FAMILY planning is a socio-economic requirement for a healthy and rapidly advancing nation. Since male sterilisation is unpopular, the options commonly available for contraception target the females.
In healthy females of child-bearing age, the ovaries are key in the reproduction system where they produce hormones such as oestrogen and progesterone, in varying levels, depending on the phase of the menstrual cycle.
Oral contraceptives have over 99 per cent efficacy on pregnancy prevention. Its mechanism of action targets three ways: preventing ovulation (most fertile period in a woman’s cycle when the eggs are released from the ovaries), thickening of the mucus at the neck of the womb making sperm penetration very difficult and preventing implantation of a fertilised egg unto the wall of the uterus by reducing its thickness.
There are many forms of contraception such as barrier method (both male and female condoms, vaginal ring and diaphragm), IUD (intra-uterine device for example copper T), IUS (intrauterine system which releases progesterone instead of copper), subcutaneous implants, and injections.
This fading taboo topic may be the reason why oral contraceptives have been referred to as “the pill’. Today it is normal for females to make decisions about their reproductive health with or without consultation of their male partners and their extended families. There is one type of oral contraceptives, emergency contraceptives, which are permitted for over the counter sale without a prescription.
Emergency contraceptives are referred to as “Plan B” and come under various manufacturer brands such as Prostinor, which comprises of 2 pills or Postpone 72 which is a higher concentration in one pill. These formulations are designed to be used within 72 hours of unprotected intercourse to prevent pregnancy. However, it must be understood that no one should have an emergency every day or every week. But in unavoidable cases where you do find yourself in such situations, you should consider a safer contraceptive option which is the daily pill.
There are various other combinations of the artificially produced female hormones under brands such as Microgynon, Diane 35, Yasmin and Qlaira. They are packaged in boxes of monthly supply (21s and 28s) or quarterly supply (three cards) and are safer than emergency contraceptives since small incremental doses are taken daily.
Daily oral contraception requires routine ingestion at a convenient time to your schedule 24 hours apart. Some brands have just 21 active pills whilst others have an additional seven dummy pills on the card totalling 28. During that seven day break (absence of the active hormone), there is a mirage menstruation or withdrawal bleeding. On the 28 pill card, the seven blank pills are usually iron supplement. The purpose for the dummy pills is two-fold – to supplement the body and to prompt when to start the next card. The pills are taken sequentially as indicated by the arrows on the card commencing between the first to the third day of bleeding.
Minor side effects are associated with oral contraception such as mood swings, breast tenderness, headaches and nausea, which are transient. However there may be more pronounced side effects such as heavy bleeding and weight gain with other forms of contraception like implantation and injectable, more so with the single hormone preparation like Depo Medrol. The simple reason is because of the higher strength administered which is expected to last a longer period (three months).
However, weight gain from using the pill is a myth. Some persons may experience a temporary water retention which should be resolved in two to three months. Numerous studies were reviewed but there is no evidence or data published to support increase in body weight due to fats.
There is a very low risk for blood clots and cervical cancer in young women who are non-smokers. However, for women over 35 years who are smokers, the combined oral contraceptives may not be an appropriate choice, especially with a pre-existing medical condition.
With regards to mental health, there are mixed views on the effects of the pill and where some persons claim to have associated depression but there is no conclusive evidence.
Patients are advised to communicate with the prescriber if the side effects experienced do not normalise or are intolerable so that other treatment options could be tried until there is a resolution of adverse effects.
If for some unrelated reason you vomited after taking the pill, then you should re-dose as soon as possible. Missing a dose is not advisable that is why you should have a convenient routine time that will be remembered; maybe just before your bedtime, providing that you have a standard bedtime.
Apart from contraception, pills are used for other female-related problems such as endometriosis, premenstrual syndrome (PMS), heavy or painful menstruation. However, for those females desirous of getting pregnant, quitting the pill does not automatically result in pregnancy. It is advisable to quit at least three months to one year in advance; the latter is more applicable with injectable contraception.
Note that the pill is not a shield against STD (sexually transmitted disease), so for such protection a condom will be most appropriate.
For further pharmacological guidance and physician referral, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.