Is It Safe To Take Birth Control Pills?

birth control pills

The pill (Birth control pill, ovulation inhibitor) is the most frequently used contraceptive in Germany; 38% of women between the ages of 14 and 44 use it. Although there are different types of pills, they are mostly referred to as the "pill". Each "pill" consists of a combination of the man-made sex hormones estrogen and progestin. An exception is the minipill, which only contains progestin. By taking hormones regularly, the body is simulated a hormonal situation like after ovulation and this prevents it. The "pill" is very safe as a contraceptive. Suitable for everyone, especially young women with irregular menstrual cycles and regular sexual intercourse. The "pill" is often prescribed for medical reasons, e. B. with hormonal skin problems such as some types of acne, premenstrual syndrome, menstrual disorders and menstrual disorders. On the other hand, there are also exclusion criteria for which the "pill" is not advisable. The "pill" works from the first day of use and also provides protection during the one-week pill break.

Execution. Before the gynecologist prescribes the "pill", he will examine the woman gynecologically, ask her about her cycle and discuss any risk factors or exclusion criteria that may be present in her. The aim is to find the preparation that is best tolerated by the woman the "pill", the gynecologist usually first prescribes a preparation for three months and then larger packs for six months each. Even if the woman is healthy, the body first has to get used to the "pill". Some complaints, such as a slight headache or intermenstrual bleeding, are quite normal in the first few months. If there are unpleasant side effects, the gynecologist should be consulted.

For girls under 14 years of age, the gynecologist needs the written consent of a parent to prescribe the "pill"; between 14 and 16 years he will consider whether to prescribe the "pill" without consent. From 16 you no longer need a declaration of consent.

It is important to always take the "pill" at about the same time, for example in the evening before going to sleep. A forgotten "pill" can usually be made up within 12 hours without any problems; if it is more than 12 hours it provides protection Not more reliable, and additional contraception must be used until the next menstrual period (e.g. with condoms). In order to avoid intermenstrual bleeding, the pack should be taken to the end even if a “pill” is forgotten. After the last pill intake, there is a week during which the woman has her menstrual period (withdrawal bleeding) The next break follows 21 days. The "pill" can also be used to bring the menstruation forward or to postpone it.

The different preparations - there are over 100 - can be divided into groups:

  • One-step, single-phase preparations contain the hormones estrogen and gestagen in each tablet, the dosage of which remains the same during the cycle (e.g. Diane 35®, Belara®, Valette®).
  • The aim of multi-stage single-phase preparations is to adapt the hormone dose to the natural cycle; these are the most common preparations today. Especially those with a lower dosed and well-tolerated estrogen content of only ~ 20 µg (0.02 mg), also called micropills by some manufacturers, are recommended by gynecologists today. With two-stage, single-phase preparations, the gestagen dose is lower in the first half of the cycle and slightly higher in the second half (e.g. Sequilar®). With three-stage single-phase preparations, the estrogen hormone dose varies in three stages (e.g. Triquilar®).
  • Two-phase preparations contain only estrogen in the first half of the cycle and progestin in the second half (e.g. Ovanon®, Oviol®).

The triple contraceptive effect of the "pill" includes the inhibition of the secretion of sex hormones, which prevents the egg cell from maturing and ovulation. Second, the "pill" solidifies the mucus plug in the cervix and the sperm cannot penetrate the uterus. And finally, the lining of the uterus does not build up sufficiently, so that an egg that may still be fertilized cannot implant itself.
Georg Thieme Verlag, Stuttgart

In practice, the doctor further differentiates oestrogenic pills (e.g. Oviol®) from progestogen-based pills (e.g. Marvelon®). This distinction is especially important when side effects occur: If these can primarily be assigned to the estrogen or progestin component of the pill preparation, the symptoms can often be improved by switching to a preparation with a different emphasis on hormones.

Security. With a Pearl Index of 0.5, the "pill" is one of the safest contraceptives. But here, too, there are exceptional cases: In the event of vomiting or diarrhea, the "pill" no longer provides adequate protection and additional contraception must be used.

Exclusion criteria (contraindications). With many pre-existing illnesses, taking the "pill" entails significantly greater risks. There is a particular risk of serious illnesses due to vascular occlusions, i.e. thromboses, embolisms and even strokes. Therefore, anyone who:

Risks of long-term contraception. Apart from the risk of developing a thrombosis or embolism, long-term use of oral hormonal contraceptives poses no health risks. A study that has been ongoing in England since 1968 could not find any evidence of an increased cancer risk either. The researchers neither demonstrated a greater risk of breast cancer, nor did they find a connection between the use of oral contraceptives and the development of carcinomas of the lungs, gastrointestinal tract, thyroid or skin. They even recognized protective effects for cancers such as ovarian and endometrial cancer. Only women who were infected with the human papilloma virus and who had been taking the pill for more than five years had a three-fold increased risk of cervical cancer. So far, however, it is unclear whether it is a causal or promotional effect.

Many women have the feeling that they gain weight from the "pill". However, this has not been scientifically proven. Some women even report weight loss while taking the pill.

Drug interaction. The hormones in the "pill" are broken down in the liver - like many other drugs. Some drugs, such as anti-epileptic drugs, psychotropic drugs and some antibiotics taken for a long time, stimulate the liver metabolism so that the "pill" is broken down more quickly than normal their effect wears off. Irregular spotting can be a sign of the reduced effectiveness.

Many pill manufacturers also point out that taking St. John's wort preparations at the same time can reduce the effect of the "pill". However, study results have shown that this reduction in effectiveness is only insignificant.

Stopping the "pill". If the "pill" is stopped, there is no longer any contraceptive protection. Women react very differently to stopping the "pill". For some, the next ovulation occurs immediately afterwards, but for many women it does not happen for a few months, which often triggers fears if there is a desire to have children, although the "pill", according to all international studies, indicates fertility after weaning Not impaired. Frequent discontinuation and restarting of the "pill" should nevertheless be avoided, because pill breaks expose the organism to senseless stress due to the hormonal "alternating baths".

In Germany, the "pill" requires a prescription: Various pill preparations are available in all pharmacies against a prescription. For women under the age of 18, the statutory health insurance pays the costs, women between 18 and 20 only pay the prescription fee. except when prescribed for medical reasons (e.g. against acne) - then the health insurance fund usually pays.

Continue reading: other hormonal birth control methods

Authors

Dr. med. Andrea Stadler, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 11:18