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| :: Birth Control Pills: Ask Your Doctor About the Benefits :: |
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Introduction
If you are thinking about birth control, the chances are good that you or your significant other will choose the birth control pill (also called OCP, for oral contraceptive pill) for pregnancy prevention, since it's the most frequently used form of reversible contraception in the United States. Indeed, more than 80 percent of American women use the Pill at one time or another in their lives. Today, approximately 26 percent of U.S. couples are using the Pill to help prevent an unintended pregnancy. The high popularity of the birth control pill continues despite the many myths allowed to circulate about this excellent contraceptive choice.
Is the Pill Safe?
OCPs are an extremely safe form of contraception. It is estimated that women who become pregnant will have more complications from the pregnancy than they would if they were Pill users. One estimate states that for every 100,000 women who carry a full-term pregnancy, 10 will die from the pregnancy, whereas two deaths might be attributable to the Pill. Put another way, Pill use decreases a sexually active fertile woman's chance of death fivefold. Interestingly, a woman who smokes has a 250 times greater chance of death from the negative cardiovascular effects resulting from cigarette smoking, and an eightfold greater risk of death by auto accident, than by Pill use. Most women who hear that OCP use is life-saving are astounded that these facts are not widely publicized.
Benefits of Taking the Pill
Are there other advantages to OCP use? The answer is a resounding yes. Women who use OCPs, when compared to their non-pill counterparts, have fewer occurrences of acne, cystic breasts, ovarian cysts, painful periods, lower occurrences of anemia, pelvic inflammatory disease, ectopic pregnancy, and osteoporosis. Thus, the range of Pill benefits varies from those that are cosmetic to those that improve your quality of life by keeping you healthy and limiting extra visits to the doctor's office.
In my opinion, the most important benefit of the Pill is its consistent ability to prevent cancer in women. Several studies have shown a 40 percent decrease in the occurrence of ovarian and uterine cancers in Pill users when compared to those who do not use OCPs. This well-described benefit of OCP use has unfortunately been overshadowed by media portrayals of the Pill as a predominant cause of breast cancer. The good news is that Pill users can derive all these Pill benefits and worry less about the possibility of breast cancer. The largest breast cancer study, published in 1996, included nearly 54,000 cases and did not confirm an overall greater lifetime risk of breast cancers among Pill users. The breast cancers detected in OCP users tended to be more localized and therefore more curable when compared to cancers occurring in women who don't take the Pill.
Numerous studies have also confirmed that no overall risk of MI (myocardial infarction-heart attack) or stroke is increased in OCP users, unless they are smokers. Pill users will occasionally experience blood clots (thrombophlebitis) at annual rates that are higher than in the general nonpregnant population. If you have a history of blood clot occurrences, you should not use OCPs. Blood clotting occurs more often in pregnant women than in those using the Pill. The annual risk of blood clotting will be 50 percent lower in OCP users than in the pregnant patient who carries to term. Thus, the birth control pill not only safely prevents an unplanned pregnancy, but also imparts many life-saving advantages to those women who use it consistently for long periods of time.
The Pill is Suitable for Most Women
The ideal candidate is any healthy, sexually active female-there is no age limit for Pill use. Currently available OCPs contain lower doses of the hormone estrogen compared with previous OCP formulations. If you are interested in reversible contraception and are willing to take a pill daily, then the birth control pill may be the ideal choice.
Medical conditions
Women with certain medical conditions may still be considered acceptable candidates for this excellent form of contraception, since an unintended pregnancy often leads to a worsening of chronic diseases. For example, low-dose combination OCPs can be safely used if you have either uncomplicated diabetes or well-controlled hypertension (high blood pressure), as long as you are willing to be monitored by your doctor and take the medications she has prescribed. If you have been diagnosed with other medical conditions that are stable, such as Crohn's disease, arthritis, or have undergone a kidney transplantation, and are at risk for a pregnancy, it is possible that you could also derive the benefits of the Pill, which have been outlined above. I recommend that you discuss this option in depth with both your specialist and your gynecologist to determine if you would be an eligible Pill candidate.
Mini-pills
Patients who are are medically not allowed to take estrogen, which is a constituent present in combination OCPs, may elect to use mini-pills, which contain only progesterone. If you experience estrogen-induced headaches or severe breast tenderness, then you might consider using a mini-pill.
Who should not take the Pill?
There are few women who would not be considered good candidates for the Pill. Patients who should not use combination pills under any condition are smokers older than the age of 35, those with a history of spontaneous estrogen-induced blood clotting, those with an estrogen-dependent malignancy, and those who are already pregnant.
Pill Side Effects
The evolution of modern-day, low-dose Pills has shifted the discussion of Pill safety from those serious side effects, which have been virtually eliminated, to the potential nuisance side effects, which include breakthrough vaginal or menstrual bleeding, nausea, breast tenderness, and bloating. Although not life-threatening in nature, these annoyances can have a dramatic impact on how you feel about taking the Pill and thus, should be avoided whenever possible. I feel that with the nearly 100 Pill types available today, our chances of matching the right formulation to your needs, if you happen to experience one of these rare nuisance side effects, are greatly increased.
Unexpected breakthrough bleeding may occur in the first three months of Pill usage as your endocrine or hormone system adjusts to the circulation of Pill hormones, which signal the ovaries to halt ovulation for that cycle. Taking your Pill consistently at the same time each day eliminates this unexpected menstrual bleeding. If you choose ultra-low-dose Pills (which have the lowest hormonal content), you must try to take them at the same hour each day or you may experience light spotting, and may require the use of a panty liner.
Nausea and breast tenderness are caused by estrogens found in the Pill. Nausea is avoided by taking the Pill on a full stomach. Breast tenderness is usually decreased after two or three cycles (months), but if it persists, it can usually be eliminated by switching to a lower estrogen formulation.
Bloating is limited to the second half of the cycle and can be controlled, as you would with a natural menstrual cycle, by avoiding salty foods and keeping well-hydrated.
Weight gain is the number one concern expressed to me by my patients using the Pill. The good news is that some newer Pills studied did not cause significant weight gain in the first year of use. Some women have attributed weight gain to their tendency to feel hungrier and to eat more while using the Pill. My counseling approach to avoiding weight gain is to raise your awareness of this observation and to help you avoid the temptation to eat more by teaching you to count your calories. Sometimes, all that is needed is a refresher on how to quantify a portion of food and the number of calories in that portion. More often, an official consultation with a nutritionist and exercise trainer is needed to modify our eating behaviors, which are usually too heavy in carbohydrates.
Cancer Clarifications
The most controversial topic that concerns women about hormonal pill usage (both birth control and estrogen-replacement therapy) is whether long-term use of hormones can cause cancer of the breast and uterus. The best evidence to date suggests that the Pill has been strongly associated with a decreased risk of cancers of the ovary and uterus. Cervical cancer is not increased in Pill users although some rare forms of endocervical cancer have been found to be more common. Breast cancer seems to be detected more often in women younger than the age of 35 years during the first five years of Pill use. Experts attribute this fact to Pill users having more frequent physical exams by their healthcare providers. The breast cancers found in these women were also easier to cure, due to their local occurrence and their tendency not to spread. This fact is also consistent with no overall greater lifetime risk of breast cancers among Pill users. Still, whether or not OCPs will increase a woman's risk of breast cancer remains very controversial.
Patients' Frequently Asked Questions
What is the lowest level of estrogen available in the Pill?
Low-dose oral contraceptive pills generally contain 30 or 35 micrograms of estrogen, while those considered to be ultra-low-dose contain 20 micrograms of estrogen or less.
At what age must I stop using the Pill?
Due to the many health benefits and minimal serious side effects resulting from Pill use, nonsmokers who are older than 35 are allowed to use the Pill until menopause, which occurs around age 51. There is no limit to the number of years you can use the Pill. I have met many women who were told to stop using the Pill, without any good reason, as a sort of "Pill rest," who ended up becoming unintentionally pregnant.
What day of the week should I start the Pill?
The best day to begin Pill use is the first Sunday after your last regular menstrual cycle. It is easier to track missed pills and ensures that most of the menstrual flow will stop before the weekend. You can also start the Pill on the first day of your normal menstrual cycle, but this will lead to more weekend flows and is less convenient for some.
When will the Pill start protecting me from pregnancy?
Within the first week, if taken as directed after the last regular menses. Always use condoms during the first week.
Which Pill do you recommend I use?
Since all Pills available in the United States prevent pregnancy and have similar nuisance effects, any choice you and your provider decide to make will usually be right for you. If you experience any of the above-mentioned minor side effects for more than three months, you might be reassured to know that there are about 99 other formulations to consider.
Why do some Pill users complain of spotting?
Many common problems associated with Pill use follow from inconsistent use. For instance, menstrual spotting may result if the Pill is not taken at the same time each day.
What do I do if I forget to take my Pill?
If you forget to take the Pill for one day, simply "double up" by taking two pills the next day. Be sure to take them on a full stomach, preferably several hours apart to prevent nausea and/or vomiting. If you have sex, use a condom as backup. The next day, resume taking your Pill on a daily basis. It is a good idea to continue using condoms until you have consistently used the Pill for one week. If you forget two days worth of Pills it is best to use a backup method such as condoms and start a new Pill pack to avoid confusion. I prefer Sunday starts since they make pill-taking easier to predict. Keep using condoms as a backup for two weeks.
Conclusion
The purpose of this Pill summary is to heighten your awareness about the medical benefits of oral contraceptives that have been published in the last 20 years in scientific literature. A few of these benefits include: shorter, less painful periods; cycle regularity; protection from cancers of the ovary and uterus; and stronger bones. Breast-cancer risk appears to be weakly associated with Pill use and the best studies to date suggest that this association is a result of more frequent surveillance of women by their gynecologists while using the Pill. These multiple-health preventive side benefits of Pill use overwhelmingly impart life-saving advantages to women who choose them, leading many public health advocates to continue recommending oral contraceptives to women at risk of pregnancy.
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Source/Author Info:
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Healthology, Inc. |
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