Oral Hormonal Contraceptives: How they work, side effects and more

Current statistics show an exponential rise in the use of oral hormonal contraceptives all around the world. Women below the menopausal age take it mainly for the prevention of pregnancy however, there are other uses which are accepted in general practice.

Some include the management of acne (pimples), heavy or irregular periods, etc. However, just like with all other growth, there are some problems that ensue with the surge of oral contraceptives. The purpose of this article is to educate us on oral contraceptives, and their appropriate use. 

What are oral hormonal contraceptives?

Oral hormonal contraceptives also commonly called birth control pills, as the name suggests, are medications that are routinely taken to prevent unwanted pregnancy. Some common brands in Ghana are secure and Lydia contraceptive pills.

They contain hormones (estrogen and progestin) that are naturally present in the body. These hormones control the female menstrual cycle by stimulating the formation and release of the eggs, preparing the womb for pregnancy amongst others.  

Most oral contraceptive pills contain estrogen and progestins or sometimes only progestins (sometimes called the mini-pill). Most of the products on the market are either synthetic versions or sometimes even conjugated forms of these hormones.

Some include ethinylestradiol, estrone (estrogen analogues), levonorgestrel, norethindrone (progestin analogs) etc.

How do they work?

The only way a woman can become pregnant is by fertilization of an egg, released after ovulation, by a sperm. The fertilized egg must then attach to the walls of the womb and with appropriate nutrients, develop into the baby. Oestrogen and progestins regulate this process and thus the functions of these oral contraceptives are linked with their varied actions in the body.

Generally, the oral contraceptives act by either inhibiting the body’s natural production of these hormones resulting in prevention of ovulation, or thickening of the mucus in the cervix (opening of the womb) to prevent the sperms from entering.

Some of these pills also cause thinning of the walls of the womb (endometrium) which prevents the fertilized egg from being attached to the womb and thus prevent pregnancy. Despite the effectiveness of these pills in preventing pregnancy, they do not prevent the transmission of STIs.

Are oral hormonal contraceptives effective?

Several scientific journals have published the efficacy of oral contraceptive pills. It is estimated that if taken correctly within the specified time range, there is about 92 to over 99% efficacy depending on the particular product.

Who can take oral contraceptives?

Oral hormonal contraceptives usually come as the 28-day pack or 21-day pack. The 28-day packs contain 7 hormone-free pills (spacers) whereas the 21-day packs have all pills containing hormones (the active ingredients). It has been so made so as to mimic the female menstrual cycle and provide a 7-day period during which the female can still menstruate.

Examples of the 21-day pills are Microgynon, Yasmin, etc. Examples of the 28-day pills are Lydia, Microgynon ED, etc.

Oral hormonal contraceptives can be started any day of the week and on any day of the menstrual cycle but it should be taken at the same time every day.

Women should test to confirm they are not pregnant before taking the pills and also use “backup” birth controls such as condoms, for 7 days after starting the pill. 

Side effects

Almost every medication has side effects however, for oral contraceptives, these effects vary depending on the type of hormone and the levels present. 

Some common ones include vaginal spotting and abnormal bleeding which usually decreases after the first 3 months, breast tenderness, bloating, and nausea. However, for issues concerning weight gain, studies have shown that they are not really massive.

Ask your pharmacist or doctor before taking oral contraceptives with other drugs because they can be rendered ineffective. Every day (ED) oral hormonal contraceptives are not the same as emergency pills and must be taken regularly for maximum effect and it is usually recommended if you are likely to have multiple sexual intercourses with no intention of pregnancy.

Take home note about oral hormonal contraceptives

  • Oral contraceptives have been estimated to be 92-99% effective if taken correctly
  • Generally, oral contraceptives act by inhibiting the body’s natural production of these hormones resulting in the prevention of ovulation, thickening of the mucus in the cervix (opening of the womb) to prevent the sperms from entering.
  • Oral contraceptives do not prevent the transmission of STIs eg. HIV/AIDs
  • Emergency contraceptives are taken once in a while to prevent pregnancy after unprotected sex. The everyday (ED) oral hormonal contraceptives are not the same as emergency pills and must be taken regularly for maximum effect and it is usually recommended if you are likely to have multiple sexual intercourses with no intention of pregnancy 
  • Some common side effects include vaginal spotting and abnormal bleeding which usually decreases after the first 3 months, breast tenderness, bloating, and nausea. However, for issues concerning weight gain, studies have shown that they are not really massive.

WRITTEN AND EDITED RESPECTIVELY BY:

Prince George Acquah
Pharm D Candidate at Kwame Nkrumah University of Science and Tachnology

Prince George Acquah Jnr. is an award-winning poet and the CEO of NALANOM INC. He is also a PharmD final year student, Music lover, Chelsea fan, Dreamer, Academic, and the Author of the anthology, 24 and Gnashing.

Chief Editor at Wapomu.com

MPSGH, MRPharmS, MPhil.

Isaiah Amoo is a practicing community pharmacist in good standing with the Pharmacy Council of Ghana who has meaningful experience in academia and industrial pharmacy. He is a member of the Royal Pharmaceutical Society, England, UK and currently pursuing his overseas pharmacy assessment programme (MSc) at Aston University, UK. He had his MPhil degree in Pharmaceutical Chemistry at Kwame Nkrumah University of Science and Technology. He has about 5 years’ experience as a community Pharmacist and has also taught in academic institutions like KNUST, Kumasi Technical University, Royal Ann College of Health, and G-Health Consult. He likes to spend time reading medical research articles and loves sharing his knowledge with others.

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