WARNING

Estrogen and progestin, commonly found in oral contraceptives (birth control pills), are generally safe for most women when used as prescribed. However, like any medication, they come with potential risks and side effects. It’s important to note that individual responses can vary, and the benefits of contraception often outweigh the risks for many women. Here are some potential risks associated with taking estrogen and progestin oral contraceptives:

• Blood Clots: Oral contraceptives can increase the risk of blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism. This risk is higher in women who smoke, are older, or have a history of blood clots.
• Cardiovascular Issues: Some women may experience an increase in blood pressure while taking oral contraceptives. Women with a history of cardiovascular problems or hypertension may face a higher risk.
• Stroke: There is a small increase in the risk of stroke associated with the use of oral contraceptives, especially in women with other risk factors such as smoking, obesity, or high blood pressure.
• Liver Issues: Although rare, oral contraceptives can potentially cause liver problems. Women with a history of liver disease or certain liver conditions should consult their healthcare provider.
• Breast Cancer: Research on the link between oral contraceptives and breast cancer is inconclusive. Some studies suggest a slightly increased risk, while others do not find a significant association.
• Mood Changes: Some women may experience mood swings, depression, or changes in libido as a side effect of hormonal contraceptives.
• Weight Gain: While weight gain is a concern for some women, studies have not consistently shown a direct association between oral contraceptives and significant weight gain.

It’s crucial for individuals to discuss their medical history, lifestyle, and any concerns with their healthcare provider before starting or changing contraceptive methods. The decision to use oral contraceptives should be based on a thorough assessment of individual health factors and the potential benefits and risks associated with the medication. Regular check-ups and monitoring can help manage and mitigate potential risks.

Why is this medication prescribed?

Estrogen and progestin oral contraceptives, commonly known as birth control pills, are prescribed for several reasons:

• Prevention of Pregnancy: The primary purpose of oral contraceptives is to prevent pregnancy. These pills work by inhibiting ovulation (the release of an egg from the ovaries), thickening cervical mucus to prevent sperm from reaching an egg, and thinning the lining of the uterus to make it less receptive to a fertilized egg.
• Menstrual Cycle Regulation: Oral contraceptives can help regulate menstrual cycles, making them more predictable. They often reduce menstrual cramps and make periods lighter and less painful.
• Treatment of Menstrual Disorders: Some women may be prescribed oral contraceptives to manage conditions such as irregular periods, heavy menstrual bleeding (menorrhagia), or conditions like polycystic ovary syndrome (PCOS).
• Hormone Replacement Therapy (HRT): Oral contraceptives containing both estrogen and progestin may be prescribed as hormone replacement therapy for women experiencing menopausal symptoms.
• Acne Treatment: Certain types of oral contraceptives are FDA-approved for treating moderate acne in females by regulating hormones that contribute to acne formation.
• Management of Endometriosis: Oral contraceptives can help manage the symptoms of endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus.

How should this medicine be used?

It’s crucial to use oral contraceptives exactly as prescribed by a healthcare provider. Here are some general guidelines:

• Consistency: Take one pill at the same time each day to maintain the effectiveness of the medication.
• Follow the Prescribed Schedule: Some packs have a 21-day supply of active pills followed by a 7-day break or a 28-day supply with a combination of active and placebo pills. Follow the prescribed schedule.
• Start on the Right Day: Begin taking the pills on the first day of your menstrual cycle or as directed by your healthcare provider.
• Missed Pills: If you miss a pill, follow the instructions provided by your healthcare provider or the package insert. Missing pills can reduce contraceptive effectiveness.
• Regular Check-ups: Regularly visit your healthcare provider for check-ups and to monitor any potential side effects or changes in health.

It’s important to note that individual responses to oral contraceptives can vary. Before starting or changing any contraceptive method, it’s recommended to consult with a healthcare provider who can assess your medical history and provide personalized advice based on your individual health needs and considerations.

Other uses for this medicine

Some of the additional uses include:

• Hormone Replacement Therapy (HRT): Estrogen and progestin combinations are sometimes used in postmenopausal women as hormone replacement therapy to alleviate menopausal symptoms such as hot flashes, vaginal dryness, and mood swings.
• Menstrual Disorders: Oral contraceptives may be prescribed to regulate menstrual cycles, manage heavy or irregular periods, and reduce symptoms associated with premenstrual syndrome (PMS).
• Endometriosis: Women with endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus, may use oral contraceptives to help manage symptoms and reduce the growth of endometrial tissue.
• Polycystic Ovary Syndrome (PCOS): Oral contraceptives are sometimes prescribed to regulate menstrual cycles and manage symptoms associated with PCOS, such as acne and excessive hair growth.
• Acne Treatment: Certain oral contraceptives with anti-androgenic properties can be prescribed to treat moderate acne in women.

What special precautions should I follow?

While oral contraceptives are generally safe for many women, there are some special precautions and considerations to keep in mind:

• Smoking: Smoking while taking oral contraceptives, especially in women over 35 years old, increases the risk of cardiovascular complications, such as blood clots, stroke, and heart attack. It’s advisable to quit smoking when using oral contraceptives.
• Medical History: Inform your healthcare provider about your complete medical history, including any history of blood clots, cardiovascular issues, liver disease, or breast cancer.
• Drug Interactions: Some medications, including certain antibiotics and anticonvulsants, may interact with oral contraceptives, potentially reducing their effectiveness. Inform your healthcare provider about all medications you are taking.
• Blood Pressure Monitoring: Regular monitoring of blood pressure is recommended, as oral contraceptives can, in some cases, cause a slight increase in blood pressure.
• Age: Women over 35 who smoke are generally advised to choose alternative contraceptive methods due to the increased risk of cardiovascular complications.

Always follow your healthcare provider’s instructions and attend regular check-ups to monitor any potential side effects or changes in health while using oral contraceptives. If you experience any unusual symptoms or side effects, consult your healthcare provider promptly.

What special dietary instructions should I follow?

There are generally no specific dietary restrictions for women taking oral contraceptives. However, maintaining a healthy lifestyle can contribute to overall well-being. Consider the following:

• Calcium and Vitamin D: Some women may be advised to ensure an adequate intake of calcium and vitamin D, especially if they are at risk of osteoporosis. This is because long-term use of oral contraceptives may impact bone density in some women.
• Folate: If you are planning to become pregnant in the future, consider maintaining adequate folate intake, as some studies suggest that oral contraceptives may lower folate levels.

What should I do if I forget a dose?

If you miss a dose of your oral contraceptive, follow these general guidelines:

• Combined Pills (Estrogen and Progestin):
  • If you miss one active pill, take it as soon as you remember and take the next pill at the usual time.
  • If you miss two consecutive active pills, take two pills on the day you remember and two pills the next day. Use a backup method of contraception for the next seven days.
  • If you miss three or more consecutive active pills, follow your healthcare provider’s instructions. You may need to start a new pack or use a backup method of contraception.
• Progestin-Only Pills:
  • Take the missed pill as soon as you remember, even if it means taking two pills on the same day.
  • Use a backup method of contraception for the next 48 hours if you have sex during the time you missed a pill.

What side effects can this medication cause?

Estrogen and progestin oral contraceptives, like any medication, can cause side effects. It’s important to note that not everyone will experience these side effects, and for many women, the benefits of oral contraceptives often outweigh the risks. Common side effects may include:

• Nausea: Some women may experience nausea, especially when starting a new pack of pills. Taking the pill with food or at bedtime can help alleviate this side effect.
• Breast Tenderness: Oral contraceptives can cause breast tenderness or enlargement. This side effect is usually temporary and tends to resolve with time.
• Weight Changes: While weight gain is a concern for some women, studies have not consistently shown a direct association between oral contraceptives and significant weight gain. Any changes in weight are often minimal.
• Headaches: Some women may experience headaches, which can be a side effect of hormonal fluctuations. If headaches become severe or persistent, consult your healthcare provider.
• Mood Changes: Mood swings, depression, or changes in libido can occur as a side effect of hormonal contraceptives. If these symptoms are severe or persistent, discuss them with your healthcare provider.
• Breakthrough Bleeding or Spotting: Women may experience irregular bleeding or spotting between periods, especially during the first few months of using oral contraceptives. If this persists or becomes bothersome, consult your healthcare provider.
• Changes in Menstrual Flow: Oral contraceptives can affect menstrual flow. Some women may experience lighter periods, while others may have heavier or more prolonged bleeding.
• Changes in Sexual Desire: Some women may notice changes in sexual desire or libido while taking oral contraceptives.
• Blood Pressure Changes: In some cases, oral contraceptives can cause a slight increase in blood pressure. Regular monitoring is recommended.
• Eye Changes: Contact lens wearers may experience changes in tolerance or fit. Consult your eye care professional if you notice any vision changes.
• Skin Changes: Oral contraceptives may affect skin conditions. While some women experience improvement in acne, others may notice skin changes or melasma (darkening of facial skin).

It’s essential to be aware of these potential side effects and communicate with your healthcare provider if you experience any unusual or bothersome symptoms. Serious side effects, though rare, may include blood clots, stroke, heart attack, or liver problems. Seek immediate medical attention if you experience severe chest pain, shortness of breath, severe headaches, or other signs of a serious adverse event.

Before starting oral contraceptives, discuss your medical history and any concerns with your healthcare provider, and attend regular check-ups to monitor your health while on the medication.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Keep oral contraceptives at room temperature, away from moisture and direct sunlight. Follow the specific storage instructions provided by the medication packaging.
• Disposal: Dispose of unused or expired medication according to local regulations. Do not flush medications down the toilet unless instructed to do so. Check with your local pharmacy or healthcare provider for proper disposal methods.

In case of emergency/overdose

In case of a suspected overdose or emergency, seek medical attention or contact a poison control center immediately. Symptoms of overdose may include nausea, vomiting, and vaginal bleeding.

What other information should I know?

• Regular Check-ups: Attend regular check-ups with your healthcare provider to monitor your health and discuss any concerns or potential side effects.
• Missed Doses: If you miss a dose, follow the specific instructions provided by your healthcare provider or the package insert for your particular oral contraceptive brand. Use a backup method of contraception if necessary.
• Follow Healthcare Provider’s Advice: Always follow your healthcare provider’s advice and instructions regarding the use of oral contraceptives. They can provide personalized guidance based on your individual health needs.
• Interactions with Other Medications: Inform your healthcare provider about all medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins, as some medications may interact with oral contraceptives.
• Smoking and Age Considerations: If you smoke, especially if you are over 35, discuss the risks with your healthcare provider. Smoking increases the risk of cardiovascular complications when combined with oral contraceptives.
• Blood Pressure Monitoring: Regularly monitor your blood pressure, as oral contraceptives can, in some cases, cause a slight increase.
• Medical History: Provide your healthcare provider with a comprehensive medical history, including any history of blood clots, cardiovascular issues, liver disease, or breast cancer.
• Allergic Reactions: Seek medical attention if you experience symptoms of an allergic reaction, such as rash, itching, swelling, severe dizziness, or difficulty breathing.
• Emergency Contraception: Oral contraceptives are not intended for use as emergency contraception. If you need emergency contraception, discuss options with your healthcare provider.

Always consult with your healthcare provider for specific advice tailored to your individual health needs. If you have questions or concerns about your medication, do not hesitate to contact your healthcare provider or pharmacist for guidance.