CONTRACEPTIVE PILLS: Oversight, Choice, Side Effects in 10 min!

You can find in this Youtube video and in this health and wellness blog article :

- The different phases of the menstrual cycle in women

- How do periods appear?

- Hormones in the menstrual cycle (roles, fluctuations, feedback, ...)

- The different types of contraceptive pills

- The estroprogestogenic pill

- The microprogestogen pill

- Side effects of the pill

- How to choose your contraceptive pill?

- What to do if you forget to take your pill

- Emergency contraception and the morning-after pill

The different phases of a woman's menstrual cycle

The menstrual cycle begins on the first day of the last period, it lasts on average 28 days, it is on the 14th day of the cycle that ovulation occurs, that is to say the release of an ovum (female reproductive cell also called female gamete) by the ovaries (genital glands of the woman responsible for the production of the ovum and the female hormones).

How do periods appear?

If there is no intercourse and without any contraception, the egg is eliminated and the period arrives. This blood loss comes from the small arteries that are set up to receive the future embryo formed by the meeting of the egg and the spermatozoon.

Hormones in the menstrual cycle (roles, fluctuations, feedback, ...)

It is important to know that all the phenomena of the menstrual cycle occur under the influence of female sex hormones such as estrogen and progesterone which are themselves under the influence of other hormones released by the pituitary gland and the hypothalamus. The latter are glands located in the brain.

It is the fluctuation of estrogen and progesterone levels during the menstrual cycle that allows for the formation of the egg and the onset of menstruation.

The hypothalamus releases a hormone called Gnrh which causes the pituitary gland to produce FSH. FSH in turn stimulates the production and release of estrogen in the ovaries.

When the level of estrogen in the blood increases, the production of GnRH, LH and FSH decreases in the brain, this is negative feedback.

The different types of contraceptive pills

There are different types of contraceptive pills depending on their composition.

The estrogen-progestin pill (how it works, side effects)

There are the estroprogestogenic pills, which are made up of estrogens and progesterone in varying doses.

The principle of these contraceptive pills is to mimic the action of estrogen and/or progesterone.

They stop the production of FSH and LH by the brain. The ovaries are no longer stimulated by LH and FSH, the level of estrogen and progesterone in the ovaries does not fluctuate, they are in a sort of pause, ovulation does not occur and therefore there is no risk of fertilization.

These contraceptives also limit the entry of spermatozoa by promoting cervical secretions and making the uterus unfit to receive an embryo.

Like the hormones naturally secreted by the ovaries, these substances also cause the formation of small arteries within the endometrium. As soon as you stop taking them, the hormone level decreases, which causes the arrival of your period.

Estrogen-progestin pills trigger "false menstruation", because there is no real ovulation.

It is interesting to know that this method of contraception also helps to limit the risk of ovarian and endometrial cancer.

These pills are very effective provided they are taken every day.

The microprogestogen pill (how it works, side effects)

The microprogestogen pills are only based on low-dose progestogens, they prevent the entry of spermatozoa by increasing the secretions in the cervix and by making the uterus unable to accommodate a future embryo.

These pills are also effective, it is essential to take them every day at the same time, without interruption, and even during the period.

Microprogestogen pills can cause light bleeding and are generally recommended for women who cannot take estroprogestogen pills.

These pills do not have the side effects associated with the formation of thrombus (clot that can block the passage of blood through the blood vessels), so they limit the risk of occurrence of phlebitis (thrombus that blocks the passage of blood through a vein).

It is important to know that during the first cycle of taking microprogestogen pills, another method of contraception must be used for optimal effectiveness. These pills are really effective from the second cycle onwards.

Some treatments given to treat acne in women contain estrogens and progesterone, in which case it is not useful to take a contraceptive pill in addition.

How to choose a contraceptive pill?

The choice of the type of birth control pill depends on various criteria, including age, medical history, whether the person has one or more diseases, whether the person is taking other treatments, lifestyle, etc. Usually, the doctor tests several pills before finding the one that best suits the patient.

For estrogen-progestin pills, there are different types depending on the dosage. Blister packs can contain 21 or 28 tablets.

If it is a 21-pill pack, you must take 1 pill every day until the 21st day, then stop for 7 days and start a new pack.

For the 28-pill pack, you should take 1 pill a day without interruption until the 28th day. 22 to 28 pills are placebos, they do not contain any active substance, they allow you to maintain the reflex of taking the pill.

It is important to know that estrogen-progestin pills can increase the risk of thrombus formation, which is amplified by smoking. These pills are therefore contraindicated for women over 35 years of age who smoke more than 10 cigarettes a day, as well as for people who suffer from diabetes, high blood pressure, high cholesterol or who have a history of phlebitis.

The most common side effects are nausea, blood loss, breast swelling and skin disorders.

What to do if you forget to take your pill?

If you forget to take your pill, it depends on the type of pill you are taking and how long it has been since you normally take it.

If you forget to take your pill less than 12 hours before, in the case of estrogen-progestin or microprogestin pills containing desogestrel, or less than 3 hours before, in the case of levonorgestrel, you should take the forgotten pill immediately and resume taking it at the usual time.

If you forget to take the pill more than 12 hours ago or 3 hours ago for levonorgestrel, take the forgotten pill immediately and add another non-hormonal method of contraception. If you have intercourse within 7 days of forgetting to take the pill, you should add another method of contraception (e.g., a condom).

If you are taking an estrogen-progestin pill and the tablets to be taken during the next 7 days are the inactive tablets of the pack (22nd to 28th), you must start a new pack with the active tablet number 1.

If you forget to take your pills for several days or if you have had intercourse in the 5 days before you forget to take them, you should consult your doctor or pharmacist for emergency contraception.

Emergency contraception and the morning-after pill

The morning-after pill is emergency contraception. It is not a method of contraception to be used on a long-term basis, as its effectiveness decreases with the time elapsed since intercourse.

The morning-after pill should be used as soon as possible, within 72 hours of intercourse.

The substance used in the morning-after pill is a progestogen (levonorgestrel or ulipristal at a particular dose) that prevents the attachment of the potentially fertilized egg to the uterus. This pill also limits implantation.

I would like to point out that the morning-after pill is not a voluntary interruption of pregnancy.

It is important to know that emergency contraception can disrupt the menstrual cycle and should only be used in an emergency.

The side effects of the morning-after pill are nausea, headaches, abdominal pain, painful periods, breast pain and dizziness.

I would like to draw your attention to the fact that certain treatments and medicinal plants can interact with the contraceptive pill and reduce its effectiveness, such as St. John's wort, certain antiepileptics, antifungals (treatment of fungi), and antiretroviral drugs, particularly those used to treat AIDS.

It is recommended to add another means of contraception when taking these treatments or medicinal plants.

Dr Noura Marrai (Doctor of Pharmacy, YouTuber Health, creator of the health well-being Pharmaquiz application),

Pharmaquiz YouTube channel:

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