Taking control with oral contraceptives

Family planning is essential to maintain one’s quality of life.

Good family planning will enable a woman to space out her pregnancies in order to ensure optimum maternal health before her subsequent pregnancy.

There are different types of contraceptive methods available in the Malaysian market such as implants, injections, intrauterine devices (IUD), patches, condoms, and oral contraceptive pills.

An oral contraceptive pill is a common form of contraception widely used by women due to its accessibility and affordable price range.

The public is advised to seek medical consultation from doctors or pharmacists before using the contraceptive pill.

The ideal oral contraceptive may differ amongst individuals depending on their comorbidities and state of health. Individuals with certain medical issues or those currently taking specific types of medication may not be suitable candidates for oral contraceptive use.

Oral contraceptives contain hormone to prevent pregnancies by intercepting the secretion of eggs from the ovary and thickens cervical mucus which in turn reduces sperm motility and keep the sperm from entering the uterus.

Generally, there are two types of oral contraceptives; the combined oral contraceptive pill (COC) which contains progesterone and estrogen, and the progesterone-only pill, also known as the mini pill.

COC is a more widely used form of oral contraception. It is 99 per cent effective at preventing pregnancy when taken correctly.

Depending on the brand, there are different ways of using COC.

The standard way of using COC is to take one pill every day at approximately the same time for 21 days, then have a break for seven days or take the sugar pill for seven days.

During these seven days, the user will be having her period. To ensure continuity of contraception, one should continue with a new packet of COC after seven days.

Discuss with your doctors and pharmacist for a more tailored regime.

On the other hand, the mini pill only contains progesterone and is generally used by breastfeeding mothers as it does not reduce breast milk production.

It is 99 per cent effective at preventing pregnancy if taken correctly and has no break between packs.

One needs to take the mini pill every day at the same time to ensure efficacy and protection. Depending on the brand, a mini pill might not be effective if taken more than three hours or 12 hours later than usual timing.

Among the common side effects associated with contraceptive pills are headache, nausea, dizziness, mood changes, breast tenderness, weight change, and irregular bleeding.

Side effects are generally mild and usually last for the first few months after starting the pill. Do not be alarmed as you may or may not experience any of the side effects.

If symptoms persist, discuss them with your doctor or pharmacist.

Women are advised to carefully read the patient information leaflet that comes together with the oral contraceptives in order to fully comprehend how to take the medication appropriately and the steps to be taken if there are any missed doses.

Instruction on missed doses may vary depending on the brand and number of missed doses.

Alternative forms of contraception such as condoms may be used as a barrier method if protection is compromised due to missed doses.

One should be aware that oral contraceptives do not protect one from sexually transmitted infections (STI) such as HIV, chlamydia, and syphilis.

Use condoms to prevent STIs.

In order to ensure the efficacy of oral contraceptives, it is advisable to take the medication at the same time every day as instructed. Failure to do so may result in pregnancy.

Here are a few tips to avoid missing contraceptive pills:

· Choose a convenient time to take your medication.

· Use an alarm or application available on smartphones.

· Use a calendar to mark off doses once taken.

Always obtain advice from a medical doctor or a pharmacist on the appropriate form of oral contraceptive.

Should you have any queries, please contact the National Pharmacy Call Centre, NPCC at 1-800-88-6722, available on Mondays to Fridays from 8 am to 5 pm (except on public holidays).

Audrey Lim is a pharmacist at the Institute for Clinical Research, Health Ministry.

Reference: 1. https://www.uptodate.com/contents/contraception-counseling-and-selection 2. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/ 3. https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/ 4. https://www.bayer.com/en/pharma/contraception