The most common type of contraception that falls within this category is the combined oral contraceptive pill. The newest type of contraceptive that falls into this category is the patch.
Combined oral contraceptive pil (COCP)
This is the most popular form of contraception for women in the UK
How it works
It works by preventing ovulation. There is also a minor secondary effect by making cervical mucous hostile to sperm
Types
There are many types with two different oestrogens available and a number of different types of progesterone. The dose of oestrogen and progesterone may vary also.
If a pill has the same dosage of oestrogen and progesterone throughout the cycle it is called a 'monophasic' pill. Some pills might have three different dosages and these are called 'triphasic' pills.
Risks
Contrary to popular belief, weight gain is very slight on the pill and only occurs in the first few months. Hypertension and thrombo-embolic disease is increased. Some women get migraines on the pill.
Advantages
Much publicity is available over the risks of the pill. However, there are a number of advantages. These include;
- Very effective
- Easily reversible
- Does not rely on the man to participate in contraception
- Reduces the amount of chlamydial infections
- Reduces the amount of ovarian cysts
- Protects against ovarian cancer (50% protection with 5 years use)
- Protects against fibroids
- Protects against uterine cancer
- Two pills (Dianette & Yasmin) are good for acne & hirsuitism
Disadvantages
Breakthrough bleeding and minor sideeffects are common in the first few months. These normally resolve with time.
Contraindications
These include;
- Heart disease
- Focal migraine
- Personal history of venous thrombosis
- Smoker over 35 years of age
- Some rare liver conditions
- Inherited risk of venous thrombosis
Effectiveness
The failure rate is 0.2 - 3 per 100 women years.
How to use the COCP
- Start on the second day of the cycle
- If changing pill and going down a dose of oestrogen use additional contraception for 7 days and do not take a pill free break
- If you forget a pill > 12 hours take that pill and use additional contraception for 7 days (omit the pill free interval if in the last 7 days).
- Beware that some drugs interact with the pill making it less effective (e.g. some epilepsy drugs and antibiotics).
- Monophasic pills can be taken for three packets in a row without a pill free interval (tricycling) but triphasic pills cannot be taken in this manner.
Contraceptive patch
This is a newer way of taking combined oestrogen and progesterone contraception. It involves placing a patch on you skin for a week.
