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Birth control pills(Oral contraceptives)

Birth control pills(Oral contraceptives)

Oral contraceptives are those medicines that prevent pregnancy. This is the one method of birth control.

Oral contraceptive is hormonal preparations containing a combination of estrogen and progestin or progestin alone. the combination of estrogen and progestin prevents pregnancy by inhibiting the release offollicle-stimulating hormone(FSH)and luteinizing hormone(LH) from the pituitary gland.

LH and FSH play an important role in egg development and uterus lining for the implantation of an embryo. Progestin makes the uterine mucus that surrounding the egg more difficult for the sperm to penetrate. In some cases it inhibits ovulation.

There are many types of birth control pills combination which are

Monophasic birth control

These pills give an equal amount of estrogen and progestin every day.

Biphasic birth control

These pills provide the same amount of estrogen daily for the first 21 days of the cycle. During the second half, the progestin/estrogen ratio is higher to allow the normal shedding of the lining of the uterus to occur.

Triphasic birth control

These pills have variable estrogen concentration and varying progestin concentration throughout the cycle. There is no such evidence that monophasic is more effective than bi or triphasic or vice versa. The woman needs to take it daily approximately at the same time of the day. Oral contraceptives are not a good form of birth control when doses are missed frequently. Combination contraception should not be given to women older than 35 years who also smoke because the risk of the blood clot is increased or the woman who has high blood pressure, heart disease, migraines, liver, and cholesterol problems.

How to take oral contraceptives?

Oral contraceptive is prescribed for 4 weeks at a time, with each 4-week packet containing 4 to 7 days of hormone-free days. All women who start taking contraceptives should first have a pregnancy test to confirm that they are not already pregnant.


If birth control pills are taken perfectly there will be a 0.1% chance of getting pregnant. however, accounting for the missed days of use there will be 8%chance of pregnancy every year.

Side effects

  1. Nausea
  2. Headache
  3. Weight gain
  4. Premenstrual syndrome
  5. Mood swings
  6. Heart attack
  7. Blood clot
  8. Stroke
  9. High blood pressure


Several medications, including some antibiotics and antiseizure medications, can decrease the blood levels of oral contraceptive hormones, but an actual decrease in the effectiveness of the oral contraceptive has not been convincingly proven. Nonetheless, because of this theoretical possibility, some physicians recommend backup contraceptive methods during antibiotic use. Examples of medications that increase the elimination of estrogens include

  • Carbamazepine (Tegral)
  • Phenobarbital
  • Phenytoin (Dilantin)
  • Primidone (Mysoline)
  • Rifampin (Rifadin)
  • Rifabutin (Mycobutin)
  • Ritonavir (Norvir)

Birth control pills with higher concentrations of estrogen or alternative forms of contraception may be necessary for women using those medications.


If a patient takes too many oral pills at one time the most likely complication will be severe nausea vomiting and headache.there is no antidote to treat the overdose of oral contraceptives pills, just treat the condition with antiemetic or analgesics.

If the patient has other risk factors such as thromboembolism one may consider using prophylactic anticoagulant medicine. High levels of estrogen and progesterone are even treatment for hemorrhage that has led to severe or symptomatic anemia.

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