Pharmacy Times

Oral Contraceptives

Author: Marcy Frusti, BSN, RN

Oral contraceptives (the ?pill?) were introduced more than 40 years ago, and they immediately became the most popular method of preventing unwanted pregnancy. Today?s pill, when taken correctly, is almost 100% effective and has few side effects. In addition, it may be prescribed for other medical conditions, such as acne or menstrual problems. The pill is not good for everyone, however. You should discuss whether it is right for you with your doctor, but a pharmacist can also provide important information.

Additional Benefits of the Pill
The pill has long been known to improve acne and reduce the irregularity of menstrual periods. New evidence suggests additional health benefits from the pill. It may help prevent:

? Cancer in the reproductive organs
? Ovarian cysts
? Breast disease
? Iron deficiency anemia
? Toxic shock syndrome
? Colorectal cancer
? Rheumatoid arthritis

Who Should Not Take the Pill?
Some women should not take the pill. If you have any of the following conditions, the pill might not be right for you:

? History of heart attack or stroke
? Blood clots in the legs, lungs, or eyes
? Chest pain
? Cancer of the breast, uterus, cervix, or vagina
? Vaginal bleeding with no cause
? Liver problems (jaundice, tumors) during pregnancy or during prior use of the pill
? Suspected or known pregnancy

Also, women who take the pill and smoke and those over age 35 have an increased risk of developing blood clots and blockage of blood vessels. These conditions can lead to a heart attack or stroke, with serious injury or death.

Side Effects
Some women may experience irregular vaginal bleeding. This is quite normal and usually goes away within the first few months. If the bleeding is heavy or bothers you, or if you also have pain, contact your physician. Other side effects include nausea, vomiting, changes in appetite, fluid retention, spotty darkening of the skin, headache, nervousness, depression, dizziness, scalp hair loss, rash, or vaginal infection. These side effects are usually temporary. If they continue or cause worry, however, call your health care provider.

Some women are concerned about gaining weight. Most of today?s lower-dose pills have been found not to cause weight gain. If you gain a large amount of weight and see signs of swelling, call your doctor.

Drug Interactions
A number of drugs?such as antibiotics, St. John?s wort (a popular herbal remedy for depression), or some drugs that prevent seizures?may make the pill not work as well as it should. This could lead to pregnancy or menstrual irregularities. Bleeding between periods can often be stopped by taking a higher dose of the pill.

It can be helpful to talk to your pharmacist about these other medications.

What If I Missed Taking My Pill?
Most packages of oral contraceptives have step-by-step instructions on how to handle missed pills. In most cases, if you missed only 1 pill, you should take the missed pill as soon as you remember, and take the next 1 at the regular time. If you missed more than 1 pill, instructions usually vary with the type of pill used. The pharmacist can tell you what to do. As a precaution, use backup methods of contraception for the rest of your menstrual cycle.

Frequently Asked Questions
How long should I wait after stopping the pill before trying to become pregnant?
In most cases, a waiting period of 2 to 6 months is suggested, but you should consult with your doctor regarding an individual plan.

Can I get a sexually transmitted disease while taking the pill?
Oral contraceptives cannot protect you against sexually transmitted diseases, such as AIDS, herpes, and gonorrhea.

What is emergency contraception?
Emergency contraception involves preventing pregnancy after unprotected sexual intercourse. Taking a larger number of oral contraceptive pills as a ?morning-after? solution has been studied, and some brands of oral contraceptives include instructions for this use. Taking a larger number of pills can lead to side effects, such as nausea and vomiting. Before you attempt this method, consult your doctor or a pharmacist for advice.

Resources
? Planned Parenthood Federation of America: 800-230-PLAN
? Emergency Contraceptive Hotline (operated by the Reproductive Health Technologies Project): 888-NOT-2-LATE or www.not-2-late.com.