Contraception - the Pill

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Contraception - the Pill

The ‘pill’ is a highly effective form of oral hormonal contraception for women. There are two types of oral contraceptive available by prescription in Australia: the combined pill and the mini pill.

Different methods of contraception may suit you at different times in your life. Discuss the benefits, risks and alternatives with your doctor or other reproductive health advisor.

The combined pill
The combined pill is made of synthetic versions of the hormones oestrogen and progesterone. The pill works by:

* Preventing ovulation
* Thickening the cervical mucus so sperm cannot enter the uterus easily
* Changing the lining of the uterus to make it less suitable to receive a fertilised egg.

The combined pill is 99 per cent effective if used correctly.

The combined pill comes in a variety of types:

* Pills with fixed dose combinations
* Pills that vary in dose throughout the cycle
* Pills with different types of the synthetic versions of oestrogen and progesterone hormones.

The combined pill is packaged in either 21-day or 28-day ED (everyday) packs. Both packs contain 21 hormone pills. With the 21-day packs, pills are taken for 21 days with a seven-day break; the 28-day packs contain seven inactive (sugar) pills so a pill is taken every day.

Advantages of the combined pill
Advantages include:

* Taking the pill generally results in light regular periods.
* Symptoms associated with periods such as pain, premenstrual syndrome and headaches may improve.
* The pill reduces the incidence of cancer of the ovaries and uterus.
* Periods can be safely skipped for convenience.
* Acne usually improves.

Disadvantages of the combined pill
Disadvantages include:

* Regular contact with health providers for a prescription is necessary.
* Cost may be an issue.
* Women need to take a daily pill.
* Side effects such as nausea, breast tenderness, headaches and increased appetite may occur.
* Serious complications such as deep vein blood clots, heart attacks and strokes are possible.
* It is not suitable for women with risk factors for serious conditions, such as smokers over 35 years of age.
* Diarrhoea or vomiting, some antibiotics and other medications (including natural therapies) can affect the pill’s effectiveness.
* The combined pill does not protect against sexually transmissible infections (STIs).

The mini pill
The mini pill or progestogen only pill (POP) contains only one hormone – synthetic progesterone. It works by making the cervical mucus thicker, which prevents the sperm from entering the uterus. A pill is taken every day at the same time. If the mini pill is taken carefully, it is very effective and has a success rate of 96–99 per cent.

Advantages of the mini pill
Advantages include:

* The mini pill is suitable for most women for whom oestrogen is not recommended.
* It doesn’t affect breastfeeding.

Disadvantages of the mini pill
Disadvantages include:

* The mini pill must be taken within three hours of the same time every day.
* It may cause unpredictable bleeding patterns.
* The mini pill does not protect against sexually transmissible infections (STIs).
* Diarrhoea or vomiting, and some drugs (including natural therapies) can affect the pill’s effectiveness.

Cancer concerns and the pill
Early research linking the pill with increased cancer risk caused concern for many women. In fact, the pill has been found to reduce the incidence of cancer of the ovaries and uterus. It may also reduce the risk of bowel cancer.

Whether the pill increases the risk of breast cancer is still a hotly debated question; however, experts agree that if there is an increase in risk, it is small.
Consult with your doctor to discuss the risks, benefits and alternatives to taking the pill.

Emergency contraception
Sometimes it’s necessary to prevent pregnancy after sex rather than before: for example when a pill is forgotten or a condom breaks, or in the case of rape. Emergency contraception was previously known as the ‘morning after pill’.

The most commonly used form – two tablets of synthetic progesterone hormone – can be prescribed by a doctor or is available over the counter at many pharmacies throughout Australia. This pill needs to be started within 120 hours of unprotected sex.

Other types of contraception
There are a number of contraception choices available in Australia. Consult with your doctor, reproductive health nurse or reproductive health provider such as Family Planning Victoria about your options. The method of contraception you choose will depend on your general health, lifestyle and relationship. It is important to weigh up the benefits and possible negative effects of each method and think about your current and future needs.

Protect against STIs
It is important to practice safe sex as well as protect yourself against pregnancy. The best way to reduce the risk of sexually transmissible infections (STIs) is to use barrier protection such as male and female condoms and dams (a thin piece of latex placed over the anal or vulval area during oral sex). Condoms can be used for oral, vaginal and anal sex (in conjunction with other contraceptive methods where required) to help prevent the spread of infections.