we notice regularity. When it does occur, it will usually be shorter, less heavy and less painful than typical menstrual bleeding. People taking contraceptive pills usually welcome withdrawal bleeding with enthusiasm, as it is not particularly bothersome and is a signal that pregnancy has not occurred. However, the lack of bleeding does not automatically mean that conception has occurred. There may be several reasons, including hyperplasia of the mucous membrane. In such cases, it is worth seeing your doctor - it may be useful to change the pills.
How will I feel when using hormonal contraception?
With properly selected contraceptive pills, nothing particularly bothersome should happen, although at the beginning of use, side effects may occur in the form of nausea, headaches or breast pain, decreased libido and slightly lowered mood. Such symptoms usually disappear in the first months of using contraceptive pills. After 3 months, we go for a check-up and possibly change the means if something is wrong. Oral hormonal contraception can improve general well-being in the long term. How is this possible?
If you want to know how birth control pills can affect libido, read the article on this topic here .
Contraception and Period – Benefits
Taking birth control pills is often accompanied by pleasant "side effects", such as better well-being, relief from painful menstrual symptoms or improvement in the condition of the skin and hair. They depend on the specific substances contained in the pills. During the visit, it is worth mentioning which ones we are counting on the most. Here are the benefits we can expect when using oral contraception.
Regulating your cycle and minimizing pain
If irregular periods have been our bane so far, birth control pills will help them get organized a bit - the action of hormones from the pills finally imitates a regular cycle. Bleeding is less intense, and period pain (mainly abdominal pain) may stop completely, because uterine contractions and other processes accompanying menstruation are alleviated. If we feel the need (often before important events), thanks to the pill, we can also postpone our period.
How to delay your period?
The procedure for delaying your period is quite simple, although to be sure that it will not harm you in any way, it is worth asking your gynecologist for details. If you are taking a pill that contains 2 types of hormones, you simply start the next pack, skipping the 7-day break, which will result in no withdrawal bleeding.
Birth control pills to regulate hormones, i.e. healthy appearance and well-being
Some pills (specifically, progestogen pills with anti-androgenic effects) can be used to improve the appearance of the skin, as hormones regulate processes such as sebum secretion. They can also be helpful in the case of acne, seborrhea and hirsutism (excessive hair growth), and are also used in the treatment of conditions such as endometriosis or polycystic ovary syndrome . Among the myths about contraceptive pills, there is a common statement that they contribute to weight gain (which is not related to weight gain, but to water retention) and a decrease in libido (which - if it occurs at the very beginning of taking the pill - is short-lived and goes away on its own), but these days this is an extremely rare side effect - a properly selected pill does not have this effect. However, if time passes and you still feel suspicious - go to a gynecologist.
What could go wrong?
In fact, very little ;) For those still unconvinced, we have a short overview of common doubts about hormonal contraception.
I missed my birth control pill. What should I do now?
Don't panic, most likely nothing happened :) However, on the leaflet attached to the pills you will find a procedure for such cases, which you can follow just in case. The most common rules are as follows:
- If you missed a pill in the first week of use: if you did not have intercourse and there is no risk of pregnancy, you can continue taking the pills. It is worth adding a second form of contraception just in case. If you did have intercourse during this time, do a pregnancy test.
- If you miss a pill in week 2: take the missed pill as soon as possible and continue as before - there is probably no break in protection, but use a condom just in case.
- If you have missed a pill in the 3rd week of use: you can now start the 7-day break or the next strip.
Can I combine 2 packs of contraceptive pills without taking a 7-day break for bleeding?
Yes. This is the method already discussed to postpone your period.
Does hormonal contraception cause cancer? What about thrombosis?
Studies show that people using hormonal contraception are at slightly higher risk of developing breast cancer, while the risk of ovarian cancer, endometrial cancer and colon cancer is reduced. It has been proven that the estrogen contained in birth control pills can indeed contribute to the development of thrombosis. This sounds quite serious, but pregnancy is associated with the same risk of this condition. People who smoke or struggle with overweight and hypertension are more at risk. However, before the doctor prescribes contraception, laboratory tests will be performed to assess the risk of thrombosis. If, despite this, you are worried about the prospect of drastic side effects, remember that using the pill will mean that you will be visiting your gynecologist relatively often, so you can discuss any worrying symptoms and possibly change the type of contraceptive.
Is it true that when using hormonal contraception you need to be careful with antibiotics?
Yes. It happens that some medications (mainly antibiotics, but this also applies to herbal remedies – St. John's wort is censored, for example) have adverse reactions with contraception. Always report to your doctor what medications you are taking. It is also good to get into the habit of reading information about medications. If you have any doubts after reading the information in the leaflet, relying on guesswork will not be the best decision.
Also read the text " Intimate gel and contraceptive pills – do they interfere with each other? "
Can I drink alcohol while taking birth control pills?
Yes. Alcohol has no effect on hormones and is not something to worry about when it comes to the effectiveness of birth control pills. However, it is a good idea to make sure that you do not get carried away by the partying – both the pills and alcohol go through the liver metabolism, so daily drinks can put an additional strain on this organ. Moreover, if you vomit or have diarrhea after a night of drinking, there is a risk that the body will get rid of the pill that has not yet had time to absorb it. And speaking of partying – you should not go crazy with smoking cigarettes. As with alcohol, nicotine itself does not have a direct effect on the effectiveness of birth control pills, but it does increase the risk of thrombosis.
Read also our article: Alcohol and period - friend or foe ?
Can hormonal contraception make it harder for me to get pregnant later?
No, and it even increases the likelihood of getting pregnant with twins ;) One of the advantages of using oral hormonal contraception is its temporary effect. Taking hormones does not lead to an irreversible shutdown of the reproductive system. Most people return to full fertility mode in 2 to 3 cycles, it is possible already in the 1st cycle after discontinuation. If this does not happen, the doctor will prescribe medications that will allow the situation to normalize within a few months. Of course, there is no guarantee of problem-free conception, but if problems appear in this area, they do not result from the use of contraceptive pills.
Contraceptive pills are therefore one of the most reliable methods of preventing conception. In addition to their high effectiveness, their advantage is that they can have a positive effect on health, as evidenced by their use to solve other health problems. Is this method for everyone? The final word always belongs to the doctor, which is why it is so important to perform the required tests and be honest in the office. This will allow you to choose the method that best meets your individual needs.
- K. Barnhart, C. A. Schreiber, Contraception , in: Yen & Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management. Seventh Edition , ed. J. Strauss, R. Barbier, Philadelphia 2014, https://www.sciencedirect.com/science/article/pii/B9781455727582000366 [accessed on 02/08/2021].
- Birth control pill FAQ: Benefits, risks and choices , https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136 [accessed on 2/08/2021].
- Birth Control Pills: Medical Uses , https://youngwomenshealth.org/2011/10/18/medical-uses-of-the-birth-control-pill/ [accessed 2/08/2021].
- Recommendations of the Polish Gynecological Society regarding the indications and safety of using hormonal and intrauterine contraception , "Ginekologia Polska" 2014, no. 3, pp. 234-239, https://publicum.umed.lodz.pl/info/article/AMLe55f585fd91f4829897a083f187f798f/ [accessed 21/12/2021].
- Birth control pills protect against some cancers , https://www.mp.pl/ginekologia/aktualnosci/161713,tabletki-antykcyjne-chronia-przed-niektorymi-nowotworami [accessed 2/08/2021].
- RB Taylor, Birth Control for Acne , med. rev. SS Gardner, https://www.webmd.com/skin-problems-and-treatments/acne/birth-control-for-acne-treatment [accessed 2/08/2021].
- Z. Wojtasiński, Newer contraceptives increase the risk of breast cancer , https://www.mp.pl/ginekologia/aktualnosci/177099,nowsze-preparaty-antykcyjne-zwiekszaja-ryzyko-raka-piersi [accessed 2/08/2021].
Created at: 14/08/2022
Updated at: 14/08/2022
