More on The Pill

Firstly some corrections to our last article From the wording in the section on the Mini Pill, it would seem that there is more than one hormone in the mini pill. There is in fact only one - a progestagen - in this oral contraceptive.

Contraceptive safety during the first cycle, begins after 14 days of starting the pack, rather than the whole cycle as previously stated. Also if at any stage in any cycle a pill is missed and not taken for 12 hours or more then protection cannot be guaranteed.

The Nature of the Period

The effects of the combined pin (two hormones given simultaneously) lead to a menstrual period that is different from the natural period. The period is more regular and of shorter duration. The volume is also reduced. It is often the brownish colour of old blood as opposed to the brighter red loss of natural menstruation. Be assured there is nothing wrong with this.

Stopping the Pill

Though there may be an interval of amenorrhoea (no periods), generally most women return to their pre-pill cycle, and have the same chances of conception after they stop. The occurrence of prolonged post-pill amenorrhoea is more likely in those who had persistent irregular periods before taking the pill. There appears to be no evidence to suggest a relationship between the duration of use of the pill and amenorrhoea.

Therefore, it is essential that a doctor has full knowledge of your menstrual patterns before going on the pill, as it could cause suppression of ovulation after stopping the pill. This would then cause difficulties when trying to conceive.

Also there is no reason generally for a break from the pill. However, if a woman wants a break, she should use alternative means of contraception, even in the absence of periods. Please discuss this with your doctor.

Suitability

We discuss here the odd effects of the Pill, but note, in the main these are the problems your doctor is concerned about Certain existing conditions often indicate that that person would be unsuitable for this form of contraception. High blood pressure may not necessarily mean that the pill cannot be used. Blood pressure must be checked frequently.

Users with a history of episodes of depression should make their doctor aware of this. In these cases there are certain types of pill more suitable than others.

The pill does not cause varicose veins and they should not be a reason for non-use However, women with large and tender varicose veins should discuss birth control and treatment with their doctor.

Although there is no relationship between the duration of use and problems of the circulation, other factors such as age, race, smoking habits and type of pill must be considered.

It is advisable if surgery is planned, to ask your doctor if it is necessary to discontinue the pill for some time prior to the operation The usual practice now is to continue taking your pill during surgery. Diseases of the circulation are more likely to occur in women who smoke and those over 40 years of age.

Liver disorders can also be aggravated by pill-taking. Your doctor must be notified of any history of liver disease, that you or members of your family, have suffered.

Other Possible Effects

(a)	Possible effects on foetal development if exposed to these hormones during pregnancy.
(b)	Breakthrough bleeding. A particular pill should be persisted with for two to three months to allow such side effects to settle. If it persists a change may be necessary.
(c)	Weight gain. Those with a tendency to weight gain should watch their diet though fluid retention due to the introduction of extra hormones, could be part of the cause, if you do gain weight you can have your pill changed.
(d)	Irritability, depression and loss of sexual drive may become a problem. Treatment may involve stopping the pill or changing the type or giving supplementary vitamins.
(e)	Epilepsy can be affected by oral contraceptives (Increases the number of fits), interaction with epilepsy medications may also affect the reliability of the pill.
(f)	Thrush incidence can be increased by the pill due to changes in the vaginal lining and secretions.
(g)	Acne though often improved, may be increased which might call for a change in the oestrogen component of the pill. (h) Migraine may be caused or frequency of attacks increased by the pill, in which case the advice may be to discontinue. However, known sufferers can take the pill provided it does not aggravate the condition.

This and other methods of birth control can be discussed with us at Student Health.