Mediscene

A PILL IN TIME

The oral contraceptive pill is the most popular and convenient birth control method used by women worldwide. Despite this, there are several misconceptions about the pill among women in our country which make them reluctant to choose it as a form of contraception.

More women should be encouraged to go on the pill, says Dr. Ramya Pathiraja, Consultant Obstetrician and Gynaecologist at the Colombo South Teaching Hospital and Senior Lecturer at the University of Sri Jayewardenepura. Apart from its effectiveness in preventing pregnancy, the pill has several additional health benefits, she reveals in this interview with Ayesha Inoon.

What is the contraceptive pill?

It is a tablet containing a combination of the female hormones oestrogen and progesterone that is taken orally to prevent pregnancy. There are also pills containing single hormones, but these are not available in Sri Lanka.

How does it work?

The pill prevents ovulation or the releasing of an egg into the womb each month. In addition the hormones thicken the secretions around the cervix, making it more difficult for sperm to enter. It also makes the lining of the womb thinner, so that it is less receptive to an egg.

How effective is it?

When taken correctly the pill is 100% effective in preventing pregnancy.

Is it safe?

Basically, yes. The pill can safely be taken by a majority of women. There are, however, a few exceptions. Women with a history of diseases such as hypertension, deep vein thrombosis, migraine, clinical depression and liver disease should not take the pill. For this reason, it is always best to consult a doctor before starting a course of these tablets.

Are there side effects?

The current birth control pills come in very low dose forms, so the side effects are minimal. Many people believe that it causes weight gain and mood-swings, but there is no evidence to support this. There may be some nausea in the beginning which usually settles down as one continues to take the pill.

Does age make a difference?

The pill can usually be taken safely by women even up to the age of 50.

Are there other benefits to taking the pill apart from contraception?

The pill has several major health benefits for women.

It regulates the menstrual cycle.
It reduces the symptoms of pre-menstrual syndrome.
It reduces bleeding during menstruation as well as the cramps that accompany it. Therefore, there are less chances of becoming anaemic from heavy bleeding.
It reduces the risk of pelvic inflammatory disease as well as benign breast disease.
It reduces the risk of ovarian cancer by 50%.
Contrary to common belief recent studies have shown that it does not increase the risk of breast or cervical cancer.

These benefits increase the longer you are on the pill.

Will the pill lessen the chances of getting pregnant later?

The pill does not affect fertility in any way. You can stop taking the pill at any time if you want to conceive. There is also no necessity to wait for a period of time after stopping the pill before trying to conceive.

If a woman finds out that she is pregnant while taking the pill will it affect the baby?

If for some reason you find out that you are pregnant - by not taking the pill according to instruction, or beginning it while being unaware of a pregnancy - there will be no adverse effects on the baby.

Can the pill be taken by breastfeeding mothers?

Breastfeeding mothers are not encouraged to take the pill since it can reduce the flow of milk.

How is it taken?

A pack of birth control pills usually contains 28 pills. You take one every day for three weeks. At the end of the three weeks you will have your periods. The other 7 tablets, which are often iron tablets, are taken during that week, and at the end of that week you start on a new pack. The purpose of the 7 tablets taken during the week you have your periods is to make it easier to remember to start the next course of pills.

What if a woman misses a pill?

If you have missed just one pill you should be safe by taking two pills within the next 24 hours. If it is more than one, however, it is best to use some other form of contraception until your next period.

Does anything make the pill less effective?

Yes, the pill is less likely to work if you have diarrhoea, vomiting or are on certain drugs such as some antibiotics or antiepileptic drugs.

What is the Emergency Contraceptive Pill?

This is not a family planning method. It can be taken to prevent pregnancy within 72 hours of unprotected intercourse or a known or suspected birth control failure such as a broken condom or missed pills. However, it should not to be taken regularly as a form of contraception.

How does one choose a pill?

In Sri Lanka the most popularly used local brand is 'Mithuri'. There are also other commercial preparations available. Talk to your doctor about which brand is best for you.

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