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...So, are you on the pill

Though they have a failure rate of less than one per cent, lots of women avoid using oral contraceptive pills. The reason: Parul Khanna unravels many myths...

health and fitness Updated: Apr 04, 2009 19:12 IST
Parul Khanna

Though they have a failure rate of less than one per cent, lots of women avoid using oral contraceptive pills. The reason: The many myths surrounding them. Here’s what’s true and what isn’t:

The pill makes you gain weight: Some women do seem to gain weight after starting the pill. This usually happens because of its estrogen content, which causes water retention. The percentage of weight gain differs from person to person. Dr Manju Hotchandani, consultant gynaecologist, Moolchand Women’s Hospital, Delhi, feels that water retention might cause a woman to gain half a kg in the first six months. But some women have experienced 25 per cent weight gain in the initial months of regular use.

Some studies claim that women begin using the pill during a time of life that happens to coincide with weight changes, giving the pill an unfair reputation for causing weight gain. However, third generation contraceptive pills claim not to have this particular side effect.

Dr Kiran Coelho, consultant gynaecologist and co-coordinator, department of gynaecology, Lilavati Hospital, Mumbai, says, “These newer pills are more patient-friendly. They do not cause weight gain and have negligible side effects.”

Taking the pill regularly results in decreased fertility: Experts do agree that it is necessary to take a break from ingesting pills. But this has nothing to do with decreased fertility. “The pills do not affect a woman’s fertility. They only suppress ovulation and prevent a woman from conceiving. Fertility can return almost immediately after stopping the pill, which is why it’s important not to miss taking it. However, some women may face a delay in becoming pregnant after stopping the pill, especially if they had irregular periods before starting it,” says Dr Hotchandani.

Doctors do advise women to take a break – for example, a patient who starts using the pill regularly for a year should go off it for three months or so. This, says Dr Coelho, is to avoid excessive exposure to hormones. “Stopping the pill for some time would allow the pituitary gland to function normally. A woman might not get periods for some time, but one shouldn’t get alarmed,” she says.

The pill causes birth defects: This is completely false. The pill is one of the world’s most researched and prescribed medications. As with any medication, certain risks like nausea, vomiting and thrombosis are linked to the use of pills, but serious side effects are rare. However, it is essential that a woman starts the pill only after a complete check-up and on the recommendation of a gynaecologist. That’s because there are different varieties of pills that offer slightly different benefits and/or side effects.

“If a woman is predisposed to deep vein thromboses, the high doses of estrogen in the pills can cause blood clots. People who smoke, have heart problems, high BP, or are over 35 years old, are at risk, so we need to know the history of a patient,” explains Dr Coelho.

Pills are only useful as a contraception device: Pills don’t only prevent pregnancy; they have other benefits. “Oral contraceptives guard against acne, benign breast diseases, ovarian cysts, pelvic inflammatory disease, osteoporosis, excess facial and body hair and some types of migraines,” says Dr Hotchandani. The pill is also effective in regularising menstrual cycles, stopping ovulation pain, reducing menstrual cramps, minimising PMS symptoms and lowering the risk of anaemia.

Pills cause cancer: A recent report suggested that oral contraceptive use has already prevented 2,00,000 cases of ovarian cancer and 1,00,000 deaths from the disease. “But regular and long-term use of pills are associated with a marginal risk of breast cancer,” says Dr Hotchandani.

Women over 35 can’t use the pill: Healthy women with normal blood pressure, no increased risk for heart attacks or stroke, and who don’t smoke can often use low-dose pills until menopause. “Though studies recommend that pills are beneficial for women nearing menopause, we discourage women over 35 to use pills for long periods as there appears to be a two- to three-fold increase in the incidence of cardiovascular events,” says Dr Hotchandani.

Emergency Contraceptive Pills

Myth: Emergency birth control (EBC) pills cause an abortion
Fact: Lots of women mistake emergency birth control pills to be abortion pills. Emergency birth control pills do not cause abortions and don’t have any affect on fertilised eggs. “EBCs inhibit or delay eggs from being released from the ovaries, they inhibit the sperm and the eggs from being transported to the uterus, or the pills may cause the lining of the uterus (that supports a developing embryo if a woman is pregnant) to shed and hence prevent pregnancy,” says Dr Anuradha Kapoor, senior consultant gynaecologist, Max Healthcare, Delhi. The ‘abortion pill’ is a different drug altogether.

Myth: Emergency birth control pills are unsafe
Fact: Because of the high dose of hormones, EBCs cause mild side effects, like nausea, diarrhoea, and fatigue – for a short period.

Though health journals claim that EBCs do not cause ectopic pregnancy (a complication when the fertilised ovum implants in any other tissue than the uterine wall), doctors in India differ.

“There is no scientific explanation, but most of us have seen that regular use of EBCs increases the risk of ectopic pregnancy,” says Dr Kapoor.

Myth: Regular use affects fertility
Fact: No, EBCs do not in any way, even when taken regularly, affect the fertility of a woman. These pills will only keep you from getting pregnant when they are taken within the prescribed time after unprotected sex. If you have unprotected sex after taking EBCs, you can get pregnant.

The pills are safe, but doctors recommend that they should be used only in an emergency situation and should not be used as an alternative to oral contraceptives. A big reason is their high failure rate. “The pills are effective only within the prescribed time of 72 hours. They are most effective when taken within 12 hours of unprotected sex and the failure rate increases as time goes by. These pills have a failure rate of 15 to 20 per cent,” says Dr Hotchandani.

Accidental pregnancy is a big complication. Says Dr Kapoor, “Normally, after taking EBCs, one has spotting or bleeding within a day or two because of the progestin withdrawal. Most women mistake this bleeding for their periods, but that is not the case. However, women will get their period within a month of having taking an emergency pill.”

Another complication associated with frequent use is irregular menstrual cycles, another reason why it is not recommended for regular use.