Oral contraceptive pills: The advantages and disadvantages you should know

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Jason Loo
PhD, MPharm, RPh

 

Oral contraceptive pills (OCPs), also popularly known as “the pill”, are an effective mode of contraception for family planning. They typically contain either one hormone (progesterone only pills) or two different hormones (estrogen and progesterone). When taken properly, they are over 99% effective and are considered to be even more effective than using a condom. While many young women are worried about the unwanted effects of taking hormone containing pills, research has shown that there are many beneficial effects associated with the use of OCPs.

Some OCPs actually provide the following advantages:

  • Make period bleeds more regular and less painful
  • Reduce the symptoms of Pre-Menstrual Syndrome (PMS)
  • Reduce the risk of Pelvic Inflammatory Disease (infection of the female reproductive system)
  • Reduce the risk of colon, ovarian, and womb cancers
  • Estrogens in OCPs may reduce acne in some patients
  • Reduce the risk of fibroids, ovarian cysts, and non-cancerous breast disease

There are some disadvantages as well, which are relatively rare and minor:

  • Many women worry about weight gain, but there is very little evidence of this happening. Nevertheless, some women may experience water retention hence should consider switching to formulations containing drospirenone (with anti-mineralocorticoid effect) which prevents water retention.
  • Some patients experience temporary side effects such as headaches, nausea, swollen breasts, and mood swings. These normally go away on their own after a while, but if they persist, switching to a different brand of OCP might help
  • Some progestogens with androgenic properties may cause acne. Less androgenic progestins, such as norgestimate and drospirenone, may be preferred in women with acne.
  • It may increase blood pressure.
  • It does not protect against sexually transmitted disease (therefore the use of a condom to prevent sexually transmitted diseases is still a good idea).
  • There is a small risk of serious health problems such as blood clots and breast cancer.

Overall, OCPs are a suitable method of contraception for many young women.  However, there are certain women such as those above 35 years who smoke, women with heart disease, or women with a previous blood clot (such as a stroke or deep vein thrombosis) for whom combined OCPs are not suitable. In these cases, a progesterone-only pill might be a more appropriate form of contraception. Talk to your pharmacist to get more advice on which type of oral contraceptive pill is best for you.

 

References

Kaunitz, A. (2017). Contraceptive counseling and selection. [online] Uptodate.com. Available at: https://www.uptodate.com/contents/contraceptive-counseling-and-selection [Accessed 29 Aug. 2017].

Martin, K. and Barbieri, R. (2016). Overview of the use of estrogen-progestin contraceptives. [online] Uptodate.com. Available at: https://www.uptodate.com/contents/overview-of-the-use-of-estrogen-progestin-contraceptives [Accessed 29 Aug. 2017].

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