Sexual health is no stranger to public opinion. With the concern for birth control a pressing topic amongst the likes of healthcare professionals, democratic lawmakers and most importantly, women, the conversations surrounding contraceptives have been gaining prevalence in modern-day society. And this only marks a big step for the future of health and safety regarding the female body, as transparency surrounding female health begins to strip back such taboo topics.
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Thanks to advancements in technology, contraceptive methods now sees itself in a multitude of forms, from condoms and pills to contraceptive implants and IUDs. But diving into a journey of self-discovery regarding contraceptives and sexual health can be an intimidating one. Even by searching up the most commonly used method—birth control pills—will inundate you with a plethora of resources within seconds, and it might be overwhelming to glean insight or important information.
To save you from information fatigue, we sought out some answers from Dr Fiona Ng, a doctor at Ova, s digital health platform managed by ORA Clinic, centred on reproductive health care, for all your female health queries and beyond.
How birth control pills work and its effect on your body
There are two different types of birth control pills—combined oral contraceptives and mini pills, differentiated by the type of hormones it contains. The former primarily contains ethinyl estradiol and progestin, while the latter only contains progestin, and is also known as progestin-only pills. Progestin plays a crucial role in preventing pregnancy, as it prevents a surge in hormones, which in turn prevents ovulation. The hormone also thickens the cervical mucus, building a stronger barrier against sperm entering the womb. Progestin reduces chances of implantation through thinning of the womb as well.
Ethinyl estradiol on the other hand, aids in preventing follicle development in the ovaries. This hormone stabilises the womb lining, reducing a common side effect of spotting. “Ethinyl estradiol also enhances the effects of progestin,” explains Dr Ng.
The effectiveness of birth control pills on preventing pregnancy
The effectiveness of birth control pills essentially comes down to the type of contraceptive you choose, and how accurately you use them. Consistency and accuracy is key, ensuring you are using your birth control method regularly and correctly for maximised effectiveness. “For example, birth control pills are 98-99% effective if you use it perfectly. However, it is easy to forget or miss pills—so in reality the pill is about 91-93% effective,” explains Dr Ng.
The difference between birth control and emergency contraceptive pills (the morning after) pill
Birth control refers to any method, medication or device that is used to prevent pregnancy. Some contraceptive methods, like condoms, also provide dual protection from the simultaneous risk of sexually transmitted infections. Meanwhile, emergency contraceptive pills, also known as ‘the morning after pill’, is used as backup contraception to prevent pregnancy should the primary method of birth control fail or you miss a pill. “Emergency contraceptive pills should not be used as a form of routine contraceptive, neither do they protect you against sexually transmitted infections,” Dr Ng forewarns.
Skipping out on your birth control pill routine
Missing your regular dose may affect the effectiveness of the pills in preventing a pregnancy. “It can also increase the risk of breakthrough bleeding due to the drop in hormone levels,” states Dr Ng. In the event you miss your daily dose, Dr Ng recommends referring to the patient information leaflet enclosed in your respective pill box or seeking advice from your doctor on what to do moving forward.
The changes your body goes through while on birth control pills
While the primary purpose of birth control pills is essentially to prevent pregnancy, it also helps with period pain and heavy flow. Combined oral contraceptives have an additional benefit of regulating your menstrual cycle. Newer generations of birth control pills may also help improve your skin. On the flip side, some side effects may pop up when you first start taking them. Common side effects include nausea, headache, breast tenderness and swelling, mood changes, spotting and some acne breakouts. “However, as your body adjusts to the hormones, the side effects should disappear after about 3 months of use. If they do not, you can visit your doctor to discuss alternative birth control pill brands or contraceptives,” Dr Ng advises. Surrounding the hearsay of weight gain being a significant side effect, Dr Ng expounds that the weight gain tends to stem from water retention rather than actual fat gain. This is due to the oestrogen found in the contraceptive.
Getting off the pill
When you stop your birth control pills, it is common for your period to be irregular in the first few months. Your menstrual cycle will be regulated in due time as your body adjusts to being off hormonal contraceptives. However, if you were taking contraceptive pills to help with heavy periods or regulation, expect to see such problems return. If you experience irregular or heavy periods, consult a doctor for a workup regarding the aetiology of your irregular/heavy period. Taking such pills to alleviate dermal issues or mood swings will also see a return of breakouts or mood changes should you stop your dose of birth control pills completely.
Contraceptive methods will not negatively impact your future ability to get pregnant, save for sterilisation, a typically permanent procedure. You will likely start ovulating once you are off oral contraceptive pills. Most women will resume a normal menstrual cycle within one to three months after getting off the pill.
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Where and how to obtain contraceptives
For the best and safest way to obtain birth control, Dr Ng advises to consult and discuss with your doctor about the most suitable contraceptive method tailored for you.