Patients often come into the clinic puzzled about the complexities of birth-control and that confusion is pretty common. There are many factors to consider when choosing a method that is specifically right for you. Several of those include allergies, current and future menstrual cycle, length of protection, discreetness, etc. In this series, we’ll explore different contraceptive methods and provide an overview of how to use them and what to expect. As always, we recommend discussing with your healthcare provider what works best for you at your next office visit or annual pap-smear.
Oral contraceptive pills (OCP), more commonly known as, “the pill,” are the most popular form of birth-control used today. There are many formulations of birth-control pills with various levels of synthetic hormones, and for the sake of clarity, we will break down the intricate details of the pill.
How does it work?
The birth control pill is often made with one or two different chemicals that mimic pregnancy hormones – estrogen and progesterone. In pregnancy, the combination of estrogen and progesterone suppress your ovaries from ovulating (releasing eggs for fertilization) and this is the aim of combination pills (those comprised of synthetic estrogen and progesterone.) Basically, the pill “tricks” your body into believing it’s pregnant. Some pills, often called “mini-pills,” only contain progesterone, which does not inhibit ovulation on its own; instead, it makes the uterus a hostile environment for sperm, which in turn thins the lining of the uterus to make it more difficult for a fertilized egg to implant.
How do I take the pill?
Oral contraceptives need to be taken every day at the same time to be most effective. It is strongly recommended that patients set a daily alarm, so that any disruption to their usual routine does not hinder them from taking their pill at the right time. There are a plethora of apps, gadgets, and websites that help aid in this time-sensitive ritual, such as Bedsider, Spot On, Flo, Eve, Clue and Popit Sense. If you’re the kind of person that prefers the old-fashioned method of plugging in your own reminders, you can use these 23 examples from Buzzfeed for some inspiration!
Now, imagine the simple graph below illustrates what happens when you take a single OCP once – your hormone levels spike and then drop again because you didn’t take any additional pills. If taking the pill “tricks” your body into thinking it’s pregnant, the drop in hormones will “trick” your body into thinking you have ended a pregnancy and need to empty your uterus causing you to bleed.
What are the possible side effects?
The pill mimics the hormones that your body produces during pregnancy, therefore, many women experience analogous symptoms, such as nausea, breast tenderness (and breast enlargement), mood swings, weight gain, spotting, decreased sex drive, headaches* (more on this later), and changes in vaginal discharge. Light bleeding or spotting, along with the aforementioned side effects, are entirely normal for the first three months of taking the pill, as your body adjusts to the alterations in hormones. Contact your healthcare provider if after three months you are still experiencing symptoms that are disruptive to your everyday routine.
There are a few very serious side effects to look out for which indicate you should stop taking the pill and seek medical attention. Here is an easy way to remember what to look out for:
A – abdominal pain
C – chest pain
H – (severe) headaches
E – eye problems (blurred vision, loss of vision)
S – swelling/aching pain in legs
Who shouldn’t take the pill?
If you have experienced any of the above symptoms, or ACHES, during pregnancy or previous OCP’s use, then avoid the pill and consider alternative forms of birth-control. Also, if you’ve been diagnosed with thrombosis – or blood clots – in the veins, lungs, brain, or heart then OCP’s is not for you, due to the hormones causing an increased risk of developing blood clots. If you are over the age of 35 and smoke, there is also a higher risk of developing blood clots with OCP’s and a different form of birth control is recommended. Lastly, if you have a personal history of liver or heart disease, breast or uterine cancer, uncontrolled blood pressure, or migraines with auras, you are also not a candidate for the birth-control pill.
How much does the pill cost?
This frequently asked question is important to consider when deciding on what birth control is right for you. Many insurance plans cover all or most of the cost of birth control, but those who are uninsured or under-insured may be surprised to learn how expensive the pill can be. Some pills are newer to the market and therefore do not have any generic forms available, and this often means they cost more. If you are concerned about birth control being cost prohibitive, mention it to your health care provider because they may be able to start you off with sample, prescribe a generic brand, or suggest where you might find coupons. GoodRX can often compare costs of medications at various pharmacies and provide links to coupons, if any are available.
If you liked this article, send us a message or tell us about what you would like to read about. For those interested in scheduling an appointment, please call us at 512-443-2888 or contact our sister facility Brookside Women’s Medical Center at 512-443-9595.