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  Birth Control Pills - Dosing, Precautions & Use
Oral contraceptives (birth control pills) are medications that prevent pregnancy. They are one of the methods of birth control.

Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin or progestin alone. Combinations of estrogen and progestin prevent pregnancy by inhibiting the release of the hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland in the brain. LH and FSH play key roles in the development of the egg and preparation of the lining of the uterus for implantation of the embryo. Progestin also makes the uterine mucus that surrounds the egg more difficult for sperm to penetrate and, therefore, for fertilization to take place. In some women, progestin inhibits ovulation (release of the egg).

The combination birth control pills that contain estrogen and progestin are called "monophasic," "biphasic," or "triphasic."

  • Monophasic birth control pills deliver the same amount of estrogen and progestin every day.
  • Biphasic birth control pills deliver the same amount of estrogen every day for the first 21 days of the cycle. During the first half of the cycle, the progestin/estrogen ratio is lower to allow the lining of the uterus (endometrium) to thicken as it normally does during the menstrual cycle. During the second half of the cycle, the progestin/estrogen ratio is higher to allow the normal shedding of the lining of the uterus to occur.
  • Triphasic birth control pills have constant or changing estrogen concentrations and varying progestin concentrations throughout the cycle. There is no evidence that bi- or tri-phasic oral contraceptives are superior to monophasic oral contraceptives, or vice-versa, in the prevention of pregnancy.
 

STORAGE: All oral contraceptives should be stored between 15°C (59°F) and 30°C (86°F).

PRESCRIBED FOR: Birth control pills are prescribed to prevent pregnancy. When taken as directed, birth control pills fail in less than one in every 200 users over the first year of use.

Birth control pills also are prescribed to treat mid-cycle pain which some women experience with ovulation. Birth control pills, while regulating the menstrual cycle, reduce menstrual cramps and heavy bleeding, and, because of the reduced bleeding, they may prevent the anemia that can develop in some women. For this reason they also are sometimes prescribed for a number of conditions that are characterized by excessive bleeding or painful menses.

DOSING: Doctors sometimes prescribe higher doses of birth control pills for use as a "morning after" pill to be taken up to 72 hours after unprotected intercourse to prevent fertilization and pregnancy. Most birth control pills are packaged as 21-day or 28-day units. For 21-day packages, tablets are taken daily for 21 days. This is followed by a 7-day period during which no birth control pills are taken. Then the cycle repeats.

Newer formulations with 24 days of hormone pills and only four days of placebo pills are now available, as are continuous or extended-cycle oral contraceptive regimens, in which only active hormone pills are taken. Extended-cycle preparations include 7-day intervals of placebo pills to be taken approximately every three months.

Women just starting to take birth control pills should use additional contraception for the first seven days of use because pregnancy may occur during this period.

If women forget to take their tablets, pregnancy may result. If a single tablet is forgotten, it should be taken as soon as it is realized that it is forgotten. If more than one tablet is forgotten, the instructions that come with the packaging should be consulted, or a physician or pharmacist should be called.

DRUG INTERACTIONS: Estrogens can inhibit the metabolism (elimination) of cyclosporine, resulting in increased cyclosporine blood levels. Such increased blood levels can result in kidney and/or liver damage. If this combination cannot be avoided, cyclosporine concentrations can be monitored, and the dose of cyclosporine can be adjusted to assure that its blood levels do not become elevated.

WARNING: Smoking cigarettes while using these medications increases your chance of having heart problems.

USES: These medications are used to prevent pregnancy or to regulate your menstrual cycle. Certain brands of birth control pills may be used for treating acne or as a "morning after" pill for emergency contraception. Use of this medication does not protect you or your partner against sexually transmitted diseases (e.g., HIV, gonorrhea).

HOW TO USE: Take these medications with food or immediately after a meal to prevent stomach upset. Try to take these medications at the same time each day. This may help you to remember to take it.

SIDE EFFECTS: These medications may cause dizziness, headache, lightheadedness, stomach upset, bloating, or nausea. If these effects persist or worsen, contact your doctor. Notify your doctor if you experience: severe depression, groin or calf pain, sudden severe headache, chest pain, shortness of breath, lumps in the breast, weakness or tingling in the arms or legs, yellowing of the eyes or skin.

PRECAUTIONS: Before you take these medications, tell your doctor your entire medical history, including family medical history, especially: asthma, high blood pressure, kidney disease, liver disease, heart disease, stroke, history of jaundice (yellowing skin/eyes) or high blood pressure during pregnancy, excessive weight gain or fluid retention during menstrual cycle, blood clots, heart attack, seizures, migraine headaches, breast cancer, high blood level of cholesterol or lipids (fats), diabetes, depression. These medications pass into breast milk. This may affect milk production and may have harmful effects on a nursing infant. Consult your doctor before breast-feeding.

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