The oral contraceptive pill, commonly known as “the pill,” is a hormone-based method of preventing pregnancy. It can also help resolve irregular menstruation, painful or heavy periods, endometriosis, acne, and premenstrual syndrome (PMS).
Birth control pills work by preventing ovulation. No egg is produced, so there is nothing for the sperm to fertilize. Pregnancy cannot occur.
“The pill” is used by nearly 16 percent of women aged 15 to 44 years in the United States, and it has both advantages and disadvantages. People with different risk factors may be advised to use a particular kind of pill.
There are different types of contraceptive pills. They all contain synthetic forms of the hormones estrogen, progesterone, or both. Synthetic progesterone is called progestin. Combination pills contain progestin and estrogen. The “mini pill,” contains only progestin.
Monophasic pills all contain the same balance of hormones. With phasic pills, two or three different types of pill are taken each month, each with a different balance of hormones.
Another option is “everyday pills” and “21-day pills.” A pack of everyday pills lasts 28 days, but seven of the pills are inactive. The everyday pill may be easier to use correctly, as the routine is the same every day.
Used correctly, the pill is highly effective, but because people make mistakes, 6 to 12 pregnancies in every 100 are thought to occur each year while using it. The Centers for Disease Control and Prevention (CDC) put the failure rate for both types of pill at 9 percent.
Birth control pills do not prevent sexually transmitted diseases (STDs). Only a condom can help prevent this type of infection.
These are the most common birth control side effects you should know about:
Headache, dizziness, breast tenderness
“These side effects seem to go away after you’ve been taking the Pill for a while,” says Hilda Hutcherson, MD, an ob-gyn professor at Columbia University, in New York.
If they don’t, switching brands may help.
You’re gaining weight
Some women experience a temporary amount of weight gain, says Dr Masterson, but this side effect is typically correlated with the amount of oestrogen in the particular pill you are taking (though it can happen on progestin-only options too).
“As the pill has evolved, we’ve been able to lower the amount of oestrogen in the pill and still have it be effective,” she explains. “Less oestrogen can mean less weight gain, so lower-dose pills are helpful for patients experiencing weight gain.”
You’re having some pretty serious mood swings
Any time you introduce hormones into your body via birth control, it can cause mood changes. “Having crying spells, not seeing the joy in life and having difficulty getting out of bed are all signs of depression,” says Dr Masterson.
“If you’re experiencing any of those symptoms, or having harming thoughts, experiencing difficulty functioning at work, or your relationships are starting to become affected, you should have a conversation with your doctor,” Dr Masterson adds, especially if you’ve been feeling that way for longer than four to six weeks.
Some people experience mild nausea when first taking the pill, but symptoms usually subside after a while. Taking the pill with food or at bedtime may help. If nausea is severe or persists for longer than 3 months, you should seek medical guidance.
Even with proper pill use, a period may sometimes be missed. Factors that can influence this include stress, illness, travel, and hormonal or thyroid abnormalities.
If a period is missed or is very light while using the pill, a pregnancy test is recommended before starting the next pack. It is not unusual for a flow to be very light or missed altogether on occasion. If concerned, seek medical advice.
The hormone or hormones in the contraceptive pill can affect sex drive or libido in some people. If decreased libido persists and is bothersome, this should be discussed with a medical provider.
In some cases, the birth control pill can increase libido, for example, by removing concerns about pregnancy and reducing the painful symptoms of menstrual cramping, premenstrual syndrome, endometriosis, and uterine fibroids.
Changes in vaginal discharge may occur when taking the pill. This may be an increase or a decrease in vaginal lubrication or a change in the nature of the discharge. If vaginal dryness results, added lubrication can help make sex more comfortable.
These changes are not usually harmful, but alternations in color or odor could indicate an infection. Anyone who is concerned about such changes should speak with their medical provider.
Hormonal changes caused by the birth control pill have been linked to a thickening of the cornea in the eyes. Oral contraceptive use has not been associated with a higher risk of eye disease, but it may mean that contact lenses no longer fit comfortably.
Contact lens wearers should consult their ophthalmologist if they experience any changes in vision or lens tolerance during pill use.