Contraceptive pills containing synthetic hormones are taken orally for contraception. The mechanisms of contraceptive actions include the suppression of ovulation, and thickening of cervical mucus hence rendering it impervious to sperm. There are Progestogen Only Pills (POP) and Combined Oral Contraceptives (COC). They usually come in 21-day, 24-day or 28-day packs. The first tablet is taken between the 1st and 5th day of the menstrual cycle, and then continued with 1 tablet a day. If the first tablet is taken on or after the 6th day of the menstrual cycle, additional contraception like condom is required if you have sex during your first week on the pill. If using the 21-day pack, there should be a break of 7 days before starting the next pack. For 24-day packs, there should be a break of 4 days before starting the next. For the 28-day pack, there is no break between finishing one pack and starting the next.
Nursing mothers less than 6 weeks postpartum; women with confirmed pregnancy, clotting disorders, cancer of the breast or reproductive organs, unexplained vaginal bleeding, chest pain due to heart disease, severe hypertension, migraine, cerebrovascular or coronary artery disease, thromboembolism/deep vein thrombosis, complicated valvular heart disease, diabetes with complications, active hepatitis, severe liver cirrhosis, benign or malignant liver tumour are contraindicated for the use of contraceptive pills.
The risk of adverse effects on the heart and blood vessels increases with age and with heavy smoking (15 or more cigarettes per day). Smokers over 35 years of age should stop taking COC.
Both POP and COC pills will not cause infertility, but it takes some time to resume regular ovulation after stopping the POP.
Progestogen Only Pills (POP)
Progestogen Only Pills contain progestogen only. Breastfeeding and postpartum women can use POP. Side effects include (but not exclusive of): nausea, weight gain, dizziness, headache, breast tenderness, fluid retention and mood changes. These symptoms are usually transient and disappear after a few weeks. Menstrual irregularities are common and persist with use. Some women will eventually be amenorrhoeic but this will not affect your health.
Combined Oral Contraceptives (COC)
Combined Oral Contraceptives contain estrogen and progestogen. Side effects include (but not exclusive of): nausea, dizziness, headache, breast tenderness, fluid retention and mood changes. These symptoms are usually transient and disappear after a few weeks. COC can be used safely by breastfeeding women 6 weeks after delivery and they should monitor milk production. If milk supply diminishes, COC should be stopped and re-stimulate supply with frequent breastfeeds.
