“The pill is not only for birth control. It can also be used for prevention or treatment of acne, reducing menstrual pain and symptoms of pre-menstrual syndrome, as well as regulating a woman’s menstrual periods,” said pharmacist Prudence Masemola of Medipost Pharmacy.
“Oral contraceptives are prescribed to help control physiological hormonal mechanisms in the body, which is why the pill can be effective for menstrual cycle control, severely painful or heavy periods known as dysmenorrhoea, polycystic ovarian syndrome, and endometriosis. It is important to note that these conditions must be managed by a medical practitioner,” said Dr Sharmistha Heeralal.
Masemola added that most oral contraceptive pills include a daily calendar to help women keep track of their medication. This includes placebo pills for a few consecutive days each month to allow the body to release menstrual flow.
“For special occasions, such as a holiday or sports event, women can safely skip their period by not taking the placebo pills and continuing with the active pills instead. Although this should not be done too regularly, it is a very convenient option for those times when you have activities planned that would otherwise be hampered by menstruation,” she said.
MANY OPTIONS FOR FAMILY PLANNING
When it comes to birth control, there are many options available to couples other than oral contraceptives. “Condoms offer the additional benefit of protection against sexually transmitted infections (STIs). Abstaining from sex is the only fully reliable option for preventing pregnancy and transmission of STIs, including HIV,” said Masemola.
“Injectable contraceptives, which are administered at two- or three-monthly intervals depending on which type is prescribed, only contain progesterone alternatives. This contrasts with the contraceptive pill, which involves both oestrogen and progesterone hormones, and prevents pregnancy more effectively because it includes an additional barrier to falling pregnant,” explained Dr Heeralal.
For longer-term birth control, women can also consider having an intra-uterine device (IUD) fitted, which remains in the uterus, or an implant device, which is inserted into the upper arm and releases small amounts of progesterone to prevent pregnancy. Both options can provide up to five years of protection.
“Once the individual feels their family is complete, the couple could consider more permanent surgical options. For women, a procedure called tubal ligation seals the fallopian tubes to prevent pregnancy. A less invasive procedure available to men, known as a vasectomy, prevents the release of sperm to avoid unwanted pregnancy,” Dr Heeralal explained.
POSSIBLE SIDE-EFFECTS AND WARNINGS
“As with any medication, everyone’s experience differs and there are possible side-effects although many will not feel any symptoms at all. The most commonly experienced are nausea, some gastrointestinal disturbances, headaches, weight gain, inter-cyclical spotting or ‘breakthrough bleeding’, pre-menstrual symptoms such as breast tenderness, and missed menstrual periods. Most side effects pass after the first two weeks, however if symptoms persist, the woman should contact her prescribing doctor,” the GP said.
“Any woman who is considering oral contraceptives should also be aware that there is a very small risk of serious side effects relating to conditions caused by blood clots, known as thromboembolic diseases, including potentially increased risk of stroke,” Masemola said. Always remind patients to read package inserts thoroughly.
Pregnancy must be ruled out before a woman starts taking the pill. Women who have a history of thromboembolic disorders, such as deep vein thrombosis or pulmonary embolisms, undiagnosed abnormal genital bleeding, or suffer frequent headaches should make sure their treating doctor is aware of these factors, as this could mean the pill is not the right choice for them. The same applies to women with known or suspected breast or ovarian cancer and oestrogen-related disorders, or a family history of these conditions.
“It must be noted that compliance is a key factor to this method of contraception being effective. The pill needs to be taken every day, around the same time for it to be optimally effective,” Dr Heeralal said.
Masemola also stressed the need to remind patients that once they decide to stop taking oral contraceptives, it can sometimes take a few months for their monthly cycle to return to normal and allowing for conception to take place. “If pregnancy is not desired, alternative contraceptive methods should be started when [patients] stop taking the pill.”