As with any medication, you should know what 'The Pill' does for you and how to use it.
 Protection
The contraceptive pill is the most reliable guard against pregnancy – it is over 99 per cent effective. However, unlike condoms, the pill does not offer any protection against sexually transmitted diseases.
Brands
There are over 10 brands of contraceptive pills available in Singapore. Each contains a specific blend of synthetic hormones oestrogen and progestin, and has its own set of pros and cons.
For example, Diane-35 contains cyproterone acetate, an anti-androgen that can treat problem skin and hair loss. On the downside, there may be side effects like water retention and weight gain.
Dosage
The average menstrual cycle is 28 days. Hence, most pills are taken continuously for 21 days, then stopped the following week for menstruation to occur. However, the newest brand Yaz does not have a pill-free break in between dosages. Instead, it consists of 24 active tablets and four placebo tablets. Placebo tablets do not contain any hormones. They facilitate uninterrupted daily dosages, hence minimising the chance of a woman forgetting to take the pill.
Missed pill
For most brands, as long as the next pill is taken within 12 hours of regular dosage time, its efficacy remains unaffected. However, if a pill is taken more than 12 hours late, irregular bleeding may occur. This is a normal consequence of a missed pill and is no cause for alarm, said Dr Wee Horng Yen, an obstetrician and gynaecologist at KK Women’s and Children’s Hospital. While one can take the forgotten pill as soon as possible, missing a pill will lower the contraceptive protection.
Lighter periods
One should expect a lighter menstrual flow while on the pill. This is because the pill thins the endometrium or the lining inside the womb that is the source of menses. The lighter flow is neither a signal of ill health nor the common belief that it is due to a lack of “cleansing”, said Dr Wee.
Starting and stopping
The conventional time to start on a new course of the pill is the first day of menses. If one wishes to stop taking the pill, it is best to finish the pack first in order to ensure protection for the entire month. There is no minimum number of packs one should take. After stopping the pill, ovulation will begin in the next menstrual cycle. The pill does not cause fertility loss. However, if one has been on the pill for a long time, it may take a few months for the menstrual cycle to regulate itself.
Suitability
Not every woman can go on the pill. Those who are at risk of suffering blood clots – such as those with a family history of heart attack and stroke – or have diabetes, severe hypertension and liver or gall bladder disease may not be suited for the pill.
This is because the pill may bring about a minor risk of deep-vein thrombosis, where a blood clot forms in a vein and stays there. Women who are breastfeeding should also avoid taking the pill. Sufferers of breast cancer, epilepsy and abnormal vaginal bleeding are advised to first seek a doctor’s opinion.
Alternative forms
The pill also comes in patch, implant and injection forms. The patch is applied directly to the skin, while implants are inserted beneath the skin, usually on the inside of the arm. The patch is applied weekly for the first three weeks of every menstrual cycle, while an implant lasts up to three years. Contraceptive injections are given every three months.
Ref: V10
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