Birth control pills, or oral contraceptives, are a common and effective technique of preventing pregnancy. These pills include synthetic hormones—either a mix of oestrogen and progestin or just progestin—that operate together to regulate a woman's menstrual cycle and prevent ovulation.

‍

Birth control pills work extremely well when used at the same time every day. They prevent the ovaries from releasing eggs, making conceiving virtually impossible. Birth control pills not only suppress ovulation but also thicken the mucus in the cervix, making it more difficult for sperm to reach an egg. They also thin the uterine lining, which reduces the likelihood of a fertilised egg implanting and developing.

‍

Aside from conception prevention, birth control tablets can help regulate menstrual cycles, reduce painful periods, manage acne, and even cut the risk of certain diseases such as ovarian and endometrial cancer. However, they are not appropriate for everyone, especially ladies with a history of blood clots, migraines with aura, or certain cardiovascular disorders.

‍

‍

Types of Birth Control Pills

There are two types of birth control pills: combination pills and progestin-only tablets  (sometimes known as mini-pills). The most common prescription is for combination tablets, which include both oestrogen and progestin. Progestin-only pills are frequently prescribed for women who are unable to take oestrogen due to medical issues such as high blood pressure or a history of blood clots.

‍

‍

How They Are Taken

While birth control pills are extremely effective, they must be taken appropriately to maintain their effectiveness. With perfect use, the tablet is 99% effective; however, with ordinary use—including missed or late doses—the effectiveness rate lowers to roughly 91%. It's also worth noting that some medications, such as antibiotics or anticonvulsants, can interfere with the pill's effectiveness, so talk to your doctor before taking any new prescription.

‍

‍

‍

Mechanism Of Action

The main mechanism by which birth control tablets function is to stop ovulation, or the release of an egg from the ovaries. Without ovulation, there is no egg for sperm to fertilize, which significantly reduces the chance of pregnancy. This is achieved by the synthetic hormones in the pill, either a combination of estrogen and progestin or progestin alone, which regulate the body's natural reproductive cycle.

‍

Preventing Ovulation: The synthetic hormones in the pill stop the pituitary gland from releasing the hormones that trigger ovulation. If no egg is released, sperm has nothing to fertilize, thereby preventing pregnancy.

‍

Thickening Cervical Mucus: The progestin in birth control pills thickens the mucus in the cervix, making it difficult for sperm to enter the uterus and reach an egg. This acts as a second line of defense against pregnancy.

‍

Thinning the Uterine Lining: Birth control pills also thin the lining of the uterus (endometrium). A thinner lining makes it harder for a fertilized egg to implant and grow, providing an additional safeguard against pregnancy.

‍

By working through these three mechanisms—preventing ovulation, thickening cervical mucus, and thinning the uterine lining—birth control pills offer a highly effective method of contraception. However, for these mechanisms to work optimally, the pills must be taken consistently at the same time each day.

‍

‍

Effectiveness Of Birth Control Pills

Birth control pills are one of the most reliable methods of preventing pregnancy when used correctly. Their effectiveness is categorized into two rates: perfect use and typical use.

• Perfect Use: When the pill is taken exactly as directed—at the same time every day without missing any doses—the effectiveness rate is over 99%. This means that fewer than 1 out of 100 women using the pill perfectly will become pregnant in a year. 
  ‍
• Typical Use: This reflects how most people use birth control pills, factoring in occasional missed doses or taking the pill at inconsistent times. Under typical use, the pill is about 91% effective. This means that about 9 out of 100 women using the pill will become pregnant in a year. 
  ‍

‍

Factors that Affect Effectiveness

1. Missed or Late Pills: The most common reason for reduced effectiveness is missing or taking pills late. Even one missed dose can increase the risk of pregnancy. 
   ‍
2. Interactions with Other Medications: Some medications, such as antibiotics (e.g., rifampin), certain anticonvulsants, and herbal supplements like St. John’s Wort, can interfere with the pill’s effectiveness. 
   ‍
3. Vomiting or Diarrhoea: Gastrointestinal issues, such as vomiting or severe diarrhoea, can prevent the pill from being fully absorbed by the body, reducing its effectiveness.

‍

To ensure optimal effectiveness, taking the pill consistently and following up with a healthcare provider about any medications or conditions that may impact its performance is important. For those who may find it challenging to take the pill at the same time every day, setting reminders or using additional contraception, such as condoms, can provide extra protection.

‍

‍

Benefits Of Using Birth Control Pills

While birth control pills are primarily known for preventing pregnancy, they offer several other health benefits that extend beyond contraception. These additional advantages make the pill an appealing choice for many women, whether or not they are sexually active.

Regulating Menstrual Cycles

Birth control pills help to regulate periods, making them more predictable. This is especially beneficial for women who experience irregular or unpredictable cycles, as it allows for better planning and consistency.

‍

Reducing Menstrual Cramps and Flow

By preventing ovulation and altering the hormonal balance, birth control pills can reduce the severity of menstrual cramps (dysmenorrhea) and lighten menstrual bleeding. This can be life-changing for women who suffer from heavy or painful periods.

‍

Managing Acne

The hormones in birth control pills can lower the levels of androgens in the body, reducing oil production in the skin. As a result, many women see an improvement in acne after starting the pill, making it a common treatment for hormonal acne.

‍

‍

Treating Symptoms of Polycystic Ovary Syndrome (PCOS)

For women with PCOS, birth control pills can help manage symptoms such as irregular periods, excess hair growth, and acne. The pill helps regulate hormone levels and reduce the risk of endometrial hyperplasia, a condition that can lead to cancer.

‍

Reducing the Risk of Certain Cancers

Long-term use of birth control pills has been shown to reduce the risk of ovarian and endometrial cancer. By suppressing ovulation and stabilizing hormone levels, the pill can lower a woman’s lifetime risk of developing these cancers.

‍

Managing Endometriosis Symptoms

Birth control pills can help manage the pain and discomfort associated with endometriosis by suppressing ovulation and reducing the growth of endometrial tissue outside the uterus.

‍

‍

Improving Symptoms of Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

By stabilizing hormone levels throughout the cycle, birth control pills can alleviate some of the emotional and physical symptoms of PMS and PMDD, such as mood swings, bloating, and irritability.

Preventing Anaemia

For women with heavy menstrual bleeding, birth control pills can reduce the volume of blood lost each month, lowering the risk of developing iron-deficiency anaemia.

‍

While the primary purpose of birth control pills is contraception, these additional health benefits contribute to their appeal for managing various reproductive and hormonal health issues. However, it’s important to discuss your individual health needs with a healthcare provider to determine if the pill is the best option for you.

‍

‍

Potential Side Effects and Risks

While birth control pills offer numerous benefits, they can also come with potential side effects and risks. Understanding these can help women make informed decisions about their contraceptive options.

‍

‍

• Nausea: Some women may experience nausea, particularly when first starting the pill. This side effect often subsides after the body adjusts. 
  ‍
• Headaches: Hormonal fluctuations caused by birth control pills can lead to headaches or migraines in some users. Women prone to migraines may need to try different formulations. 
  ‍
• Breast Tenderness: Increased estrogen levels from the pill can cause swelling and tenderness in the breasts, especially in the initial months of use. 
  ‍
• Mood Changes: Some women report mood swings, anxiety, or depression while on the pill. If symptoms persist, this can be due to hormonal shifts and may require switching to a different formulation. 
  ‍
• Spotting Between Periods: Also known as breakthrough bleeding, spotting can occur when using birth control pills, particularly during the first few months of use. 
  ‍
• Weight Changes: While research is mixed, some women notice changes in their weight when taking birth control pills, though this is typically due to water retention rather than fat gain.

‍

Who Should Avoid Birth Control Pills?

• Women with a history of blood clots, stroke, or heart disease should generally avoid birth control pills, especially those containing estrogen.
• Women over 35 who smoke are at higher risk of complications and should seek alternative contraception methods.
• Women with certain types of migraines (those with aura) may experience an increased risk of stroke when using hormonal contraceptives.

‍

How to Manage Side Effects

• Most side effects, such as nausea, breast tenderness, and spotting, usually improve after a few months of consistent use. Taking the pill with food can help ease nausea, and switching to a different formulation may alleviate other symptoms. 
  ‍
• If serious side effects like leg pain (a sign of blood clots), chest pain, severe headaches, or vision problems occur, it's important to seek medical attention immediately.

‍

‍

Alternatives for Women at Risk

• Women who are at high risk for complications may benefit from non-hormonal methods, such as copper IUDs, or progestin-only pills, which carry fewer risks related to estrogen.

‍

While birth control pills are safe for most women, being aware of potential side effects and risks is important. Always consult a healthcare provider to discuss your personal risk factors and the best birth control method for your health and lifestyle.

‍

‍

Conclusion

Birth control pills are a highly effective and convenient method of contraception, offering numerous benefits beyond pregnancy prevention, such as regulating menstrual cycles, reducing acne, and lowering the risk of certain cancers. However, like any medication, they come with potential side effects and risks that should be carefully considered. By understanding how birth control pills work, their effectiveness, benefits, and possible drawbacks, women can make more informed decisions about their reproductive health.

‍

It's essential to consult with a healthcare provider to discuss individual needs, lifestyle, and any medical conditions that could influence the choice of birth control. Ultimately, the goal is to find a contraceptive method that balances effectiveness with comfort, while also supporting overall health and well-being.

‍

Take control of your reproductive health with expert guidance from Rocket Health. Get personalized advice on birth control options and access trusted healthcare support. Contact us today!

‍

‍

Reference

‍

Cooper, & Patel. (2024). Oral Contraceptive Pills. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430882/

‍

Frye, C. A. (2006). An overview of oral contraceptives. Neurology, 66(66_suppl_3). https://doi.org/10.1212/wnl.66.66_suppl_3.s29