Birth Control Pills: A Detailed Analysis

Highlights:

  • First birth control pill was designed and produced in the early 1960’s
  • UN says 1.1 billion women today are in need of some kind of contraceptive method

Contraceptive or birth control pills are a very effective method for couples to avoid unplanned pregnancy. These are hormone-based pills which help in avoiding the fertilization of the female egg by a male sperm. Such pills usually contain two types of hormones- estrogen and progestin.

How Does Birth Control Pills Work?

Birth control pills can work in mainly three ways. First it can avoid the woman’s body from ovulating i.e. the woman’s body would no longer produce a fertilizable egg during the course of the medication.

Some of the hormones in these pills may also completely alter the structure of cervix [by thickening cervical mucus and by thinning endometrium] in a woman that would eventually prevent a male sperm from entering the uterus thus avoiding pregnancy.

Lastly, the hormones used these pills can also fundamentally alter the lining of the uterus which in turns avoids the fertilized egg from attaching to the uterus.

Many combinations can be found for the use of birth control pills. These may include monthly packs and some extended regimes can also come in 91-day cycles. Usually despite the cycle you choose a pill a day is what is recommended for effective birth control. Progestin-only pills are however only prescribed in a 28-day format with the method of delivery being the same as combination pills. However, women who are estrogen intolerant are only prescribed Progestin containing pills.

There are also emergency contraceptive pills that are to be used within 72 hours of an incidence of unprotected sex. The success rate for such pills is reported to be one is to three.

 

Are Birth Control Pills Effective?

The Center for Disease Control and Prevention recommends birth control pills are largely very effective in avoiding unplanned pregnancies with the reported success rates as high as 91%. CDC also reports that to use the fullest potential of both, combination as well as progestin pills, the pill must be consumed during the same three hours of each day for the duration for the course. There are many antibiotics, HIV medication, stomach illnesses etc. that could render the pill to be ineffective.

 

Examples of Contraceptive Pills:

Combination Pills [estrogen + progestin]:

Some of the examples of combination contraceptive pills have been listed below-

Ocella, Ortho-Novum, Low-Ogestrel, Natazia, Beyaz, Levora, Yaz, Beyaz etc.

Progestin only pills:

Some of the pills that contain only progestin are listed below-

Heather, Jencycla, Camila, Errin, Ortho Micronor, Nor-QD etc.

 

Apart from the apparent benefit of avoiding unplanned pregnancies, such kind of pills also have a number of side effects which are discussed below.

Side effects of contraceptive pills:

As every human being has a different body structure, not all woman may respond to the birth control courses in the same way. While some of the patients may be tolerant to hormones like estrogen and progestin others may suffer from serious side effects like irregular heavy bleeding, fungal infections and cystitis, migraines, breast pain or enlargement, depression etc. These are only some of the side effects the woman may face while undergoing birth control course.

Although these are side effects are known to wear off after usage over time it can only be assessed through medical examination that what would be best type of hormones that are to be prescribes to a particular woman.

Use of external hormones also increase the chances of blood clots. One such condition that has been linked to its intake over a long period of time is that it may lead to a condition known as Venous thromboembolism (VTE). Symptoms of this condition may include formation of blood clots in legs, arms, groin and some cases these clots are known to have travelled as far as the lungs.

 

Some of the Benefits of Contraceptive Pills:

Birth control pills can have a number of health benefits which are often ignored due to the stigma attached with the concept. Some of them are as follows:

  • Women who have irregular periods can often benefit from contraceptive pills
  • They are a better option than most in preventing unwanted pregnancy
  • They would not cause any permanent effects and the bodily functions would also return to normal once the patient stops taking pills
  • These pills can also be used as prevention rather than cure

Some of the benefits of only progestin-based drugs are as follows:

  • Preferable for women with estrogen intolerance
  • Can be used by the women who are currently breast feeding
  • Can be used by women who suffer from blood clots
  • Can be used by women who are older and are smokers

Some of the benefit of combination pills may include:

Such pills provide protection against acne, thinning bones, heavy or irregular periods, endometrial and ovarian cancer, non-cariogenic breast growth, severe menstrual cramps, anemia etc.

 

Birth Control Pills Don’t Prevent Sexually Transmitted Diseases!

Even though these pills have a very high rate of avoiding pregnancy they are no help in avoiding sexually transmitted diseases. The only way to prevent STD’s is to use protection during sex, namely condoms. In a situation where a woman feels she might be prone to STD’s the best way is to visit the doctor as soon as possible.

 

Stigma Related to Birth Control Pills

According to a study published in Taylor & Francis Online, various combination contraceptive pills were available in the UK as an emergency exit door since 1960’s. However, the UK government inly licensed the first combination birth control pill in 1982 to be sold over the counter. The UK’s National Health Scheme has also made the emergency contraceptive pills available to women free of cost.

The WHO has over 20 years stated, “repeated use [of EHC] poses no health risks and should never be cited as a reason for denying women access to treatment.”

During the early stages of its release the price of emergency contraceptive pills was also set to be much higher as to dissuade woman from opting to such ‘immoral ways’. British Pregnancy Advisory Service (BPAS) also in 2017 campaigned extensively and managed to reduced the prices of such pills by half. It is still far greater than what it actually costs to produce such kinds of pills.

Such products largely remain off limit to in store advertising, even in 2020. If women do not meet the criteria for contraceptives to be prescribed to them, NHS requires them to fix an appointment with the clinic and get the required documentation prepared. This is a tricky situation in a time sensitive case such as an unplanned pregnancy.

Early manufacturers of such pills made the doses in such a way that is would encourage women to have sex less frequently. For Example: A Hungarian pharmaceutical company Gedeon Richter marketed a blister packet of 10 pills each containing 0.75 mg. Women were instructed to take two per episode of unprotected sex, but this multiple-use package came with the warning not to use them more than four times per month.

Even today the National Health Service has classified emergency contraceptive pills as Pharmacy medicine (P) instead of General Sales List (GSL) medication, which would allow the pills to be sold and procured through NHS without any questioning.

In this situation the UK need to step up its political debate on the subject and follow the lead of countries such as Norway, Sweden, The Netherlands and North America. However, in recent years debate over birth control pills has reignited in the US with both sides making fierce arguments regarding the issue. With the Democrats in support and Republicans against any birth control measures.

Breaking the Social Stigma:

Nicole Liu, the founder of Kin Fertility, when she was only 25 years old found herself in a predicament of getting proper guidance and access to fertility and contraceptives related information. Knowing from her experience about the struggles to get proper online medical care network with a certified fertility expert, she thought of launching Kin Fertility.

Nicole was misdiagnosed with polycystic ovary syndrome (PCOS) and found it almost impossible to get the right answers from the people or even the doctors around her. This led to her belief that de-stigmatization to topics such as fertility and reproductive health is an absolute necessity in the modern age.

Kin Fertility is the Australia’s first home delivery service that would deliver contraceptive pills to your doorstep, no questions asked. After being launched in 2019 Blackbird Ventures had provided the start up with the initial investment of $1 million. The start up was also supported by Eucalyptus.

According to the company website of Kin Fertility, ‘The contraceptive pill delivered to your door. Kin lets you ditch the in-person doctor’s appointment, without compromising quality healthcare. Life is full of loop-the-loops. But, access to your contraception should be straightforward.’

Young entrepreneurs like Nicole are today leading the fight against stigmatization of birth control pills. As millions of young women are denied contraception through birth control pills, we must all come together as one and force our policy makers to make positive changes so that these kinds of measures are readily available.

 

What Does the United Nations Say?

According to the United Nations report ‘Contraceptive Use by Method 2019’ the prevalence of specific contraceptive methods varies widely across the world.

The study further points out that 1.1 billion women today are in need of some kind of contraceptive method. Out of these 842 million use modern methods of contraception and 80 million use traditional methods while 190 million women want to avoid pregnancy and do not use any contraceptive method.

The UN further points out the number from 1994 to 2019 of women relying on contraceptive pills has increased from 97 million to 151 million.

 

Why Talk to a Doctor Before You Start Taking Birth Control Pills?

Though birth control pills are one of the best choices available to avoid an unwanted pregnancy there are many factors at play here. Only your physician or doctor could be best informed to make this decision for you. It would be even better to visit a doctor who would know about your pre existing conditions, if any. Factors affecting the decision may include:

  • At this point what would be the best option to consider for birth control
  • What are the medicines that you are currently consuming and what side effects will a combination of birth control pills have?
  • How and what would be the recourse in case of a missed dose?
  • Do I have any pre conditions that would lead to severe complications like blood clots if you start a birth control course?
  • What would be the best type of birth control pill for me to consider?
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