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what are birth control pills
Obstetrics and Gynaecology

What are Birth Control Pills: Types and Effectiveness

admin Apr 12, 2024


Formal advertising of birth control increased dramatically after the oral contraceptive pill became legally accessible to women.

Did you know? Enovid, the first oral contraceptive, was approved by the Food and Drug Administration in May 1960. Still today, several women planning to delay motherhood face the dilemma regarding the use of birth control pills. One question might arise in some women: Why am I pregnant despite doing everything right? So, let’s find out more! 

What are Birth Control Pills?

Birth control pills or oral contraceptives are hormone-containing medicines that are taken orally. They inhibit pregnancy by preventing ovulation and prohibiting sperm from penetrating through the cervix.

Prominent Types of Pills Available

Combined Contraceptive Pill

It inhibits pregnancy by keeping the sperm and egg (ovum) apart or by preventing ovulation.

Progestogen-Only Pill

It inhibits pregnancy by thickening the mucus in the cervix and inhibiting the sperm from reaching an egg.

Effectiveness of Birth Control Pills

Correct Use: More than 99% effective. Less than 1 in 100 females will become pregnant in a year when having the combined pill precisely.

Classical Use: Approximately 91% effective. Around 9 in 100 females using the combined pill will become pregnant in a year.

At a Glance: How to Use a Contraceptive Pill?

The standard way to take the pill is to have one pill every day for 21 days, then have a gap of seven days. During this week, the woman will have a period of bleeding. They can then start taking the pill after seven days.

Human Error: On Missing the Pill

Remembering to have birth control pills every day can be difficult, but it’s crucial if a woman wants to maintain consistent contraceptive protection. When pills are taken off-schedule, the chances of an undesired pregnancy increase. That said, at certain times, mistakes happen, and a pill is forgotten, or a pack started late. What next?

In Case of Missed Combination Contraceptive Pills

If a woman misses one hormonal pill (by 24–48 hours) or if she is simply late taking one pill (for less than 24 hours):

  • They can take the late or missed pill at the earliest. 
  • Continue having the remaining pills at the usual time

If a woman misses two or more consecutive hormonal pills (more than 48 hours have passed), she should: 

  • Take a pill immediately.
  • Continue taking pills on schedule.
  • Make use of backup contraception (e.g., condoms) or hormonal pills for seven consecutive days.

In Case of Missed Progestogen-Only Pills (“Mini Pills”) 

If a woman gets menstrual periods (even if she is breastfeeding) AND she has missed one or more than one pill by more than 3 hours, she should: 

  • Consume one pill at the earliest. 
  • Continue having pills on schedule, one per day. 
  • Abstain from behaviors that might raise the chances of pregnancy or use backup contraception (e.g., condoms) for the next two days. 
  • Consider emergency contraception if – within the past five days – she has been involved in a behavior that puts her at risk for pregnancy.

Interaction Between Oral Contraceptives and Herbal Medicines/Supplements

Several herbal medicines are available to help support fertility in women. When they are taken along with birth control pills, studies indicate alterations in the effectiveness of oral contraceptives. Let us understand with some examples:

  • Licorice:

The saponins and isoflavones found in licorice decrease the efficacy of oral contraceptives by decreasing their absorption as they interact with estrogen receptors, reducing safety and elevating toxicity and side effects.

  • St. John’s Wort:

Oral contraceptives might be impacted by the enzymes induced by St. John’s Wort, which can cause bleeding and unwanted pregnancy.

  • Alfalfa:

The high concentration of isoflavones and saponins among the compounds present in alfalfa and the associated use with contraceptives can reduce the absorption and effectiveness of these contraceptives.

  • Soybeans:

The use of soy linked with oral contraceptives interferes with their performance because it modifies their hormone levels. This connection decreases the effectiveness and safety of contraceptives, raising the adverse and toxic effects of estrogen derivatives.

Link Between Obesity and the Pill

Obesity impacts the metabolism and distribution of various medicines and, therefore, in the case of hormonal contraceptives, can impair contraceptive efficiency. If the potency of contraception is compromised, more unwanted pregnancies can be expected.

Chronic Diseases and Contraception

Any chronic condition that prevents a woman’s body from completely absorbing birth control pills can increase the chances of pregnancy in a woman, even if she uses the pill perfectly. Among ailments of neurological and psychic origin, the impact of hormonal contraceptives is reduced by antiepileptics. Still, even in this case, older combination pills with higher doses of active ingredients can be employed. Hormonal tablets must not be consumed for hyperlipidemia and hepatic diseases.

Oral Contraceptives and Antibiotics

The use of broad-spectrum antibiotics might lessen the effectiveness of hormonal contraceptives. Lack of success of oral contraceptive steroids can lead to various consequences, comprising breakthrough bleeding, pregnancy, and menstrual abnormalities such as amenorrhea and spotting.

Apart from the reasons mentioned above, the effectiveness of hormonal contraceptives might decrease by blood pressure-lowering or cholesterol-lowering drugs and anti-fungal drugs. Furthermore, if a female who takes the pill vomits or has loose, watery bowel movements, the pill might no longer provide sufficient protection.

Oral hormonal contraceptive pills are more effective in preventing fertilization if taken in the right way. Missing a dose, consumption along with herbal medications and antibiotics, obesity, and suffering from chronic illness are certain conditions where the effectiveness of the pill may be doubtful. Reach out to a healthcare provider to discuss your options for birth control!


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