2nd of 4 pts of our contraceptives review examines different types of oral pills

Contraceptives Part 2

Oral Contraceptives (Continued)

Last week I described the two types of oral contraceptive pills are progesterone only contraceptives (POCs) or combined oral contraceptives (COCs) where progesterones are combined with oestrogens.

Combined oral contraceptives (COCs)

Advantages of COCs over POCs

1. Higher efficacy: COCs have a lower failure rate compared to POCs. When taken correctly, COCs are around 99% effective in preventing pregnancy, while POCs have a slightly higher failure rate (but still nearly 99% effective if taken properly).

2. Better Cycle control: COCs provide better control over the menstrual cycle so better control at regulating irregular periods, reducing menstrual pain, and decreasing heavy menstrual bleeding. They can also be used to skip or delay periods, which may be desired during certain situations like holidays or special events.

3. Decreased risk of ovarian and endometrial cancers: COCs have been shown to reduce the risk of ovarian and endometrial cancers. POCs do not offer the same level of protection against these types of cancers.

4. Reduced risk of benign breast conditions: COCs have a protective effect against certain benign breast conditions such as fibrocystic breast disease, fibroadenoma, and benign breast tumours.

5. Reduced risk of ectopic pregnancy: COCs have been associated with a lower risk of ectopic pregnancy compared to POCs. Ectopic pregnancy occurs when a fertilised egg implants outside of the uterus, typically in the fallopian tubes.

6. Potential acne control: Some types of COCs containing certain progestins can help improve acne by reducing oil production and regulating hormones (eg) Dianette^®.

Progesterone only contraceptives (POCs)

Progesterone-only contraceptives, also known as "minipills," contain progesterone hormones and no oestrogen.

Reasons why progesterone-only contraceptives may be preferred:

1. Safe for women who are breastfeeding: progesterone -only contraceptives are safe for nursing mothers because they do not interfere with milk production or the health of the baby.

2. Lower risk of cardiovascular health issues: Women who cannot take oestrogen-based contraceptives due to their risk of developing blood clots, stroke, or certain types of cancer (breast, ovarian, or endometrial) may be recommended progesterone -only contraceptives as a safer alternative, especially in older women of childbearing age who can be at more risk from the likes of clots.

3. Fewer side effects: progesterone -only contraceptives have fewer side effects than oestrogen-based contraceptives as oestrogen can cause headaches, nausea, and weight gain.

Reasons lower dose contraceptives may be preferred

Low dose contraceptive pills are associated with reduced side effects compared to higher dose formulations. They may have a lower risk of hormonal-related adverse effects such as bloating, weight gain, breast tenderness, and mood changes. Women who are at a higher risk of developing blood clots or those with specific medical conditions may be better suited for low-dose options. Examples of lower does COCs include Yasmin^® and Cilest^®.

To be continued… next week I discuss non oral contraceptives like patches, implants, injections, and vaginal rings

For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).