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DESCRIPTION
The goal of contraception (or birth control) is to prevent an unplanned pregnancy. The majority of methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
MoonDragon's Contraceptive Methods Compared
Oral contraceptives prevent ovulation (release of a ripened egg from the ovary). Since there is no egg to meet the sperm, pregnancy does not occur. Pills also change the cervical mucus so that the sperm are often blocked from going into the uterus. Pills also thin the lining of the uterus. and therefore make pregnancy unlikely or impossible. There are three types of contraceptive pills: combination, sequential, and daily progestin. The combination type, combining both estrogen and a synthetic progestin, are the most popular and the most effective. At present, oral contraceptives other than the combination type are infrequently prescribed and then only for special reasons. There are many types and brands of pills. They have different packaging and colors. There are 28-day packs and 21-day packs. A health care provider will help each woman to decide which brand is best for her. Always read the product insert with the oral contraceptive that you and your health care provider choose for you to use.
Mini-pills are birth control pills that contain only one hormone, a progestin. They work by thickening the cervical mucus so sperm cannot reach the egg, and by making the lining of the uterus thinner. Sometimes they stop ovulation (the release of an egg). Like other birth control pills, mini-pills must be taken every day, at about the same time of day. You cannot miss pills or you may have a higher risk of unwanted pregnancy.
Mini-pills are great for women who want to take an oral contraceptive, but have experienced unpleasant side effects from oral-combination contraceptives. However, menstrual irregularity is the most common problem with mini-pills. While there is less blood loss, bleeding may be at irregular intervals and there may be spotting between periods.
Among typical couples who use progestin-only pills, about 5% will experience an accidental pregnancy in the first year, mostly because some women do not take their pills correctly. But if these pills are used consistently and correctly, just one in 200 women will become pregnant.
The mini-pill, like the combination-pill, does not prevent the transmission of sexually transmitted infections (STIs), including HIV. To prevent sexually transmitted diseases, you will need to use condoms (male or female) along with your birth control pills.
ADVANTAGES
Effective, with lowest failure rate of any nonpermanent method - less than 0.1 pregnancy per 100 women per year, if all pills are taken as prescribed (the same as 1 pregnancy per 1000 women per year).
No estrogen side effects with mini-progestin-only pills. These can be taken by women who have had side effects or complications from estrogen-containing pills. The amount of progestin in mini-pills is less than in combined oral contraceptives.
Freedom from fear of pregnancy.
Spontaneity of sexual experiences, doesn't interrupt sex.
Regulation and less painful menstrual periods.
Decrease in the amount of menstrual bleeding in most women. Mini-pills tend to make periods short and light. You may go several months with no bleeding at all.
Nursing mothers can take progestin-only pills, preferably after the baby is six weeks old.
No increase in risk of breast cancer and decrease in risk of initiating benign breast disease (non-cancerous breast tumors).
Less likelihood of anemia or arthritis.
Decrease in incidence of pelvic inflammatory disease.
Decrease in incidence of cancer of the lining of the uterus and ovarian cancer.
May decrease acne.
It is easy to use. Mini-pills are easier to take since you take exactly the same kind of pill every single day.
DISADVANTAGES
Must be prescribed by a health care provider.
Can cause side effects, such as mood changes, headaches, nausea or spotting. Some women may experience irregular bleeding and menstrual periods with mini-pills.
Some women experience weight gain and breast tenderness. use of the mini-pill offers less protection against ectopic pregnancy.
Doesn't protect against STDs. Progestin-only pills do not protect you from HIV or other infections.
Must be taken every day. You have to remember to take a pill at the same time every single day and incorporate it into your daily routine.
You cannot "skip a period" with mini-pills as is possible with combined birth control pills.
The failure rate with mini-pills is a bit higher than with combined birth control pills.
May be hard to swallow pills.
Can cause serious health problems, such as strokes. There are many conditions that might prevent your taking the pill. Your health care provider will take a thorough medical history and perform a medical examination prior to prescribing oral contraceptives. If any of the conditions are present that preclude prescribing the pill, another form of birth control will be recommended.
There may be other side effects from the pill. Many of these occur infrequently and, even when they do, will frequently decrease in severity with passage of time. Many women experience no side effects at all. If clients have a bothersome side effect, the health care provider may change the type or brand of pill to get rid of or lessen the side effect.
Oral contraception will not protect against sexually transmitted diseases (STDs). A form of barrier protection will need to be used.
It is normal to have light bleeding or just some spotting of blood during your period when you are on the pill. These "periods" are often lighter and shorter than your normal menstrual period. You may see no fresh blood at all or just a drop of blood. If you don't have a period, it is not likely that you are pregnant if you haven't missed any pills. But, if you miss two periods in a row, see your health care provider. If you have missed one or more pills and then miss a period, you could be pregnant. See your midwife or health care provider for a pregnancy test.
Keep track of your bleeding pattern. If you do not have your menstrual bleeding when you expect it while you are taking the pill, you may want to see your health care provider.
If you see a health care provider for any reason, mention you are on birth control pills.
Your health care providers need to know if you are on the pill before they give you any medicine. Some medicines can make the pill less effective. If you need to take one of these medicines, you may need to use another method of birth control until you finish taking the medication.
SIDE EFFECTS & WARNING SIGNS
Enlargement of fibroid tumors (leiomyomas).
Non-cancerous liver tumors may occur.
Extra hair growth on the face or other parts of the body.
Breast fullness or tenderness. Breasts may increase in size.
Increase of serum copper and iron levels.
Alteration of thyroid tests as if you were pregnant.
Fluid retention.
Missed periods. Changes in bleed patterns, spotting or bleeding between periods called "breakthrough bleeding."
May increase acne. Can cause oily skin. In some cases it improves acne.
Headache, from mild to severe. In some women, these headaches may be mild. For others, they may be painful and hard to get rid of. If a headache is severe, if could be a warning sign of a health problem.
High blood pressure (hypertension). Within a few weeks after pills are stopped, the blood pressure usually returns to normal.
Thrombophlebitis - severe leg pain in the calf or thigh could mean blood clots. Blood clots can occur in the legs, pelvis or heart. This is less likely with pills with minimum estrogen content and in non-smokers.
Impairment of glucose tolerance.
Weight gain. Although some women lose weight while taking the combined pills.
Nausea, Vomiting. This is most likely to occur during the first few months of use or with the first few pills of each new pack. Many women can control it by taking their pills at night or after eating. If a woman has this side effect, the health care provider may decide to switch her to different pills.
Diarrhea.
Stroke.
Heart attack. These are most common in heavy cigarette smokers over age 35. Women over 35 that smoke cigarettes should not take any kind of hormonal contraception.
Eye problems. This can include blurred vision or partial or full loss of sight.
Depression or easy mood shifts.
Change in sex drive (may be more, may be less). Mood changes. The hormones in the pill can effect a woman's emotions.
Decrease in levels of some vitamins and minerals (as in pregnancy).
Elevation of triglycerides and cholesterol.
Increase in incidence of gallbladder disease and gallstones.
Depigmentation of areas of the skin, made worse by sun exposure. The pill can cause the "mask of pregnancy" (chloasma) in which the skin on the upper lips, forehead or below the eyes gets darker.
Increased likelihood of vaginal yeast infection, with itching and discharge.
GENERAL MEASURES
INSTRUCTIONS FOR USE (COMBINATION PILLS)
Note: Use a second contraceptive method, preferably a barrier method like condoms or spermicides during your first cycle of pills as a backup method of contraception - otherwise you will be inadequately protected.
Combination Pills: 21 Day Pills
- Usually you count the first sign of your menstrual cycle as day 1. However, there are a few methods of starting your first pack of pills, such as:
a. On the first day of your period.
Your health care provider will help you decide which may be best for you.
b. On the first Sunday after your period starts.
c. Today, if it is certain you are not pregnant.
- If you use the suggestion above for counting your first day of your menstrual cycle as day one, then on day 5, begin taking 1 pill each day. Pick a time that suits you and stick to it as your routine.
- Continue taking the pills for 21 days until pack is finished.
- Stop taking the pills for 7 days.
- Begin taking pills again for the next cycle after these 7 days, no matter when menstrual bleeding begins or ends. Don't forget and don't be late beginning the new pack.
- If you forget a combination pill take it as soon as you remember. Take the next pill at the regular time (with very lose dose pills, another form of contraception should be used for the remainder of the cycle).
- If you forget 2 days in a row, take 2 pills as soon as you remember and 2 pills the next day. Also, for the remainder of this cycle, use an additional form of contraception: condom, foam, jellies, diaphragm, and so on.
- If you forget 3 or more days, stop taking any pills, wait 7 days, then start on a brand new packet. Use another form of contraception for a month.
Combination Pills: 28 Day
- Usually you count the first sign of your menstrual cycle as day 1. However, there are a few methods of starting your first pack of pills, such as:
a. On the first day of your period.
Your health care provider will help you decide which may be best for you.
b. On the first Sunday after your period starts.
c. Today, if it is certain you are not pregnant.
- If you use the suggestion above for counting your first day of your menstrual cycle as day one, then on day 5, begin taking 1 pill each day. Pick a time of day that suits you and stick to it as your routine. The pill works best when you take it about the same time every day. It often helps to take the pill with something else that you do at about the same time every day. This could be brushing your teeth, going to bed or eating a meal.
- Continue taking the pills for 28 days until pack is finished.
- Begin taking pills again for the next cycle after the next day immediately following finishing the pack. You do not take a break with the 28 day pills, no matter when menstrual bleeding begins or ends. Don't forget and don't be late beginning the new pack.
- If you forget a combination pill take it as soon as you remember. Take the missed pill right away. For example, if you usually take your pill at night but forget, take your pill as soon as you remember the next morning. Take your next pill at your normal time, even if it means taking 2 pills in 1 day. Chances are you won't get pregnant, but with very lose dose pills, another form of contraception should be used for the remainder of the cycle).
- If you forget 2 days in a row, take 2 pills as soon as you remember and 2 pills the next day. If you get nauseous, you can take the pills a few hours apart. Also, for the remainder of this cycle, use an additional form of contraception: condom, foam, jellies, diaphragm, and so on.
- If you forget 3 or more days, stop taking any pills, wait 7 days, then start on a brand new packet. Use another form of contraception for a month. If you have any questions about this problem, consult with your health care provider.
Note: Some packets come with 28 pills. Follow instructions on the package.
Follow Up: Consult your health care provider for complete information on potential side effects.
INSTRUCTIONS FOR USE (MINI-PILLS)
Note: Use a second contraceptive method, preferably a barrier method like condoms or spermicides during your first complete cycle of pills as a backup method of contraception - otherwise you will be inadequately protected.
On day 5, begin taking 1 pill each day. Pick a time that suits you and stick to it as your routine, but continue to take a pill every day without interruption.
If you forget a mini-pill, take 2 as soon as you remember, but use an additional contraception method for 3 or 4 weeks.
MEDICATION
Do not use any medicines, even those you buy without a prescription, before discussing them with your health care provider. Carefully follow the instructions on any prescription.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You experience increased frequency, amount, or duration of menstruation.
You experience pain during intercourse or bleeding afterward.
You have a sensation of pressure on your bladder or rectum.
You develop severe chest pain, cough or shortness of breath. This could mean heart attack or blood clot.
You develop pain and swelling in the calf of your leg, or any unusual leg pains. This could be a blood clot.
Your blood pressure goes up (hypertension).
You develop symptoms of gallbladder disease: severe upper abdominal pain, fever, jaundice, nausea. Severe abdominal pain could also mean liver disease, a tumor or a blood clot.
You have any signs or symptoms that make you suspect pregnancy.
You see flashing lights or blurred images, or you ability to see decreases, or speech problems occur (could mean a stoke or high blood pressure).
You develop severe, throbbing headaches, dizziness, weakness or numbness. This could mean stroke or high blood pressure.
You have memory loss or dysfunction, severe mood shifts, seizures, or any other symptoms than may indicate developing problems.
There are some indicators that a health care provider look at before giving a client the pill. For example, health problems such as blood clots, stroke or heart disease increase the risk of having complications while on the pill. Also, women with liver problems or certain cancers may not be able to use the pill. Health care providers will also look at a woman's risk factors for circulatory problems, such as smoking or high blood pressure. If a woman has unexplained vaginal bleeding, the cause will need to be found out before starting this method of contraception. Health care providers also make sure the woman isn't pregnant before giving her the pill.
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