Know, Your Health /

Common Pill Questions…Answered!

Using the pill can be confusing – especially for first-time users. Friends and relatives always have differing views on the risks and benefits of taking the pill, and it’s hard to know who is right and who is wrong.

nzgirl and Wyeth the manufacturers of Loette have the answers to some common questions about oral contraceptives…

What makes the birth control pill low dose?
The combined oral contraceptives (COC) are available with much less hormones than the pills your mother may have taken. The pill today has between 20 – 50µg (micrograms) of oestrogen – and all are 99% effective when taken as directed. Loette contains the lowest dose formulation available, with 20µg of oestrogen.

How effective is the pill in preventing pregnancy?
The pill is one of the most effective reversible ways to prevent pregnancy as it works better than the condom, the diaphragm, or spermicidal creams.

The pill contains man-made versions of the natural hormones oestrogen and progesterone which prevents a woman’s reproductive organs from preparing for pregnancy in three ways:
– It stops the ovary from releasing an egg.
– It prevents the man’s sperm from entering the uterus by thickening the mucus produced by the woman’s cervix so that it forms a natural barrier.
– It changes the lining of the womb (endometrium) making it less likely for implantation of a fertilised egg.

When taken as directed the pill is 99% effective, however the chance of becoming pregnant increases when you take a pill at the wrong time or miss a pill (or pills) during the month. When this is taken into account the typical failure rate is around 2-6% per year.

It is important to remember that the pill DOES NOT protect you from sexually transmitted infections (STIs).

Make sure you use a condom each time you have sex to protect yourself from STIs.

How long can I stay on the pill?
As long as you are healthy and you don’t smoke, you can stay on the pill as long as you and your doctor decide it’s the right contraceptive for you.

How long does each pill protect me for?
You need to take a pill each day because there is only enough hormone in the pill to protect you from pregnancy when taken daily.

What side effects could I get taking the pill?
There are several different types of the pill on the market, and each can cause different side effects. Most side effects associated with the pill are relatively minor, and a number of them are only seen in the first few months of taking a new pill.

Some of the more common side effects include:
– Bleeding between periods (breakthrough bleeding), especially during the first 3 months. This bleeding is fairly common, and usually disappears after a few months.
– Nausea soon after taking your pill, particularly in the first month
– Headaches
– Acne or break-outs
– Breast tenderness

Be sure to discuss any concerns you may have with your doctor. (These conditions usually get better within a few months. If they do not improve, talk to your doctor.) Serious side effects occur very infrequently, especially if you are in good health and do not smoke.

What happens if I take other medications?
The efficiency of the pill may decrease when taken with certain medications. For example some of these include antibiotics, anti-convulsants, and St John’s Wort. If you’re worried about the effect your medication may have on the effectiveness of your Pill, use a backup contraceptive method (i.e. condoms) until you check with your doctor.

What should I do if I want to become pregnant?
Simply stop taking your contraceptive pill. Be sure to discuss your decision with your doctor so that you can plan for a healthy pregnancy.

Once I stop taking the pill how long before I can become pregnant?
Some women may experience a delay in becoming pregnant after they stop using the pill – especially if they had irregular periods before starting to use it. The pill does not cause infertility and is one of the most effective reversible ways to prevent pregnancy.

What else does the pill do apart from preventing pregnancy?
Women who use oral contraceptives have more regular periods and less period-related problems such as; heavy bleeding and anaemia (a reduction in the ability for the blood to carry oxygen), period pain and symptoms of PMT (pre-menstrual tension). There is also less chance of ectopic (outside the uterus) pregnancies, a decreased incidence of fibroadenomas and fibrocystic disease of the breast, less incidence of ovarian carcinoma and acute pelvic inflammatory disease (PID).

I didn’t get my period during the sugar pills. What should I do?
If your period did not start during the sugar pills and you have taken the pill according to directions and any reason, which may impair contraceptive effectiveness (ie: vomiting, diarrhoea and / or taking other medications at the same time) can be ruled out, it is unlikely that you are pregnant and you should continue taking the pill as per usual.

If your period again does not occur at the end of this second cycle or if you have not taken the pill according to directions the possibility of pregnancy should be ruled out before you continue to take the pill. You can take a home pregnancy test, visit your doctor or go to a Family Planning centre to have a pregnancy test.

What do I do if I miss or take my pill late?
If it is less than 12 hours late, take the missed pill immediately and the next pill at the usual time. No extra protection is necessary.

If it is more than 12 hours late, take the missed active pill as soon as you remember even if you take two active pills in one day. Take your next pill at the usual time and discard any earlier missed pills. It’s important that you use another contraceptive method until you have taken 7 consecutive active pills. If the pack has less than 7 active pills take all active pills as normal, then throw the pack away (do not take the sugar pills) and immediately start a new pack taking an active pill from the corresponding weekday. Since there is no 7-day break from the active pills you may not have a period until the new pack is finished. Some spotting or light bleeding may occur during this time.

If you do not have a period after finishing the new pack the possibility of pregnancy should be ruled out before you continue to take the pill, take a home pregnancy test or visit your doctor or Family Planning centre to have a pregnancy test.

If you miss 1 or more placebo pills, you are still protected against pregnancy as long as the next pack is started on time.

What if I vomit or have diarrhoea after taking the pill?
If you took your pill four hours or more before you vomited or had diarrhoea, then you do not need to worry. If the vomiting / diarrhoea occurred within four hours, you will need a replacement pill, talk to you doctor or pharmacist for advice.

Will the pill make me gain weight?
The modern low dose contraceptive pill is likely to have very little effect on your weight. Some women gain a little weight on the pill, some lose a little and many stay exactly the same. This is usually related to diet rather than any effects of the pill. The simple rule while on the pill is to eat sensibly and exercise regularly.

If you’re worried about gaining weight on the pill, try a low-dose pill like Loette which has shown not to cause weight gain (compared to placebo).

Will the pill make my face break out?
Some women have worried that the pill might cause pimples. The truth is that most of today’s pills usually help clear up existing acne for most women. Less than 1% of women on Loette stop taking it due to skin problems.

Does the pill really cause cancer?
There have been many reports in the media concerning oral contraceptives and cancer. Scientists have found that use of the pill can actually decrease the risk of cancer of the uterus and ovaries. However, some studies have suggested that the pill may increase the risk of cervical cancer; however, regular cervical smears will help detect any changes in the cervix long before symptoms are apparent which if not checked or treated can turn into cancer.

The latest studies appear to show that there is a slight increase in the risk of developing a breast cancer in those women taking the pill. However, as breast cancer is rare in women under the age of 35, the actual risk is also very low. Since these cancers are usually small at the time they are found, women taking the pill at the time they are diagnosed with breast cancer also seem to have a better chance that the cancer has not spread to other parts of the body.

Studies show the increased risk of breast cancer does not seem to increase with the length of time the pill is taken, is not affected by family history, and within 10 years of stopping the pill the risk is back to the usual risk.

Women who take the pill should have a pap test and breast check every two years. (or as recommended by their doctor) when they have their prescription renewed.

Does the pill cause blood clots?
Blood clots (also known as DVT) among healthy women are rare, but you should talk to your doctor if there is a history of blood clots in your family before you go onto a new pill. The risk of developing a blood clot is very small. For every 100,000 women who are not taking the pill, approximately 5 per year will develop a blood clot compared to 15 – 25 women per year who are taking the pill. To put this into perspective, for the same 100,000 women who are not taking the pill and become pregnant 60 will develop a blood clot.

Most pills are combined oral contraceptives and contain both oestrogen and a progestogen. Depending on the type of progestogen in the pill, they are known as either 2nd or 3rd generation contraceptive pills. Taking a 3rd generation pill doubles this very small risk of developing a clot compared to a 2nd generation pill. This is also true for women who take pills containing cyproterone acetate (like Diane 35/35ED and Estelle 35/35ED), which are often used to treat acne. Women using progestogen-only Pills are at little or no increased risk of blood clots.

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Loette oral tablets. (20g ethinyloestradiol / 100g levonorgestrel)

Loette is a prescription medicine, it can only be prescribed for you following a consultation with your doctor.. Loette is used to prevent pregnancy. You should not take the oral contraceptive pill if you have or have had: heart attack, stroke, blood clots*, gynaecological cancer, unexplained vaginal bleeding or certain liver problems. Smoking increases the risk of serious cardiovascular side effects (ie myocardial infarction, stroke) from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Smoking is not recommended while on the oral contraceptive pill. The pill does not protect against HIV or other sexually transmitted diseases. Use strictly as directed. If you require further information or have any side effects see your doctor. Possible side effects include headache, period pain, bleeding irregularities and nausea.

*Refer to Medsafe website: www.medsafe.govt.nz (Hot Topics) for independent information.

Wyeth (NZ) Limited, 15B Vestey Drive, Mt. Wellington, Auckland, New Zealand.
Freecall 0800 447 400 ® Registered Trade Mark. TAPS

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