THE DIFFERENT TYPES OF ORAL CONTRACEPTIVE PILL
The Combined Oral Contraceptive Pill (OCP)
This contains both oestrogen and progesterone in synthetic forms and in varying amounts, depending on the brand. The synthetic oestrogen used in the pill is ethinyl oestradiol and the synthetic progesterones are either norethisterone or levonorgestrel. Unfortunately, natural hormones as used in Hormone Replacement Therapy during the menopause, are not potent onough to prevent conception.
Of all the brands of combined OCPs available today, the triphasic OCP such as Triquilar comes closest to copying the natural menstrual cycle as it delivers varying amounts of hormones at different times in the menstrual cycle. This means that over one complete cycle, the total amount of hormone ingested is less than that from an oral contraceptive pill where the amount of hormone delivered is the same every day.
The Progesterone Only PHI
The Progesterone Only Pill (POP) is also referred to as the "mini pill". It contains only one hormone in the form of synthetic progesterone and does not contain oestrogen which is the other sex hormone. Commonly prescribed brands of the POP are Micronor or Microlut. Because the POP contains such a small amount of hormone, it must be taken every day, at the same time each day and without any breaks. It needs to be taken at least three hours before sexual intercourse, so that if you have sex later at night, you would be safe to take it around 6 pm each day. The POP provides such a low hormone dose that it causes only very small changes in your metabolism and thus does not cause any of the potentially serious side effects (such as blood clots, strokes or high blood pressure) occasionally associated with the combined OCP. The POP does not increase your risk of cardiovascular disease or cancer.
Because of its safety, the POP is an ideal contraceptive for women over 45 who are worried that the combined OCP may increase their chances of cardiovascular disease. Women over 35 who smoke, diabetics, migraine sufferers and women who get side effects from the combined OCP are also good candidates for the POP. The POP is a suitable and safe contraceptive for breastfeeding women and women unable to take oestrogen for medical reasons such as liver disease, blood clots or high blood pressure.
The POP has a pregnancy rate of around 4% and is not quite as reliable as the combined OCP which has a failure rate of around 1%. The POP is more suited to older women or breastfeeding mothers whose fertility is less than that of younger or non-lactating women who may fear the 4% failure rate is unacceptable.
The mini pill is safe and generally well tolerated although one in four women get annoying irregular menstruation and breakthrough bleeding. This may be too problematic for sportive, outdoor women who like to control their menstrual cycle. Other women who should avoid the POP are those with a history of ectopic pregnancy, or pelvic inflammatory disease as the POP may increase your chances of ectopic pregnancy. An ectopic pregnancy is one occurring outside the uterus, usually in the uterine tubes.
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