Oral Contraceptive Pills (OCP)

WHAT ARE THEY?

Oral contraceptive pills may also be referred to as OCPs or the Pill. They are a type of hormonal birth control that acts on a person’s monthly cycle by mimicking the actions of progesterone and estrogen. Oral contraceptive pills are a popular and suitable option for most people in good health regardless of age and can be taken long term. They are prescription tablets that are taken once a day as prescribed and ideally at the same time each day for the greatest effect.

There are two main types: 1) combination pill, which contains estrogen and progesterone; 2) progestin-only pill, which does not contain estrogen. The pill is available at pharmacies with a prescription.  

The Pill has multiple brands and each one has different amounts of estrogen and progestin in them. Newer pill options are effective at preventing pregnancy but at lower doses of hormones. You may have to try a few brands before you find one that works best for your body.

 

HOW DOES IT WORK?

Combined OCPs (estrogen and progestin containing) prevent pregnancy mostly by stopping ovulation. They also thicken the cervical mucus, which makes it more difficult for the sperm to swim to the egg, and change the lining of the uterus, so that if an egg does get fertilized by sperm, it will be more difficult for it to implant.

The progestin only pill prevents pregnancy mainly by thickening the cervical mucus and thinning the lining of the uterus. It only prevents ovulation (release of a mature egg) in about 40% of cycles.

 

HOW EFFECTIVE IS IT?

If used perfectly as directed, the Pill is 99.7% effective in preventing pregnancy. Based on average use (e.g. not taking it at the same time every day, missing pills), it is 91% effective.

The Pill does NOT offer any protection against STIs.

 

WHAT ARE THE RISKS/ SIDE-EFFECTS?

Side-effects, when they occur, are often minor. For most people, the Pill is a safe and effective option. You may experience minor side-effects, such as spotting, bloating, breast tenderness, nausea, or mood changes, but these should disappear within the first 3 months of taking the Pill. You may also notice a change in vaginal discharge.

If you have persistent side effects, our doctors may recommend trying a different type/brand of pill or another type of contraception.  

Some rare but serious risks are associated with the Pill, such as blood clots and stroke. It is important to know that the risks of using birth control pills are smaller than the health risks associated with pregnancy.

Some people may not be able to use the pill because of their health history. People who experience migraines with aura, have high blood pressure, high cholesterol, or have diabetes may not be able to use the Pill. Our doctors at the HSHC will always discuss possible alternative options with you.

 

SIGNS OF SERIOUS SIDE-EFFECTS FROM OCPs:

Please seek medical attention immediately if you experience any of the following which can  indicate that your are experiencing a rare but serious side effect (stroke, heart attack, blood clot, liver or gallbladder disease)

A bdominal pain that is severe

C hest pain that is severe, coughing, shortness of breath or severe calf or leg pain

H eadache that is severe, increase in frequency or intensity of headache, dizziness, nausea, numbness or weakness

E ye vision loss or blurring

S peech problems/ signs of stroke such as slurred speech

 

DOES IT AFFECT MY ABILITY TO BECOME PREGNANT AFTER STOPPING?

For many people with vaginas, their period returns within 30 days of stopping the Pill. Fertility and period should return to normal in almost all people with vaginas by 90 days after stopping the Pill.  

 

USE OF ORAL CONTRACEPTIVES  

  • If you begin taking birth control on the first day of your period, you do not need to use a backup birth control method (e.g. condoms) to prevent pregnancy  
  • If you start taking birth control at any other time than on the first day of your period, you should use  condoms for the first 7 days after starting the pill to reduce your risk of pregnancy  
  • For the pill to be most effective it should be taken at the same time each day
  • Start your new pack immediately after finishing your last, unless otherwise instructed.
  • The schedule for taking your pills will depend on the type of pill you are prescribed. Our doctors will discuss the ideal schedule with you.
  • For many pill brands, the last few days or week may contain placebo sugar pills to keep you on track. This is when you will experience bleeding.
  • You are protected from pregnancy while experiencing bleeding during your placebo pills as long as your previous pills were taken correctly and on schedule.  

 

WHEN TO USE BACK UP BIRTH CONTROL

  • STARTING THE PILL: If you start taking birth control at any other time than on the first day of your period you should use back up birth control (e.g. condoms) for the first 7 days after starting the pill to reduce your risk of pregnancy.
  • VOMITING: If you vomit within 2 hours of taking your pill, you should take another pill and use back birth control for 7 days following.
  • DIARRHEA: If you experience diarrhea for more than 2 days while taking the pill, continue taking the pill but use a backup method for the rest of the package.    
  • MEDICATIONS THAT CAN AFFECT THE PILL: Some medications and herbal substances, such as some antibiotics, some anticonvulsants, and St. John’s Wort, will make the pill less effective. It is important to talk about any medications or herbal substances you take with your doctor. If you are not sure if something you start taking might interact with the pill, use a back up method until you speak with your doctor or a pharmacist.  
  • MISSING A PILL: If you miss more than one pill, please call our Centre to talk to one our nurses about what to do. If you have unprotected sex after missing a pill, please contact our doctors to discuss emergency contraception options, such as the morning after pill or an emergency copper IUD insert.

 

ADVANTAGES AND DISADVANTAGES OF TAKING THE PILL

Combined Oral Contraceptive (Estrogen and Progestin)

ADVANTAGES:

  • Can decrease acne, body and facial hair growth.
  • Can reduce the risk of endometrial, ovarian and colon cancers.  
  • Can reduce perimenopause symptoms   
  • May reduce the risk of fibroids and ovarian cysts
  • Decrease blood loss and anemia

DISADVANTAGES:

In some cases, combined oral contraceptives should not be used due to increased risk of adverse events like blood clots. For instance

  • Should not be used by people over the age of 35 who smoke
  • Should not be used by people who have had migraine with aura   
  • Should not be used by people with liver disease or multiple cardiovascular risk factors
  • Should not be used by people who have had previous blood clots or stroke
  • Should not be used in some other medical conditions
  • Should not be used during pregnancy

Progestin Only Pill (POP)

ADVANTAGES:

  • May be an appropriate option for people who cannot take estrogen  
  • May be an appropriate option for people who are breast feeding
  • May be an appropriate option for people over 35 who smoke

DISADVANTAGES:

Some people may experience hormonal side-effects such as:

  • Acne
  • Headaches
  • Breast sensitivity
  • Mood changes
  • Hair growth
  • Weight gain

This kind of pill has a higher failure rate if not taken at the same time each day than the combined oral contraceptive pill.

 

HOW TO BOOK AND PREPARE FOR YOUR APPOINTMENT

BOOKING AN APPOINTMENT

Booking an appointment with us is easy! Give us a call at 902.455.9656 ext. 0. You will be speaking with either a volunteer or a medical administrator. We cannot book appointments by email or Facebook. You cannot book an appointment for someone else, even if they are your partner or child. We will need to speak with them directly. To book, we will need your full name, birth date, phone number, and a very brief reason for your visit. That’s it! The person on the phone will outline anything you need to know to prepare for your appointment. For most general appointments, we run very short waitlists! While this is not a guarantee, we can often book you in within 1-2 weeks from the day you call.

Make sure you bring your valid provincial health card with you to your appointment. Clients without health cards are subject to doctors and lab fees.

Are you a youth? You do not need parental consent for any of our appointments.

Don’t have access to or lost your health card? You are entitled to your health card information! Call MSI toll-free at 1-800-563-8880 (in Nova Scotia) or at 902-496-7008 from Monday-Friday 8am-5pm. We require the number and the expiry date. Another tip: take a picture of your card! You will never lose it again!