What are oral contraceptive pills and exactly how do they work? Sarah Craus, from the Malta Medical Students’ Association, looks at oral contraceptive pills (OCPs) from every angle.
Combined oral contraceptive pills (OCPs) are forms of hormonal contraception, which contain two types of artificial female sex hormones, oestrogen and progesterone.
Oestrogen inhibits ovulation (the release of eggs from the ovaries) and progesterone inhibits sperm from reaching the womb by thickening the mucus at its neck. The hormones also cause the womb lining to become thinner, making it highly unlikely that a fertilised egg can attach.
OCPs are one of the most common and effective methods used by women to prevent pregnancy. They also help to reduce disruptive aspects of menstruation, such as pain or cramps, heavy menstrual flow (menorrhagia), mood swings and bloating, and can also be helpful in treating conditions such as polycystic ovary syndrome, acne and edometriosis.
The oral contraceptive pills available in Malta include Yaz, Yazmin, Yasminelle, Cilest, Katya, Sunya and Mercilon. Most OCPs are monophasic, which means they are taken daily for 21 days and are not taken for the following seven days.
Yaz: This pill is used to reduce period pains and also to treat acne. Yaz cannot be taken if a woman is pregnant or breastfeeding. It is the only drug available locally that has to be taken for 28 days. The pack contains five placebo pills that help one keep a regular cycle. The period might begin during these days. All pills have the same indications apart from contra-ception, with Yaz, Yazmin and Yazminelle being the most suitable to treat acne.
Yazmin: Similar to Yaz, Yazmin is used to treat acne and it is also used to reduce premenstrual symptoms (PMS, emotional symptoms related to menstruation).
Yazminelle: Also used to reduce period pains and treat acne.
Sunya: Apart from being used to treat PMS and acne, Sunya can be used to reduce hirsutism (excess body hair).
Katya: This drug is useful to treat painful (dysmenorrhea) or heavy periods (menorrhagia), and endometriosis (when cells from the uterus grow in other areas of the body and can cause pain, irregular bleeding and infertility). Similar to Sunya, Katya can be prescribed to women with excess body hair or those who suffer from PMS.
Mercilon: This OCP is used to reduce PMS and bloating associated with the menstrual cycle. Mercilon is also useful to treat breast tenderness.
Who should not take OCPs?
• Smokers;
• Women suffering from heart or liver problems;
• Women who have high cholesterol levels;
• Women who suffer from hypertension (high blood pressure);
• Some drugs cannot be taken if one is over 35 years of age (Yazminelle);
• Individuals who suffer from diabetes;
• Females who have suffered from pancreatitis;
• Lactose-intolerant women;
• Individuals with a history of blood clots;
• Individuals with a history of cancer such as breast cancer.
What are the side effects of taking oral contraceptives?
• Water retention;
• Vaginal dryness;
• Decreased libido;
• Mood swings;
• Abdominal pain;
• Breast tenderness;
• Increased risk of bladder cancer;
• Formation of gall stones.
What should a woman do if she forgets to take a pill?
If one forgets to take a pill, one should take it as soon as one remembers and take the next at the regular time. One should not take more than two pills a day. If one forgets to take two pills, then these should be taken on the day, and two pills the following day.
Afterwards, one should continue to take one pill daily until all the pills in the pack have been taken. It is important to know that one might not be protected frombecoming pregnant in such circumstances. One’s doctor should always be consulted if in doubt.