The pill: Birth control pills for contraception

what is the pill

Since its introduction in the 1960s, the pill has been the most commonly chosen contraceptive method by women in the western world. Hardly any other medical development shaped the 20th century in such a way. For the first time, women had the opportunity to take family planning into their own hands and really protect themselves against unwanted pregnancies. Since the introduction of the pill, women have had significantly more freedom to express themselves sexually and “try it out” before committing themselves to a partner. The pill has certainly contributed a lot to the trend towards later marriage, later starting a family and the declining birth rate. The increased ability to plan the family also gives women today better access to training, studies and jobs.

How does the pill work?

The pill is a hormone preparation made from estrogens and progestins that is taken in tablet form. Both are also naturally produced by the body. The hormones naturally produced by the body regulate the female menstrual cycle. The estrogens promote the maturation of the egg cell and thus ovulation. In the event of successful fertilization, the natural amount of progestin protects the egg cell by preventing further egg cells from maturing by thickening the endometrium.

The estrogens contained in the pill, on the other hand, suppress ovulation instead of promoting it. And the progestins contained in the pill permanently thicken the uterine lining and thus ensure that if ovulation takes place despite the supply of estrogen, the egg cell is not fertilized and cannot implant itself.

Regular cycle through the pill?

Taking the pill regularly leads to an artificial and therefore more regular cycle. After the pill has been taken for 21 days, a 7-day break from taking the pill is scheduled for most preparations. During these days, stopping the pill leads to artificial menstrual bleeding. However, this is not a real menstrual bleeding, but a so-called withdrawal bleeding. This bleeding is often not as heavy as normal menstrual bleeding and is associated with fewer menstrual symptoms. Therefore, the pill is often prescribed for severe menstrual pain. In order to make it easier for many women to take control of the pill break, many companies now offer preparations that continue taking the pill during the actual pill break. The pills taken during this time do not contain any estrogens or progestins. In the meantime, women can also choose preparations that completely suppress the artificial withdrawal bleeding through a permanent supply of hormones. Women who take this version of the pill no longer have “menstrual bleeding” at all.

What is the mini pill?

While the pill used to contain a high dose of hormones, today many “mini pills” offer the same high level of safety at a much lower dose. These mini pills often no longer contain estrogens, but only progestins to thicken the lining of the uterus. They are often recommended by gynecologists because they also have significantly fewer side effects than the conventional pill.

Benefits of the pill

• With a Pearl Index of 0.1 to 0.9, the pill is one of the safest contraceptives.
• Women who suffer from painful menstrual bleeding or cyst formation in the ovaries benefit from the effect of the pill.
• Compared to other hormonal contraceptives such as the three-month injection, the contraceptive stick or the hormonal coil, the pill is very easy to stop and you can get pregnant again immediately after stopping.

Disadvantages of the pill

• The pill needs to be taken at the same time every day, if possible, to be effective. So it requires a certain discipline.
• In addition, the hormones interfere with the woman’s cycle and can cause undesirable side effects such as nausea, vomiting, weight gain, bleeding between periods, a feeling of tension in the breasts, mood changes and sexual reluctance. In rare cases, serious side effects such as high blood pressure, thrombosis (blood clot formation) and liver function disorders can also occur.
• Several medical studies, including those by the International Agency for Research on Cancer, have found evidence that taking the pill for several years can increase the risk of developing cervical cancer, breast cancer or liver cancer. At the same time, it is said to reduce the likelihood of endometrial cancer or ovarian cancer.

reliability of the pill

With a Pearl Index of 0.1 to 0.9 (number of women in 100 who became pregnant despite this contraceptive method), the pill is one of the safest contraceptive methods, provided you take it regularly and according to the instructions given. Some medications such as antibiotics, painkillers, sedatives and circulatory drugs as well as anti-inflammatory and fever-reducing drugs impair the contraceptive effect of the pill. The effect is also reduced in the event of vomiting or diarrhea, since the active ingredients are not sufficiently absorbed by the body or are excreted too quickly. So if you need to take medication, let your doctor know you’re on the pill.

If you forget to take the pill in time, your protection is at risk. In this case, be sure to read the package insert to understand the time tolerance of your supplement. If you are still unsure about the contraceptive effect, it is best to speak to your gynaecologist.