What are combined oral contraceptives?
Combined oral contraceptives are birth control pills which contain two
hormones, an estrogen and a progestin. They prevent pregnancy by stopping
ovulation (release of an egg) and by making the lining of the uterus thinner.
Among typical couples who initiate use of combined pills about 5% will
experience an accidental pregnancy in the first year. This is because
sometimes pills are not used correctly. If pills are used consistently
and correctly, just one in 1,000 women will become pregnant. A second
form of contraception (backup method) should be used for the first month
of your pills.
Complete information about this contraceptive is available from your
clinician or the package insert accompanying the specific pill brand you
are taking.
Advantages:
- Pills decrease a woman's risk for cancer of the ovary and cancer of
the lining of the uterus (endometrial cancer). Pills also lower the risk
of developing benign breast masses (breast masses which are NOT cancer)
and ovarian cysts.
- They decrease menstrual cramping and pain.
- Combined pills reduce menstrual blood loss and the risk for anemia.
- Acne often improves in women taking combined birth control pills. One
pill, Tricyclen, is formally approved for the treatment of acne.
- Many women enjoy sex more when taking birth control pills because they
know they are less likely to get pregnant.
- Some clinicians will provide 3 to 6 months of pills without a pelvic
exam.
Disadvantages:
- Pills do not protect you from HIV or other infections. Use a condom
if you may be at risk.
- You have to remember to take one pill every day.
- Nausea and/or spotting are two problems women may have the first month
on pills.
- Pills tend to make periods short and scanty. You may see no blood at
all. Most women like this when they understand it is common.
- Some women taking combined pills may experience side effects such as
headaches, depression or decreased enjoyment of sex.
- You must use a backup contraceptive for 2 weeks if you have missed pills
and are uncertain the number that you have missed.
- Serious complications such as blood clots may occur but are very rare.
- Pills require a prescription and can be expensive.
- Pills may promote growth of breast cancer but probably do not cause
breast cancer. They may lead to higher rates of one type of cervical cancer
(adenocarcinoma of the cervix).
Where can I get pills?
In the United States combined pills require a prescription. You can get
pills from your doctor, nurse practitioner, nurse midwife, health department,
or family planning clinic.
