There are two basic types: combination pills containing oestrogen and progestogen, and progestogen-only pills (sometimes referred to as the mini-pill). Both contain synthetically produced hormones similar to those made by a woman's ovaries. Combination pills prevent a woman's ovaries from releasing eggs, in other words, she doesn't ovulate. Progestogen-only pills thicken the cervical mucus, preventing the sperm from joining with an egg.
How effective is the Pill?
It's one of the most effective reversible methods of birth control if used correctly. Fewer than one out of 1 000 women who use combination pills become pregnant, and about five out of 1 000 who use progestogen-only pills become pregnant.
What are the side effects associated with taking the Pill?
There may be some minor complaints such as bleeding between periods, nausea, headaches and breast tenderness in the first few months, because the body has to get used to the additional hormones. These symptoms usually disappear spontaneously and are no reason for concern. If they persist, it's worth trying another brand with different concentrations and types of oestrogen and progestogen.
Today's contraceptives contain less oestrogen and progestogen than the first-generation Pill (which is not used any more), but offer similar contraceptive benefits. So-called second and third-generation oral contraceptives contain different forms of synthetic progestogen. Third-generation oral contraceptives, which became available in the Nineties, were designed to reduce some of the side effects associated with the Pill, such as weight gain. Contraceptive development has slowed down, as far as the pharmaceutical companies are concerned. What are the benefits of the 'new' Pill?
Research seems to indicate that users experience fewer side effects than with the older oral contraceptives, which contain up to 75% more oestrogen. The ultra-low dose oral contraceptive also appears to be just as effective in treating acne as pills with higher doses of oestrogen. Preliminary research also indicates that women who use older, 'second-generation' pills are about twice as likely to have a heart attack as woman who use 'third-generation' oral contraceptives, but bear in mind that the overall risk of heart attack remains low among women who use oral contraceptives.
What are the contra-indications of the 'new' Pill?
The reduction in ovarian cancer linked to oral contraceptive use seems to be linked to the progestogen component of the Pill. Preliminary research appears to show that women who use the low-progestogen pill are twice as likely to develop ovarian cancer than the ones using a high-progestogen pill. Further research is being conducted in this field.
New research being conducted on women using oral contraceptives and doing regular exercise seems to indicate that the oral contraceptives can prevent the build-up of bone in the spine. This is contrary to previous findings and additional studies are presently under way. There is a small risk of blood clots with all combined oral contraceptives, and this risk is slightly increased when using the third-generation Pill.
So, which one should I take?
Before starting on the Pill or switching to a different brand, it's a good idea to discuss the risks and benefits with your doctor.
How long can I keep taking the Pill?
Healthy non-smokers can safely continue taking the low-dose combined pill or the progestogen-only pill right through to menopause. The combination pill provides oestrogen, so may mask menopausal symptoms and could provide some protection against osteoporosis.
Does the pill work for you? Or do you use something else? Share your comments below.