Previously, we discussed about the Period-Delaying Pill and the Morning-After Pill. Heard of the Oral Contraceptive Pills but not really sure how it works? Fret not! By the end of this post, you’ll be sure to be well-equipped with the relevant knowledge.

Without further ado, let’s dive right into the world of Oral Contraceptive Pills and all about its mechanisms, myths, and more. You name it, we discuss it!

 

What are Oral Contraceptive Pills? How do they work?

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There are 2 types of oral contraceptive pills: Combined Oral Contraceptive Pill (OCP) and the Progesterone-only Pill.

They are both a hormonal form of birth control, consisting of pills taken daily to prevent pregnancy by stopping ovulation, through the following mechanisms:

No matter which of the 2 pills you decide to take, you have to consume each dose at the same time every day in order for it to reach its full efficacy.

Combined Oral Conctraceptive Pill (OCP) (99% effective):

How it works: Contains oestrogen and progestin. Prevents the release of eggs from the ovaries.

Suitable for: Anyone

Not suitable for: Women who smoke and are above 35 years old, Women who are already pregnant, Women who are overweight with BMI >35, Women who have severe migraines

Typically, if you suffer from long-term health issues like high blood pressure or diabetes, consult your doctor before starting on this form of contraception.

Progesterone-only Pill (97-99% effective):

How it works: Contains progesterone. Prevents the release of eggs from the ovaries. Thickens the cervical mucus and lining of uterus.

Suitable for: Women who do not want or cannot take oestrogen, Women who have severe migraine, Women who are breastfeeding, Women who smoke, Women who are above 40 years old

Not suitable for: NIL

 

Why should I take them? What are their Pros and Cons?

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You should consider starting on oral contraceptive pills if you are sexually active and do not plan on having a baby.

However, do note that the pills do not prevent you from being infected with Sexually Transmitted Diseases (STDs). Hence, if you have multiple sexual partners, it is still safer to use a condom (barrier method) instead.

Do also note that that use of condoms (barrier method) is recommended for the first 7 days the first time you start on oral contraceptives, to allow time for it to take effect.

Here are some of the Pros and Cons of OCPs:

Note: Although birth control pills in high dosages can be substituted for emergency contraceptives, it is NOT to be confused with the Morning-After Pills OR the Period-Delaying Pills.

^{(Yes, OCPs can provide menstrual cramp relief too! Find out more about menstrual cramps here)} 

Are there any side effects?

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As mentioned above under the ‘cons’ section, there may be side effects experienced from taking these pills.

Here are some of the more common side effects experienced by people. You may experience some of the side effects, or none at all – it really varies across all individuals.

• Intermenstrual spotting
• Missed periods
• Decreased libido
• Vaginal discharge
• Nausea
• Breast tenderness
• Headaches and Migraine
• Weight gain
• Mood changes
• Changes to eyesight

Most of these symptoms experienced at the beginning, however, should subside after a while. Should it persist or get worse, consult your doctor about your suitability to the pills.

 

Where do I get these pills? How much do they cost?

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Unfortunately in Singapore, like the Morning-After Pills, you too, have to get a prescription for this.

You may head to any private clinics, polyclinics, private hospitals or public hospitals to purchase them. Any GP (General Practitioner) is able to give you a prescription, after which you can purchase the pills from any pharmacy)

Cost: For Microgynon (more commonly prescribed in Singapore) – around $2 for a pack of 21 tabs, EXCLUDING consultation fees at the polyclinic.

 

What happens if I miss a dose?  

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One course or cycle of oral contraceptive pills typically consists of 21 hormone pills and 7 non-hormone pills, to be taken daily. You will get your period while taking the 7 non-hormone pills.

The 7 non-hormone pills are, however, entirely optional. You can opt to continue to the next pack while skipping the non-hormone pills.

If you realised you missed a dose of the hormone pills that was:

Less than 12 hours due: Take the missed pill as soon as you realise it, then resume taking the next one at the regular time.

More than 12 hours due: Refer to the following:

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1st week of hormonal pills:

• Take the missed pill as soon as you realise it, even if it means taking 2 pills at the same time.
• Continue to take pills at your usual time. Use a condom (barrier method) for the next 7 days.

If you had intercourse in the week before the missed pill, consult a doctor as there is a possibility of pregnancy.

 

2nd week of hormonal pills:

• Take the missed pill as soon as you realise it, even if it means taking 2 pills at the same time.
• Continue to take pills at your usual time.

If you did not take your pills correctly in the 7 days before you missed the first pill, or if you missed more than 1 pill, use a condom (barrier method) for the next 7 days.

 

3rd week of hormonal pills:

Adhere to either of the following options:

Option 1:

• Take the missed pill as soon as you realise it, even if it means taking 2 pills at the same time.
• Continue to take pills at your usual time and start the next pack right away i.e. no gap should be left between packs.

You are unlikely to have a withdrawal bleed until the end of the second pack, but may experience spotting or breakthrough bleeding on tablet-taking days.

Option 2:

• Stop taking pills and have a tablet-free interval of up to 7 days, including the day pill was missed, then start a new pack.

 

Note: If pills were taken correctly 7 days before you missed the first pill, you may adhere to either option. However, if pills were not taken correctly or more than 1 pill was missed, you will need to follow option 1 and a condom (barrier method) will have to be used for the next 7 days.

Tip: To avoid missing a dose, you can make use of a tracker app that helps remind you and keep track of the pills you’re supposed to ingest at certain timings or days.

 

Can I continually ingest these pills? Myths Uncovered! 

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Yes, you may continually take OCPs for as long as you wish, there has been no proven detrimental health effects to long-term consumption as of yet!

 

Here are some common myths surrounding these pills that we have busted for you:

Myth #1: Birth control pills causes you to become infertile.

Fact: The only permanent form of birth control is sterilisation.

 

Myth #2: Birth control pills causes abortions.

Fact: Birth control does NOT cause an abortion or end a pregnancy. Birth control PREVENTS fertilisation and/or pregnancy.

Hormonal methods work by stopping ovaries from releasing eggs, aka prevents ovulation. Hormonal methods can also increase the amount of natural mucus on the cervix. The thicker mucus makes it difficult for sperm to enter the uterus or travel well enough to fertilise an egg.

Barrier methods like condoms and female condoms physically block sperm entering the vagina and uterus.

 

Myth #3: Birth control pills increase the risk of breast cancer.

Fact: Recent research shows that birth control pills methods have little, if any, effect on developing breast cancer. Oral contraceptives may only lead to a “slightly higher risk” of breast cancer, and this effect ceases ten years after use is discontinued.

Certain forms of hormonal birth control can actually decrease a woman’s risk of developing other types of cancers, such as ovarian and endometrial cancers.

Sources: Aware.org.sg, Cancer.gov

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I hope this article has been useful for you and as usual, especially for medications, do consult your doctor first to decide on your best form of contraception before proceeding! Or if medication just isn’t your thing, check out the Fertility Awareness Method (FAM)!

Take care and we’ll see you again next time!