Facts About Today's Low-Dose Oral Contraceptives

 

Changes in the Birth Control Pill Over the Past Three Decades

Oral contraceptives (the pill) became available in 1960. Since that time, major shifts have occurred in the understanding of the safety of this method of birth control. In addition, substantial changes have taken place in the types of pills available.

Combination birth control pills contain two hormones, estrogen and a progestin. These two hormones work to prevent ovulation (when an egg is released from the ovary). By preventing an egg from being released from the ovary, no pregnancy can take place.

Over the past 35 years, several changes have occurred in pill formulations. The major change has been a reduction in the dose of both estrogen and progestin. For example in the 1970s most women took pills containing 50 mcg of estrogen. Many even took preparations with 80 mcg of estrogen. The dose of progestin was about ten times higher than it is now.

Today, 98% of all prescriptions written for the pill are for the low-dose kinds. These pills contain 35mcg or less of estrogen and low doses of progestin. It is believed that lowering the dose has helped to decrease the occurrence of serious side effects first seen with higher-dose pills. These low-dose pills have also helped decrease the occurrence of minor, but annoying, side effects, such as nausea and bloating.

The reason the dose of both steroids could be lowered so much from their original formulation is that these two steroids work together to prevent ovulation; much less is required of both than would be needed alone. When the pill was first developed, researchers did not know exactly how far the dose could be lowered while still preventing pregnancy.

Side Effects of Oral Contraceptives

Many women have heard rumors about all kinds of side effects that can occur while taking the pill. They may be afraid to take the pill because they're not sure if it's safe. Many women are afraid that oral contraceptives cause breast cancer. Or, they think they might have unpleasant side effects such as acne or weight gain. Here's the evidence about today's low-dose formulation:

Breast Cancer - The latest evidence regarding the pill and breast cancer is good news. Recently, a group of experts examined data from all over the world on breast cancer and oral contraceptives. They found that use of the pill does not increase the long-term risk of breast cancer. While women currently using the pill had a very slightly increased risk of breast cancer being diagnosed, that finding is likely due to more frequent and careful screening. Ten years after stopping use, women were at no increased risk of breast cancer. This was true of young women, older women, those with or without children, women with family history of breast cancer, women of different races and those from developed or developing countries.

Heart Attack - Ongoing research suggests that oral contraceptives do not cause heart attacks in healthy, nonsmoking women. Cigarette smoking is far more dangerous than taking the pill.

Stroke - The latest evidence from the United States and Europe suggests that currently used low-dose oral contraceptives cause no significantly increased risk of stroke in healthy women who do not smoke.

Blood Clots - Women who use birth control pills are at a slightly increased risk of having a blood clot in the legs or lungs. This risk, however, is much less than the risk of blood clots during pregnancy.

Weight Gain - Many women are afraid of weight gain while on the pill, but this fear is unfounded. Studies show that just as many women lose as gain weight while taking the pill. Weight gain is much more likely to be caused by overeating than by the pill.

Nausea - Birth control pills can cause nausea; however, this side effect is related to the estrogen dose and was much more common when higher-dose pills were used. Today's low-dose pills cause nausea in only a small percentage of women. If you experience nausea, you may want to take your pill with a mean. If the side effect is particularly bothersome, call your health care provider to discuss the situation.

Acne - Many women think that the pill causes acne. The truth is that today's low-dose birth control pills often help clear up existing acne and rarely cause it.

Infertility - The birth control pill does not cause infertility. In fact, oral contraceptives can help to preserve future fertility by protecting against pelvic infections.

Are there any test I need to have done before I can take oral contraceptives?

The most important test you need to have done before you take oral contraceptives is a blood pressure measurement. An elevated blood pressure is linked with heart disease and stoke, and it's important that your blood pressure be within normal range before you begin taking the birth control pill. Whether you need other test will very depending upon your medical history and health care provider. Remember, no matter what method of birth control you choose, it is a good idea to get regular checkups for important preventive health care, such as screening for breast and cervical cancers, and sexually transmitted disease.