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Combined Oral Contraceptives
Time:2011/12/11 1:14:33          Click:4399          Source:zizhu-pharmFont Size:  

Key Points

Take one pill every day. For greatest effectiveness a woman must take pills daily and start each new pack of pills on time.

Bleeding changes are common but not harmful. Typically, irregular bleeding for the first few months and then lighter and more regular bleeding.

Take any missed pill as soon as possible. Missing pills risks pregnancy and may make some side effects worse.

Can be given to women at any time to start later. If pregnancy cannot be ruled out, a provider can give her pills to take later, when her monthly bleeding begins.

Risk of pregnancy is greatest when a woman starts a new pill pack 3 or more days late, or misses 3 or more pills near the beginning or end of a pill pack.

Return of fertility after COCs are stopped: No delay

Protection against sexually transmitted infections (STIs): None

Who Can and Cannot Use Combined Oral Contraceptives

Safe and Suitable for Nearly All Women

Nearly all women can use COCs safely and effectively, including

women who:

l  Have or have not had children

l  Are not married

l  Are of any age, including adolescents and women over 40 years old

l  Have just had an abortion or miscarriage

l  Smoke cigarettesif under 35 years old

l  Have anemia now or had in the past

l  Have varicose veins

l  Are infected with HIV, whether or not on antiretroviral therapy (see

l  Combined Oral Contraceptives for Women With HIV, p. 9)

Women can begin using COCs:

l  Without a pelvic examination

l  Without any blood tests or other routine laboratory tests

l  Without cervical cancer screening

l  Without a breast examination

l  Even when a woman is not having monthly bleeding at the time, if it is

l  reasonably certain she is not pregnant

Side Effects, Health Benefits, and Health Risks

Some users report the following:

l  Changes in bleeding patterns including:

Lighter bleeding and fewer days of bleeding

Irregular bleeding

Infrequent bleeding

No monthly bleeding

l  Headaches

l  Dizziness

l  Nausea

l  Breast tenderness

l  Weight change (see Question 6, p. 22)

l  Mood changes

l  Acne (can improve or worsen, but usually improves)

Other possible physical changes:

l  Blood pressure increases a few points (mm Hg). When increase is due to COCs, blood pressure declines quickly after use of COCs stops.

 

Known Health Benefits    

Help protect against:

l  Risks of pregnancy

l  Cancer of the lining of the uterus

l  (endometrial cancer)

l  Cancer of the ovary

l  Symptomatic pelvic inflammatory

l  disease

l  May help protect against:

l  Ovarian cysts

l  Iron-deficiency anemia

Reduce:

l  Menstrual cramps

l  Menstrual bleeding problems

l  Ovulation pain

l  Excess hair on face or body

l  Symptoms of polycystic ovarian

l  syndrome (irregular bleeding, acne, excess hair on face or body)

l  Symptoms of endometriosis (pelvic pain, irregular bleeding)

Known Health Risks 1

Very rare:

l  Blood clot in deep veins of legs or lungs (deep vein thrombosis or pulmonary embolism)

Extremely rare:

l  Stroke

l  Heart attack

 

   

All information from WHO-handbook of family planning

 
 
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