Myths about the pill

Me again, before we move into this week’s offering, a little house keeping is in order.

Last week, I left out one other glaucoma eye drop from the list given.

Travatan is also a prostaglandin analogue and will have similar actions and side effects as Xalatan etc. but should not be kept in the fridge. Thank you RN for your reminder.

Every day, thousands of Barbadian women take the contraceptive pill, without fully understanding them. Research seen in the British Medical Journal has shown that 20 per cent of unwanted pregnancies are caused by poor knowledge on how the pill works.

What are some of the misconceptions about the pill?

The Pill Makes You Gain Weight

This is a common pill myth. Women believe that the pill causes them to gain weight, but research has shown that it isn’t due to pill use. The estrogen in the pill can make some women feel bloated, but this typically goes away. The progestin found in the pill may increase appetite, resulting in weight gain.

Also, some women may experience water retention; it can often be reduced by switching to a lower dose pill or reducing the salt intake. Indecently some studies have shown that women often begin using the pill during a time of life that happens to coincide with weight changes, giving the pill an unfair reputation for causing weight gain.

You Should Take a Break from the Pill Once in a While

There’s no medical reason for a healthy woman to take a break. Experts say the pill can be taken for 15 or more years consecutively without any increased risk. However, it is advised that you discuss your contraceptive options after 15 years of using the pill or at age of 35.

The pill is still one of the most effective contraceptive methods, so taking a break from it may increase your risk of getting pregnant (if you’re sexually active). In fact, it’s possible to get pregnant immediately after going off the pill. Taking a break can also cause some of the side effects that can be felt when first starting the pill.

The Pill is Not Safe and It Causes Birth Defects

The pill is one of the world’s most researched and prescribed medications. As with any medication, it will carry side effects, but serious side effects are rare. It is actually safer to use the pill than to have a baby.

About 100 million women worldwide use the pill. For many women, their quality of life is better while taking the pill than when not. That’s because the pill also provides health benefits, like lessening PMS symptoms. The pill can also help regulate your menstrual cycle, so you know exactly when you will have a period.

The pill has been proven as an extremely safe contraceptive. You can even use it to prevent or delay your period for certain occasions (weddings, Kadooment etc.) The pill has not been linked to any type of birth defects (even if accidentally taken through early pregnancy).

Long Term Pill Use Can Affect Fertility

There is NO connection between taking the pill and infertility. Fertility can return almost immediately after stopping the pill, which is why it’s important to take your pills every day.

Some women may face a delay in becoming pregnant after stopping pill use, especially if they had irregular periods before starting it. Women using the pill may delay childbearing until their late 30s, a time when natural fertility has waned, thereby confusing pill use as the cause for not becoming pregnant rather than age. Also, a woman may have always had a fertility problem but was unaware of it because she was not trying to get pregnant.

All Birth Control Pills Are Basically the Same

There are different brands and varieties of birth control pills. They can contain different levels of hormones and may also supply different doses at various times throughout each pill pack cycle. Oral contraceptives are classified as:

* Combination Pills (contain estrogen and progestin)-Micogynon

* Progestin-only Pills (contain progestin but not estrogen)-Exlutan

* Triphasic Pills (contain mixed doses of estrogen and progestin)-Logynon

Each pill brand may affect a woman’s body chemistry differently, and because of their variation, each brand may offer slightly different benefits and/or side effects.

Women Who Smoke or Are Overweight Cannot Use the Pill

Women should be honest with their doctors about their smoking. Women who smoke have a higher risk, in general, of having a stroke. When a woman is 35 or older, the combination of using the pill and smoking may carry a greater chance of stroke. Most doctors will not prescribe combination

pills for smokers beyond that age. Women who smoke and use the pill may also be at a greater risk for developing blood clots.

Alcohol also will have similar effects, especially with the newer pills (Yasmin, Gynera) Although, low dose combination pills as well as progestin-only pills are available for smokers, the pill is an unsafe method for women who are heavy smokers.

Women who are overweight or obese may be at greater risk for oral contraceptive failure. Overweight women may still be able to use the pill; doctors can try to offset the lowered pill effectiveness by putting heavier women on a slightly higher-dose birth control pill. Keep in mind though, that overweight women may be more likely to have cardiovascular risk factors which, in certain situations, can make pill use unsafe.

The Most Risky Time to Miss a Pill is in the Middle of the Pack

This myth reflects the idea that a woman’s most fertile time (if she has a typical cycle) is during days 8-19 of her cycle. It must be remembered though, that when you use the pill, you do not have a normal menstrual cycle because you do not ovulate. This means that there is not a time when you would be more fertile.

If you use a 28-day combination birth control pill pack, you need to take seven consecutive days of active pills in order to prevent ovulation. The last seven days of the pill pack will contain either sugar or iron and these are there to help you remember to start again, but there is no risk of ovulation or pregnancy.

Given that the first week (week one) of taking pills is the most critical, it is less risky to miss pills in the middle of a pack (weeks two and three). The 21-day pack will not carry the extra seven pills. The most unsafe time to forget a pill is at the beginning of the pack or at the very end. If you forget to start your next pack on time, it extends the pill-free/placebo week past 7 days.

Women who miss pills near the end of their pack may mistakenly think that it doesn’t matter since they are about to have their period. Missing pills at the end of week 4 may mean that you have not taken enough pills (to have accumulated enough hormones) to stop ovulation during the next month.

The Only Use for the Pill is for Contraception

The pill (as well as other hormonal options like a patch (Evra), Mirena IUD, Depo-Provera injection and NuvaRing) can be used to provide other benefits in addition to preventing pregnancy. Sometimes, women may use the pill solely for these non-contraceptive advantages.

Some examples of the pill’s health benefits include:

* Regulating periods and the ability to control the timing of your period

* Stopping ovulation pain

* Reducing or preventing menstrual cramps

* Lowering the risk of anemia (caused by having heavy periods)

* Minimising Premenstrual dysphoric disordersymptoms

Additionally, pill use can provide protection against:

* Excessive facial and body hair in women

* Ectopic pregnancy

* Acne

* Non-cancerous breast growths

* Ovarian cysts and cancer

* Pelvic inflammatory disease

* Osteoporosis

* Menstrual migraines

Women Over 35 Can’t Use the Pill & Teens Need Permission to Get the Pill

Healthy women with normal blood pressure, no increased risk for heart attack or stroke, and who don’t smoke can often use lower-dose pills until menopause. The pill may be especially beneficial for perimenopausal women in their mid-to-late 40s who are having heavy or irregular periods. But, the pill is not recommended for women over 35 who smoke due to increased health risks.

In Barbados the pill is issued only with a doctor’s prescription or in the polyclinic setting by a registered nurse. Therefore any teenager would have to show the doctor or nurse that she understands the risks/benefits of this decision. Pill use has been proven to be both safe and effective in teens. Staring the pill does not mean that the teen intends to be promiscuous However, starting the pill is a big decision, so teens may first want to discuss it with a parent or trusted adult.

The Pill Causes Cancer

This is a common myth that has been shown over and over again, in research, to not be true. The pill actually has a protective effect against certain types of cancers.

* Women who use the pill are 1/3 less likely to get ovarian or uterine cancer than those who don’t. Protection against these cancers increases with each year of use and can last up to 30 years after ending pill use. Some experts advise that all women use the pill for at least five years, solely for ovarian cancer protection (especially women with strong family histories of ovarian cancer).

* Pill use may reduce the risk of endometrial cancer by 50 per cent with protective effects lasting up to 20 years. This is true of both short and long-term use.

* There also appears to be evidence that pill use can result in an 18 per cent reduction in the risk of developing colorectal cancer. This protective effect is greatest for recent pill users.

* Most experts believe that the pill doesn’t cause any type of cancer.

* Recent research suggests that the pill has little if any effect on causing breast cancer and that taking estrogen before menopause doesn’t predispose women to breast cancer.

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