The combined oral contraceptive pill (COCP) is a type of contraception for women. It is available free of charge on the NHS in the UK and is sometimes referred to as just the pill. It contains two hormones, oestrogen and progestogen. These hormones closely resemble the oestrogen and progesterone hormones produced by a woman’s ovaries. There are lots of different COCPs available. Examples include Rigevidon, Yasmin, Lucette, Femodette, Levest, and Cilique. The amount and type of oestrogen and progestogen hormones differ between the other brands. COCPs are either monophasic (all the pills in the pack contain the same amount of hormones) or multiphasic (different pills in the pack contain differing amounts of hormones). Some are taken for 21 days, followed by a seven-day break. Others are taken daily and hold inactive (dummy) pills at the end of the pack.
When taking the COCP, you should try to take it at about the same time each day. If you are taking a multiphasic or everyday pill, ensure you take the tablets in the correct order marked on the pack. It is best to start the COCP on day one of your menstrual cycle (the first day of your period). If you start on days 1-5 of your menstrual cycle, you will receive immediate protection against pregnancy. However, if you start after the fifth day of your menstrual cycle or have a short menstrual cycle, you should use condoms or avoid having sex for the first seven to nine days until it becomes effective.
Most women taking the COCP will have a withdrawal bleed each month, usually at the end of the pack in the seven-day break or the last week of the pack for everyday preparations. However, some women may choose to follow a tailored regimen. For example, taking a 21-day preparation every day to avoid having withdrawal bleeds each month. You should speak with your doctor or nurse if you want to take the COCP in this way.
The COCP works in three different ways. It stops the ovaries from releasing an egg each month (ovulation). It also increases the thickness of the mucus produced by the neck of the womb (cervix). This thickened mucus acts as a barrier to prevent sperm from reaching and fertilising an egg. The COCP also makes the lining of the womb thinner. Therefore, making it more difficult for a fertilised egg to implant into the womb. If taken correctly, the COCP is more than 99% effective. The COCP does not protect against sexually transmitted infections. Therefore, it is best to use condoms as well.
As always, do not take the medication if you are allergic to any ingredients. Your doctor or contraceptive nurse will decide whether it is appropriate for you to take the COCP. It may not be suitable for some women to take the COCP. For example, if they are over 50, severely obese, smoke (and are 35 or above), suffer from migraines with aura, have breast cancer (or have had it in the past), have liver problems, have heart disease (or are at risk of developing it), or take certain medications such as some epilepsy medications.
As with all medications, some people may experience side effects. You should speak with your doctor or pharmacist if any side effects become bothersome. Potential side effects from the COCP can include feeling sick, headache, breast tenderness, and mood swings. Despite what many people believe, there is no conclusive evidence suggesting that COCP causes weight gain.
The COCP may slightly increase your risk of developing breast and cervical cancer. Symptoms of breast cancer can include changes in your breasts, such as any lumps, changes in the nipple, or dimpling of the skin. Symptoms of cervical cancer can include pelvic pain, pain during sex, unusual vaginal bleeding, and vaginal discharge that smells and may contain blood. You should promptly speak with your doctor if you notice any breast or cervical cancer symptoms. On the other hand, the COCP can decrease your risk of developing womb cancer, ovarian cancer, and bowel cancer.
The COCP can also slightly increase your risk of developing a blood clot. You should speak with your doctor immediately if you develop shortness of breath, chest pain, or pain or swelling in a leg or arm.
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