Birth control pills or oral contraceptives (OCPs) are pills, which are normally taken daily to prevent pregnancy. Their failure rate is suggested as 0.1%. Not taking pills regularly is always considered a problem and may lead to an increased failure rate. OCPs have other uses as well, e.g. hyperandrogenism (increased male hormones in body), dysmenorrhea (painful menstruation), and menorrhagia (vaginal bleeding).

Some of the side effects such as thrombosis (formation of blood cloth in vessels) and cardiovascular disease limit OCPs long-term use. Fortunately, there are pills with lower estrogen and progestin content available now, which have resulted in reduction of both side effects. These products seem to be better options for most people.

Previously upper age limits for birth control pills use were set as 35 years for smokers and 40 years for nonsmokers. However in1989 the age limit was removed for healthy, nonsmoking women and they can take OCPs until menopause. However OCPs should be offered with great caution for those who smoke.

Most side effects of OCPs are transient and resolve in few months. Still many patients discontinue the medication for the side effects. Side effects of OCs include bloating, nausea, weight gain, breakthrough bleeding and breast tenderness. The most common cause of breakthrough bleeding is probably missed pills. It is important to remember and take pills regularly both to avoid risk of pregnancy and breakthrough bleeding.

Although the best practice is to take your pills regularly, missing pills is inevitable. We suggest you always keep one brochure from your pillbox handy and follow the directions for missed pills in case there is a need. Don’t forget to contact your pharmacist if you need any advice.

Sepideh Nasafat, PharmD

Registered Pharmacist

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