Gynaecologist shares what women should know before considering hormonal contraception: Effects and safety issues

Dr Nidhi Sharma Chauhan shares everything that a woman should consult with her gynaecologist before starting or continuing hormonal contraception.

Among the various methods of contraception, hormonal contraception is often prescribed by doctors. But before one considers talking to their gynaecologist about it, it is important to understand the benefits, risks and side effects, believes Dr Nidhi Sharma Chauhan, consultant obstetrician and gynaecologist at Saifee Hospital, Mumbai.

“Before beginning contraception, women should know if it is safe for them and what warning signs need to be reported to their doctor,” she told HT Lifestyle, and went on to elaborate on the subject as follows.

Things to consider before starting hormonal contraception

When a woman goes to see her gynaecologist about birth control options, Dr Chauhan pointed out that there are many things that must be taken into account. These include:

• The woman’s age
• Whether she has had children
• Her current health
• Any existing medical conditions
• Her personal or family history of bleeding disorders, clotting disorders, or certain cancers

It is only with all this information that the gynaecologist can recommend a suitable option.

One should only opt for hormonal contraceptive pills after consulting their gynaecologist. (Pexel)

Getting the right hormonal contraceptive pill

“Hormonal contraceptives come in forms,” noted the gynaecologist. She explained that some pills contain both estrogen and progesterone, and are known simply as pills. There are others which are progesterone-only pills.

“The right choice depends on the woman’s health risks and personal preferences. It is important to talk about these options before starting any method,” stated Dr Chauhan.

In the words of the expert, “Hormonal contraceptives go through the liver when first used and can impact levels and the overall lipid profile. Because of this, doctors may check liver function tests and a lipid profile before starting the medicine.”

The tests are usually repeated, and if liver function is seen to be affected, doctors are likely to suggest stopping the contraception, noted the gynaecologist.

Safety issues surrounding hormonal contraception

There are also medical reasons why hormonal contraception may not be safe, noted Dr Chauhan.

In her words, “The World Health Organisation has a set of guidelines called the Medical Eligibility Criteria or MEC. These guidelines divide women into four categories. Category 1 means no restrictions. The woman can use contraception safely. Category 4 means there is a health risk and the method should not be used at all. Conditions like liver disease, certain bleeding disorders, or clotting problems may fall into this category.”

While planning for hormonal contraception, Dr Chauhan noted that women should share their lifestyle and personal preferences with their gynaecologist.

“Some women find it hard to take a pill every day. Others may feel sick. Have nausea that does not go away after a few cycles. In such cases, alternatives like a hormonal intrauterine device or a non-hormonal intrauterine device may be better options,” she noted.

The gynaecologist pointed out that hormonal contraception can also increase the risk of blood clots in some women. Because of all the reasons mentioned till now, it is best that women be aware of the warning signs after using contraception that need medical care. They include:

• Chest pain
• Trouble breathing
• Stomach pain
• Severe headaches
• Blurred vision
• Painful swelling
• Redness in the calf

“If any of these happen, the woman should stop taking the pill and seek help right away. She should not take the dose until she sees a doctor. The doctor can then run the needed tests to decide if there is a serious problem,” noted Dr Chauhan.

She further highlighted that for those who are using contraception to prevent pregnancy, taking the pill on time is very important. Missing a pill can lower the protection against pregnancy, and if one does miss a pill, she should contact her doctor. The correct action depends on which week of the cycle the pill was missed.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.