Birth Control Hormonal Methods (cont.)
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Birth Control Pills
Birth control pills, also known as oral contraceptives, have been marketed in the United States since 1962. Over the past 40 years, the type of estrogen and progestin (hormones) used in the pills has changed and the amounts of those hormones has been lowered.
Birth control pills today are designed to improve safety and reduce side effects. Lower doses of estrogen are associated with a decrease in side effects, such as weight gain, breast tenderness, and nausea.
Birth control pills are taken by mouth and swallowed with a liquid. In late 2003, the US Food and Drug Administration (FDA) approved a spearmint-flavored chewable birth control pill called Ovcon 35. These pills contain the same hormones, progestin and estrogen, that are present in standard birth control pills. Packages contain 21 active pills and 7 inactive pills to be taken throughout one menstrual cycle. You may chew the pills or swallow them whole. If you chew the pill, you should drink eight ounces of water afterward to make sure the full dose reaches your stomach. The chewable version has similar side effects to other birth control pills, such as an increased risk for blood clots, heart attacks, and strokes.
Over 30 different combinations of birth control pills are available in the
United States. Most of the combinations of these pills have 21 hormonally active
pills followed by seven pills containing no hormones. A woman begins taking a
pill on the first day of her period or the first Sunday after her period has
begun. By taking a pill a day, a woman can usually take pills consistently
throughout her cycle.
The pills prevent ovulation (release of an egg) and thus prevent pregnancy.
The association of birth control pill use and breast cancer in young women has been controversial, although more recent studies show that birth control pills will not increase one's risk to develop breast cancer.
The relationship between birth control pill use and cervical cancer is also quite controversial. Important risk factors include early sexual intercourse and exposure to the human papillomavirus. The thinking now is that if birth control pills increase the risk of cervical cancer, the risk is small and related to sexual behavior. Thus, women who use birth control pills should have a periodic Pap test.
M Samra, MD
Bryan D Cowan, MD
Francisco Talavera, PharmD, PhD
Lee P Shulman, MD
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