Birth Control Pills: ''The Pill''

Birth control pills, also called oral contraceptives, contain synthetic forms of female hormones:

Oestrogen or Progestin

The pill inhibits ovulation (the monthly release of a mature egg from the ovary) and prevents conception.

Normally a woman becomes pregnant when an egg released from the ovary (the organ that holds her eggs) is fertilized by a man's sperm. The fertilized egg then attaches to the woman's womb (uterus), where it receives nourishment and develops into a baby.

Hormones in the female body control the release of the egg from the ovary and prepare the body to accept the fertilized egg. The pill contains a small amount of synthetic progestin and oestrogen hormones that work with the body's natural hormones to prevent pregnancy.

How Does Birth Control Pills Work?

There are 4 ways it acts to stop sperm reaching an egg (ovum):

• Suppresses ovulation. It stops the body from releasing an egg from the ovary, female internal reproductive organ.

• Cervical mucus changes . It thickens the mucus in the cervix, making it difficult for sperm to reach an egg.

• Changes the lining of the womb (endometrium). It makes the cellular lining of the womb thinner, inhospitable and barren for implantation so it is less likely to accept a fertilised egg.

• Changes the movement of the fallopian tubes. This effect may reduce the possibility of the egg being fertilised.

Types of Birth Control Pills

• Combined Oral Contraceptive Pill (COCP).

Combination birth control pills are oral contraceptives that combine synthetic oestrogens and progestins, similar to the natural sex hormones (oestrogen and progesterone) produced in a woman's body. Unlike oestrogen, several types of progestin can be found in various brands of combination pills.

Conventional packs usually contain 21 active tablets and 7 inactive tablets, or 24 active tablets and 4 inactive tablets. Bleeding typically occurs every month when the inactive tablets have been taken.

• Progestin-Only Pills (POP) - Mini Pills.

The mini-pill is 'milder' than the ordinary pill. It contains one hormone, synthetic progestogens (progestins), hence, no oestrogen.

It is typically reserved for women who are unable to take the combined oral contraceptives due to a blood clotting disoder or breastfeeding mums. The normal pill could restrict milk production.

• Extended cycle combined oral contraceptive pills (COCP).

This is packaged to eliminate or reduce the bleeding that normally occurs once every 28 days in conventionally packaged COCPs. May also be called menstrual suppression.

These packs usually have 84 active tablets and 7 inactive tablets. Bleeding happens only 4 times a year during the time when the user takes the inactive tablets.

Formulation containing only active pills, eliminating bleeding or menstrual suppression is also available.

• Continuous-Cycle Pills.

Completely eliminate scheduled menstrual periods. Both continuous-cycle and extended-cycle contraceptives provide the convenience of much less menstrual periods, however, bleeding between periods or breakthrough bleeding can be more prevalent.

Combination oral contraceptive pills or birth control pills come in different phases, depending on whether the level of hormones in the pills changes throughout the month.

• Monophasic (one-phase) pills. In this type of combination pill, each active pill contains the same amount of oestrogen and progestin.

• Biphasic (two-phase) pills.

• Triphasic (three-phase) pills.

• Quadraphasic (four-phase) pills.

Multiphasic. The amount of hormones in the active pills vary in this type of combination pill.

There are several and different types of birth control pills. It can be confusing to decide which type will be the best contraceptive for anybody. Therefore, all the options should be discussed with a medical professional or healthcare provider.

The health practitioner can help narrow down the options.

How Safe is the Pill?

Many women report the following immediate side effects :

• Mood swings and an increase in weight

• Migraines and nausea

• Breast discomfort and tenderness

• Irregular Spotting or Bleeding

• Yeast infection and overgrowth

Is it a Risky Proposition for Birth Control Pills to Artificially Manipulate Hormones?

There are very serious, chronic health risks associated with using the birth control Pill - the pill:

• Cancer

Women who take birth control pills increase their risk of cervical and breast cancers, and possibly a very rare form of liver cancer as well. Nevertheless, the pill has some protection against developing cancers of the colon, endometrium (lining of the womb) and ovaries.

More oral contraceptives and cancer risks can be found at the National Cancer Institute.

• Blood clots

Oral contraceptive pills increase the risk of blood clots and subsequently stroke. If the prescription pill contains desogestrel a synthetic hormone e.g. Desogestrel and Ethinyl Estradiol, the risk of blood clots increase.

The advisory committee for the Food and Drug Administration evaluated the potential health risks of Drospirenone and Ethinyl estradiol (Yaz), Yasmin and other drospirenone containing birth control pills and recommended stronger warning labels for the drospirenone family of drugs.

Other brands containing drospirenone include Zarah, Beyaz, Gianvi, Safyral, Loryna, Syeda, and Ocella.

• Thinner bones

A study conducted by the Department of Medicine, University of British Columbia suggests that women on oral contraceptives may have lower bone mineral density (BMD) in comparison to women who have never used the pill.

Other studies suggest that combination oestrogen-progestin oral contraceptive pills increase the risk for osteoporosis later in life. Women who take birth control pills should be sure to get adequate calcium and vitamin D from diet or supplements.

Hormonal contraceptives that use progestin without oestrogen (such as Depo-Provera injection or other progestin-based contraceptives), may cause loss of bone density.

• Impaired muscle gains

Researchers and kinesiologists found that oral contraceptive use may impair muscle gains in the context of resistance exercise training. This was conducted with 73 healthy women between the ages of 18-31.

Further research may be needed to help explain the reasons behind the results.

• Long-term sexual dysfunction

Birth control may interfere with the protein that keeps testosterone unavailable, leading to long-term sexual dysfunction, decreased arousal and desire.

• Heart disease

Long-term usage of oral contraceptives could increase artery plaque build up in the body which may raise the risk of cardiovascular condition.

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