Hormonal Methods of Birth Control (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Introduction to birth control
- Types of hormonal methods of contraception
- What are advantages and disadvantages of hormonal birth control methods?
- Oral hormones: The pill
- What are the side effects of the pill?
- How is the pill taken?
- How long will it take before the pill prevents conception?
- What drugs or conditions reduce the effectiveness of the pill?
- What are the benefits of taking the pill?
- When will my I start having periods again after I quit taking the pill?
- Injection: depot medroxyprogesterone acetate (DMPA)
- Contraceptive patch: Ortho-Evra
- Contraceptive implants
- Vaginal ring: NuvaRing
- How effective are hormonal birth control methods?
- Find a local Obstetrician-Gynecologist in your town
What are the side effects of the pill?
- Some women experience temporary symptoms of spotting or light vaginal bleeding, breast tenderness, and nausea during the first one to three months of taking the pill. Nausea can be helped if the pill is taken after a meal.
- While women sometimes fear weight gain with oral contraceptives, studies of the low-dose preparations demonstrate that there is no significant weight gain with oral contraception and no major difference in weight change comparing various contraception products.
- Negative mood changes, such as depression, and pigmented patches of skin on the face (melasma) may occur with oral-contraceptive use.
- Because the progesterone in women can cause thinning of the lining of the uterus, some women may experience loss of menstrual periods (amenorrhea). Oral contraceptive-induced amenorrhea happens in about 1% of women in the first year of use. As long as the woman is properly taking her pills, amenorrhea is not harmful and it does not signal any loss of effectiveness of the pills.
Most side effects from the combination pill or the minipill decrease after two to three months of use. It is important to remember that because most side effects of oral contraceptives decrease in the first two to three months of use, women should try to avoid switching pills prior to an adequate trial. Trying to stick with any given product for two to three months may be necessary to really determine whether or not it will be tolerated over time. Switching too early to another brand may only needlessly subject the woman to the possibility of similar side effects starting all over again with the new pill.
There is no increased risk of birth defects in babies born to women who have taken the pill, but a woman should not use either type of pill if she is pregnant.
A woman who is breastfeeding should not use the combination pill because it can reduce the amount of her breast milk and the concentration of proteins and fat in her breast milk. Additionally, her breast milk will contain traces of the hormones from the pill. However, in contrast to the combination pill, the minipill is routinely used in lactating women.
Blood clots in the legs (DVT) and elsewhere are slightly more frequent with low-dose oral contraceptives, but the risk is very low, and lower than the increased risk of clotting that occurs with pregnancy. Nevertheless, oral contraceptives are not recommended for:
- women with clotting tendencies (such as antiphospholipid antibody syndrome, Leiden Factor 5),
- known coronary heart disease,
- unevaluated bbreast lumps,
- vaginal bleeding, or
- breast cancer.
Smokers over 35 years of age should not use oral contraceptives, nor should women with a significant liver disorder.
A woman should contact her healthcare professional immediately if she experiences any of these side effects while taking the pill:
- severe headache;
- leg cramps;
- change in vision, including blurred vision, vision loss, or flashing lights;
- abdominal pain;
- chest pain;
- shortness of breath;
- coughing up blood; or
- leg swelling or pain.
Next: How is the pill taken?
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