Combined contraceptive Pills

Types of contraceptive Pills

How does it work?

How reliable is the Pill?

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What are the benefits?

What are the risks?

Reasons to choose a the Pill (or CHC) option

What is Combined hormonal contraception (CHC)?

Will it affect my return to fertility?

Who should not use CHCs



Types of contraceptive Pills

 

The combined pill (also known as "the Pill") stops ovulation (an egg being released from the ovary each month) and thickens the mucus at the entrance to the womb, making it difficult for sperm to get through.It contains the hormones oestrogen and progestogen.

You get one pack of pills for every 28-day cycle. You have to take one pill per day.  Different formulations exist:

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Contraceptive Pills with additional benefits

  1. Contraceptive Pills with folate (vitamin B9)
  2. Contraceptive Pills with acne benefits
  3. Contraceptive Pills with benefits on Premenstrual Dysphoric Dysorder
  1. Contraceptive Pills with folate

Why put vitamin B9 (folate) in the contraceptive Pill?

Everybody needs vitaming B9 every day, especially women of reproductive age.

Many women find it difficult to remember to take a vitamin pill on a regular basis.7,15

Folate is an essential B9 vitamin that cannot be produced by your body, so it must be included in the diet or taken as a supplement.8

Low intake of natural food folates, processing of foods and poor absorption, limits the amount of vitamin B9 available for use in the body.2

 

Folate - Essential for Health

The contraceptive Pill Plus folate (vitamin B9) supports a range of health benefits9 and future family plans6

Folate must be obtained either from your diet or through supplementation10

Folate (Vitamin B9) is 1 of the 13 essential vitamins which are necessary for various health functions5

The importance of folate

DNA synthesis2 and normal cell division2,9

Blood cell formation (i.e. red blood cells, white blood cells and platelets)

Immune system function9

Heart health

Pregnancy9,10

 Birth defects and Autism

Nervous System

 DNA = deoxyriboneucleic acid

How reliable is the Pill?

 

The Pill is highly effective and reliable when you use it correctly! There are various types of combined pills with different advantages, so pick one perfectly suited to your needs after chatting to your healthcare professional.

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What are the benefits of the Pill?

 

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What is Combined Hormonal Contraception (CHC)?

 

Combined hormonal contraception is a group name for many different forms of contraception, including the Pill, the ring and the patch.  The reason that it is called "combined hormonal contraception" is that it contains 2 hormones that are combined in the method, an estrogen and a progestogen.  The estrogen and progestogen both play a role in ensuring that you are 99% protected against falling pregnant, and ensuring that your method choice will give you acceptable cycle control.

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Reasons why women choose a combined hormonal contraceptive (CHC) option

 

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How does it work?

 

3 mechanisms of action

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How effective are Combined Hormonal Contraceptives (CHCs)?

 

Effectiveness depends on the user. When no pill-taking mistakes are made, CHCs are more than 99% effective.

With typical use, about 8-9 pregnancies per 100 women using CHCs may occur over the first year.

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Benefits of Combined Hormonal Contraceptives

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Return to fertility of Combined Hormonal Contraceptives

 


 

 

Return to fertility by age group of Combined Hormonal Contraceptives



 

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Weighing up the benefits against the risks

 

An estimated 100 million women take the Pill and about 80% of women will use it at some time during their reproductive life.  The Pill is one of the most researched medicines currently available, and have given women the freedom to plan their families.

The use of any medicine is associated with risk and it is the role of the doctor to ensure that the benefits of a medicine outweigh the risks associated with its use.



Side effects of Combined Hormonal Contraceptives

 

Frequencies of side effects reported in clinical trials with an oral contraceptive containing drospirenone/ethinylestradiol


*usually subsides with continued treatment

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Contra-indications

 

DO NOT USE A CHC IF YOU:

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What are the risks?

 

 Some women experience side effects like nausea, breast tenderness, mood swings, changes in sex drive, headaches, bloating, weight gain or bleeding problems. These symptoms vary from woman to woman and depend on the pill taken. Often, they disappear after the first months of use.

The combined pill is associated with an increased risk of blood clots, e.g. leg thrombosis, lung embolism, stroke and heart attack.

The combined pill DOES NOT offer protection against sexually transmitted infections (STIs), so it’s safest to also use a condom if you and your partner haven’t been tested for STIs.

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About blood clots and CHCs?

 

Using a combined hormonal contraceptive (a contraceptive pill containing an estrogen and a progestogen) increases your risk of developing a blood clot compared with not using one. In rare cases a blood clot can block blood vessels and cause serious problems.

What are the chances of getting a blood clot?

Non-pregnant women, not using the pill      : 4.4 events in 10,000 women per year
Women using low dose oral contraceptives  : 9.9 events in 10,000 women per year
Pregnant women                                      :  29.1 events per 10,000 women per year



Information about blood clots

Recovery from blood clots is not always complete. Rarely, there may be serious lasting effects or, very rarely, they may be fatal. It is important to remember that the overall risk of a harmful blood clot is small.

How to recognize a blood clot in a vein


You should seek urgent medical attention if you notice any of the following signs or symptoms.

When is the risk of developing a blood clot in a vein highest?

The risk of developing a blood clot in a vein is highest during the first year of taking a combined hormonal contraceptive for the first time. The risk may also be higher if you restart taking a combined hormonal contraceptive after a break of 4 weeks or more. After the first year, the risk gets smaller but is always slightly higher than if you were not using a combined hormonal contraceptive. However, your risk of a blood clot in a vein is lower when you use the pill than if you were pregnant or during the weeks after childbirth.   

Factors that increase your risk of a blood clot in a vein

The risk of a blood clot with the combined hormonal contraceptive is small, but some conditions will increase the risk.

Your risk is higher:

The risk of developing a blood clot increases the more conditions you have. It is important to tell your doctor if any of these conditions apply to you, even if you are unsure. Your doctor may decide that the combined hormonal contraceptive is not appropriate for you.

How to recognize a blood clot in an artery

 

Factors that increase your risk of a blood clot in an artery

It is important to note that the risk of a heart attack or stroke from using the combined hormonal contraceptive is very small but can increase:

The risk of developing a blood clot increases the more conditions you have.  It is important to tell your doctor if any of these conditions apply to you, even if you are unsure. Your doctor may decide that the combined hormonal pill is not appropriate for you.

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What are my chances of dying from a blood clot?

The risk for VTE in women taking low-dose CHCs is lower than the risk when you are pregnant or shortly after you have given birth.  The risk of dying from a VTE is very small.  VTE may be fatal in 1-2% of cases.

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