Women's Health

Oral Contraceptives

Written by Mark Abell

Oral contraceptives, otherwise known as "the pill", are the most widely used contraceptives worldwide, with more than 50 million users. There are a number of other forms of contraception, such as the use of condoms, the rhythm method, and now even the implant of a drug releasing apparatus into the skin. The oral contraceptive pill, however, remains the most popular in spite of its side effects. Essentially, the "pill" prevents pregnancy in a woman by inhibiting the release (or surge) of a protein called gonadatropin from the hypothalamus, a portion of the brain responsible for the control of a number of bodily functions. The cervical mucous becomes thick, viscid, and very scanty in amount, prohibiting the penetration of sperm; thus, the uterus is unable to host the sperm and there is no pregnancy. Moreover, the functions of the Fallopian tubes (tubes running from the ovaries to the uterus) as well as their secretions, are altered. The ability of the "pill" to be effective i! s very well documented; in fact, there is less than 0.1 percent failure rate of the pill during the first year of contraception, which is a great deal lower than any other form of "reversible contraception".

There are important issues concerning the use of contraceptions which women of all ages should be well aware of before taking the pill. One of the more important issues, besides their complications and side effects, is the ability to interact with other medications. Here's the rule: whenever taking any drug, it should be stressed that one should check with their physician first; this rule should not apply only to birth control pills, but to all medications. Most of the interactions with respect to birth control pills deal with other medications being taken over a long period of time, otherwise known as chronic medications. Medications such as anticonvulsant, as in the treatment of epilepsy and seizure disorders, can reduce the effectiveness of birth control pills. The short term use of antibiotics, however, pose a very small threat to the ability of the pill to be effective. It would behoove all women taking birth control pills, however, to check with their physician before taking any other form of medication, even over the counter (OTC) medications.

There has been a great deal of hoopla and concern over the use of contraceptives and their side effects through the years; most (but not all) of the risks associated with the use of birth control pills have been effectively reduced by lowering the amount of hormones in the pill. However, there are a few complications and side effects worth mentioning. For one thing, the use of oral contraceptives increase the risk of "thromboembolism" (the development of blood clots), possibly as much as twelve times normal. A major "risk factor" associated with birth control pills and cardiovascular problems (such as blood clots) is smoking and advanced maternal age. It has been noted in recent studies that the risk of such complications (heart and blood vessel) is substantially lower in women who are under the age of 45, do not have high blood pressure, problems with cholesterol, diabetes, and who are not obese. Most clinicians believe that the use of oral contraceptives are considered "safe" in women who are not at risk (as mentioned above) until the age of menopause.

Women who use the pill are less likely to develop benign breast neoplasia (non-cancerous lumps in the breast tissue) - sometimes referred to as fibrocystic disease. It has been stipulated that the development of fibrocystic disease is a "precursor" to the development of breast cancer; so there is some belief that the pill can effectively reduce the risk of breast cancer. The jury, however, is not yet out on this concept and further studies are currently underway within the medical profession. It is known, however, that the pill can dramatically reduce the risk of endometrial cancer, by about 40 percent. There are a host of other risks and benefits of oral contraceptives. Take a look at the following web sites:

http://www.medaccess.com/workbook/healthy_heart/HHH_11.htm

http://lib-sh.lsumc.edu/fammed/pted/ocp.html

Using the pill for birth control is relatively easy. Generally, the first pill is started the first Sunday after the "period" or menstrual cycle begins. It is safe and effective, as long as they are administered each day. Should you ever have a question about the pill, its use, or side effects, seek the attention of your physician.

For further reading, may I suggest an excellent page concerning birth control pills - it's called "Ann Rose's Ultimate Birth Control Links". This is a page with a number of other links to information on the web; it's a "must have" and it can be found at the following URL:

http://www.gynpages.com/ultimate/pill.html.

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