Summary of Study Session 5

In Study Session 5, you have learned that:

  1. The combined oral contraceptive (COC) pill, oral contraceptive (OC) pill, and often just called the pill, is the most popular type of birth control. There are many different brands, and they come in packs of 21 or 28 pills. Two brands, Microgynon and Leo-femenal, both in packs of 28 pills, are the most popular ones in Ethiopia. Progesterone-only oral birth control pills, or mini-pills, come in packs of 28 pills, and users take one every day. They contain a synthetic form of the progesterone hormone called progestin and no oestrogen.
  2. The pill works mainly by changing the body’s hormonal balance so that the woman does not ovulate. It works by stopping an egg (ovum) from being released each month from an ovary, and by forming a mucus plug so that sperm cannot get into the uterus to fertilise the egg. The pill also makes the lining of the uterus thinner, which makes it unlikely that a fertilised egg will be able to attach to the uterus.
  3. If used correctly and consistently, the combined oral contraceptive pill is 99.9% effective. In lactating mothers, the progestin-only pill is more effective than the combined oral contraceptive pill, because breastfeeding itself provides some protection against pregnancy.
  4. Pills are a particularly attractive contraceptive option for women who are happy to take a daily dose and be in control of their own bodies.
  5. Women who are over 35 years should not take the pill if they have a history of heart attacks or strokes, blood clots, unexplained vaginal bleeding, known or suspected cancer, known or suspected pregnancy, or liver disease.
  6. In the mini-pill, there are hormones in all 28 pills, and no spacer pills. It is important to take a pill every day, preferably at the same time each day. Forgetting a mini-pill or taking it late increases the chance of pregnancy more than missing a COC pill. Therefore, a woman should not stop taking the mini-pill unless she wants to get pregnant or to use another method of birth control.
  7. One of the advantages of COCs is that when taken consistently and correctly, they are very effective contraceptives that give women control over their own fertility. Most women can safely use pills throughout their reproductive years as long as they want to prevent pregnancy.
  8. The major advantage of the mini-pill is that it can be used by nursing mothers, beginning six weeks after childbirth, and the quality and quantity of breastmilk is not affected.
  9. One of the disadvantages of COCs is that they are not recommended for breastfeeding women, because they do affect the quality and quantity of breastmilk.
  10. Most women who take the pill do not develop any side-effects. However, a small number of women develop nausea, headaches, sore breasts, mood changes, spotting between periods or irregular bleeding.
  11. If a woman who takes the pill experiences common side-effects, such as nausea, mild headaches, mood changes, tender breasts, spotting between periods or irregular bleeding, you should reassure her that these are not signs of more serious problems and they usually go away within three months.
  12. The effectiveness of oral contraceptives, both COCs and mini-pills, are lowered when taken with certain medications, including antibiotics, anti-seizure, anti-tuberculosis, and migraine medications.

5.6.3  Drug interactions

Self-Assessment Questions (SAQs) for Study Session 5