I am Dr. Jayanti Kamat. I am an IVF consultant obstetrician & gynaecologist consulting at Shristi Fertility Care centre & Women’s Clinic Mumbai. So today I will be talking about a topic which is known as Prevention is better than abortion. So what exactly are we talking about? Yes, we are talking about contraceptive choices. The most popular contraceptive choice is an OC pill, an oral contraceptive pill or a birth control pill. So today we are going to discuss what a birth control pill is, how do they act? What do they contain? Who should use them & who should decide what birth control pill you should be using? So birth control pill is the most popular form of contraception. Today we talk about women’s emancipation, women’s rights. So every woman has a right in a reproductive career. She has the right to make a decision when to get pregnant and also when not to get pregnant. Believe me, friends pregnancy has to be planned so whether you want to have a baby that also requires planning and if you don’t want to have a baby even that requires planning. So that is why today we are talking about birth control pills which are most widely used among all contraceptive methods.
So a lot of people have a lot of doubts and myths about birth control pills. So what are birth control pills? Birth control pills are oral contraceptive pills. Oral means you have to take them orally by mouth, contraception means that is birth control or it prevents conception. So how do they act? They act by inhibiting Ovulation. So what do they contain? They contain the two main female hormones that is estrogen and the progestogen. And the composition of all birth control pills is not the same. They contain various amount and various combinations of estrogen progeston and maybe some other hormones as well. So when exactly you have to start taking the pill. Suppose you do not want a pregnancy then you have to plan it for how long you don’t want the pregnancy. And consult your gynaecologist. She will examine you and decide what is the best pill which is suitable for you. Never take an oral contraceptive pill across the counter. One Size does not fit all so that holds true for birth control pills has. So normally when you prescribe a birth control pill how you should use it. Usually, they come in a packet, it may contain twenty-one pills or twenty-eight pills.
Most commonly they contain twenty-one pills. So ideally the first pill has to be started on the third day of your menstrural cycle. And you need to take the pill every day without fail at almost the same time. So we usually ask a patient to take it at bedtime. And why you should take it at the same time because the concentration of hormones in your blood should remain the same to exert a contraceptive effect. Now, what happens if you miss a single pill. In case you miss a single pill you take your pill on the day which you were supposed to take plus you take your missed pill the moment you remember that it is missed. Suppose this happens more than twice in the month your contraceptive pills are going to fail in the action and in such cases you should use an alternate form of contraception for example you can ask your partner to use a barrier form of contraceptive such as condoms. Now coming to the various myths which surround the birth control pills. Some women believe that birth control pills will affect their future fertility. No this is not true. Usually, a woman resumes ovulation after two to three months after she stops her oral contraceptive pill. It does not have any effect on fertility nor does it cause miscarriage and nor does it cause any birth effects in the baby.
Some people feel that this pill should not be taken for a very long time. There is some truth in this but you and your doctor should decide for how long you can continue taking the pill. It is not that once you prescribe a oral contraceptive pill you continue the same indefinitely without consulting your doctor. No that is not right because oral contraceptive pills at the time do have some undesirable side effects. For example, it can affect the liver. So you have to keep in touch with your gynaec regarding the side effects and periodic check ups are required so that you do not suffer from the long term side effects of oral contraceptive pills. Some people even feels that you should take an oral contraceptive pill for a few months and then take a break and restart it again. There is no medical evidence supporting this. A women can take her oral contraceptive pill for a pretty long time if her doctor advises her because stopping the pill will disrupt your routine and in the months which you stop the pill, you are more likely to conceive.
So if you plan to stop it and if you don’t plan for a baby then you should use an ultimate form of contraception. Another myth is that oral contraceptive decreases the sex drive in a woman, so this is not true. If for any case if this happens to you there may be a lot of other reasons or other causes for it. A very popular myth again is the increase in weight gain. The modern pill does not cause so much increase in weight gain. There may be at least 5 to 10% increase in weight gain. That is because of water retention. So you cannot blame the pill for your weight gain. There is another popular myth. People usually think that all oral contraceptives are the same. No there are not. As I said before all of contain estrogen and progestron. The estrogen may be the same but the progestrogen may be different so you can consult your gynaec and she will decide as to what pill suits you best. Now coming to side effects. There are some unwanted side effects and there are some desirable side effects. So what are the unwanted side effects. See not all people who use oral contraceptives experience the side effects. Some of the women or rather most of the women are quite comfortable using the pill.
Some of the side effects regarding the pill are nausea headache break through bleeding and etc. So once you start using the pill regularly for three months all the symptoms will disappear. Then there are some desirable side effects. A women can have predictable regular menses less incidents of dysmenoria and pre menstrural syndrome. There are lesser chances of anaemeia, lesser chances of pelvic inflammatory disease and lesser chances of non cancerous growths of the breast. So that the pill does have positive or desirable side effects as well. But suppose a woman has a history of heart attack or she has a history of blood clots in the legs then she should be very careful and pills may not be the ideal form of contraception for her.
Even women with breast cancer who have been treated for breast cancer pills may not be a very good option for her. Now, what about oral contraceptive pills and the various forms of cancer. Oral contraceptive pills have a protective effect against endometrial cancer. Endometrium is the lining of the uterus and ovarian cancer. But certain cancers are related to oral contraceptive pills such as cancer of cervix, cancer of liver ad breast cancer. So though Oral contraceptive pills are the best form or a very convenient form of contraception they should still be taken on strictly on medical supervision. You can continue the pills as long as you want but you should be under a doctor’s vigilance. For more information on Oral contraceptive pills, you can contact me at lybrate.com