Contraceptives: Is the pill safe?

Answers questions you had about oral contraceptives but were too shy to ask

What are birth control pills?

woman with pill packetBirth control pills are tablets taken by women to prevent unwanted pregnancy. They are made of a combination of hormones, mostly oestrogen and progesterone. A large variety of these pills of different strengths and hormonal combinations is available on the market.

Is it a safe method of contraception?

Yes, if it is prescribed by your doctor. This is important as the doctor first takes your detailed history—past or present illness, regularity of your periods, prior deliveries—does a thorough examination and only then prescribes a pill, which is safe for you.

Can I take these pills during menstruation?

Generally, when you start with the pills for the first time, the pills are taken on the 5th day of your period, whether you are menstruating or not. Once the pills for that month are over, you generally get your periods in 2 to 4 days.

The next pack of your pills can be again started on the 5th day of your period or after seven days of finishing your previous pack, even if you are still menstruating.

What if I forget to take the pill?

You must not forget to take your daily pill. You can ensure this by taking it every day at a fixed time—preferably at bed time, and by keeping the pill in a place where you won’t forget to take it.

However, if you still forget, take it as early as possible the next day. Plus, also take the pill that is scheduled for the day. This means if you miss your pill one day, you have to take two pills the next day. If you forget to take two or more pills, you have to use some emergency contraception after consulting your doctor, or you may get pregnant. Not taking pills regularly is the number one reason why pills fail as contraceptives.

How long can I take these pills?

For as long as you want contraception. Visit your doctor for your yearly gynaecology check-up or even earlier if you notice any side-effect. Generally, the low dose pill can be taken up to the age of 40.

Can I take the pill if I am breast-feeding?

You cannot take the usual oestrogen-progesterone combination pill if you are breast feeding. What you need is a specially-formulated progesterone pill for feeding mothers, which your doctor will prescribe. Some non-hormonal pills are also available in the market, which can also be taken by breast-feeding mothers. They are taken twice a week for three months and then, once a week thereafter.

Do contraceptive pills have any side-effects? How to deal with them?

All medicines have side-effects, but if you take the pills under medical supervision, the side-effects you face will be minimal. Usually the side-effects you may face include mild nausea, vomiting, giddiness or headache. You can avoid these by taking the pill at bedtime. However, the pill should not be taken by women with high blood pressure, migraine or depression.

The pill should also not be prescribed to women above 40 years of age, unless it is a very low dose hormonal pill or a non-hormonal pill. Still it has to be taken under strict medical supervision. If you take it without consulting the doctor, it can cause heart attacks, strokes, or gall bladder disease. Such side-effects, however, are very rare and are easily avoidable if you consult your doctor before taking the pill.

Is it normal to gain weight when I use a hormonal method of birth control?

Yes. One can gain 2 to 5 kg over a period of 2 to 3 years. However, with the new low dose hormonal and non-hormonal pills, there is no weight gain.

Is there anyone who shouldn’t use hormonal methods of birth control?

Yes. Those with thromboembolic [a condition in which a blood vessel gets obstructed] disease; women with known or suspected tumours of the breast; undiagnosed abnormal vaginal bleeding, cancer of the genitals; heart, liver or gall bladder disease; or suspected pregnancy should avoid the pill.

I no longer use birth control. Why am I having trouble in conceiving?

If you haven’t conceived after a year without using birth control, consult your doctor because there can be any one or more of a long list of reasons as to why you are not conceiving.

I didn’t know that I was pregnant and continued taking my pills. Will the hormones hurt my baby?

Yes, they can hurt your baby. Stop taking the pill immediately and consult your doctor. The doctor will prescribe certain tests, which will check whether your baby is okay.

Dr Monica Bhagat, MBBS, PGDHHM, PGFP, is the medical director of Bhagat Medicare Centre and Nursing Home in New Delhi. She has been working in the field of obstetrics and gynaecology for over 25 years and devotes her efforts towards raising the standard of women health in India.


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