Combined Oral Contraceptive  -  The  Pill

What is it ?  It is a pill women take to prevent pregnancy.  The combined pill contains the hormones oestrogen and progestogen.  These are like the hormones naturally produced by our ovaries.

How does it work ? The oestrogen and progestogen in the pill stop your ovaries from ripening eggs, so there is no egg released from the ovary for sperm to fertilise.

How effective is it ? If taken correctly this pill is 99% effective in preventing pregnancy (this means that only 1 woman out of a 100 will get pregnant each year).

Who can use it ?  If you are a healthy woman who does not smoke you can take the pill safely for many years.

Who should not use it ?

 .  If you have had a heart attack, stroke, blood clot in your leg you can not use this pill

.  If your parents or brothers or sisters have had a blood clot in the leg your doctor

    may need to do a blood test to see if you can use the pill

.  Women over 35 who smoke should not use the pill

.  Women who are overweight should not use the pill as this increases their risk of

    blood clots in the leg and heart attacks.

.  This pill is not suitable while you are breast feeding.  There are other reasons why

    this pill may not be suitable for you, such as severe migraines, or if you have your

    leg in plaster, or need a wheelchair.

What are the advantages ?

It works  It is 99% effective.

It is convenient  It is simple to take and doesn't interfere with sexual intercourse.

Periods  You will have regular menstrual periods which are usually lighter and less uncomfortable.

It is not permanent As soon as you stop taking the pill you can get pregnant.

Protection  The pill reduces your risk of cancer of the ovary and endometrium (lining of the womb) by 50%.

Acne Some pills can improve acne.

What are the disadvantages ?

You must remember to take it.   To be effective the pill must be taken daily whether you have sexual intercourse on that day or not.

You may experience some side effects.  Some women notice changes, especially when first starting the pill.  You may experience 1 or 2 of the following side effects.  These usually improve or go away within 3 months.  If you wish you can change to another pill that suits you better.

Bleeding   Bleeding between periods may occur for a month or two after starting the pill.  This may be just spotting or a bleed as heavy as a normal period.

Breast tenderness

Nausea  If you feel sick, taking your pill with food can help.

Headaches

Weight changes  Some women feel hungry and put on weight: some lose weight.

Mood changes  Some women feel better on the pill:  others notice irritability and depression.

Sexual feelings Some women find they are less interested in sex, others may be more interested.

Skin changes  Dark patches on the face may occur.

Acne  Some pills can make acne worse.

 Serious side effects are rare:

A large study has shown that pill users followed for 25 years were not at any overall greater risk of death than women who did not use the pill.

Smoking greatly increases your risk of stroke or heart attack.  If you don't smoke you are unlikely to get these serious diseases.

Pill use can increase the risk of blood clots in the leg from 1 in 30,000 to 6 in 30,000.

The following may suggest serious disease.

Contact you doctor if you:

 .  get sudden chest pain (heart attack)

 .  cough up blood (blood clot in the lung)

 .  become breathless (blood clot in the lung)

 .  have pain in the lower leg (blood clot)

 .  have severe headache (migraine, stroke)

The pill and cancer ?

Cancer of the breast - current research suggests that the pill does not cause this cancer but may lead to breast cancer being diagnosed more often.  This means that of 10,000 pill users under the age of 30 an extra 7 breast cancers will be diagnosed, and between 30-45 an extra 40 breast cancers.

Breast cancers diagnosed on the pill are less aggressive so less likely to have spread from the breast.  Ten years after stopping the pill there are no extra diagnoses of breast cancer.

Cancer of the cervix - current research shows that the pill does not cause this cancer but may alter abnormal cell changes once they have started.  The effect is small, much smaller than the affect of smoking.  Women using the pill do not need to have cervical screening more often.

Cancer of the ovary is reduced by 50%.

Cancer of the endometrium (lining of the womb) - is reduced by 50%.

Will the pill affect your chances of having a baby later ?

No.  Many women get pregnant as soon as they stop the pill, but some find it takes a few months.  However, about 10% of women will have difficulty getting pregnant whether or not they have used the pill. 

If you get pregnant while taking the pill, your chance of having an abnormal baby is no different from the usual figure of 2 in 100.

Does this pill protect you from sexually transmissible infections ?

No.  If you want to protect yourself from sexually transmissible infections, you will need to use condoms as well.

For more information about FPA resources, clinics and education go to their web site.   www.fpanz.org.nz