What is contraceptive pill, is a question asked by many. Contraceptive pills are a hormonal form of contraception and are highly effective when taken as directed.
Types of contraceptive pills and how to use them
Daily contraceptive pills
These include active (containing hormones) and inactive (do not contain hormones) pills. Menses occur while a female is on inactive pills. Daily contraceptive pills are classified as follows:
Combined contraceptive pills
These pills have both estrogen and progesterone. According to the duration of the cycle they are are used for (monthly of 4 monthly) and the type of hormones released, they are classified as follows:
- Monophasic pills: They are used as a monthly cycle pill. The monophasic type has 21 active and 7 inactive pills, and menstruation happens in the last 7 days while a female is on inactive pills. These pills release the same dose of hormones throughout the cycle. Pills should be taken at the same time every day.
- Multiphasic pills: Like monophasic pills, they are also used for a monthly cycle and consist of 21 active and 7 inactive pills. However, they release a different dose of hormones during the cycle. It should be taken at the same time every day.
- Extended-cycle pills: These pills are used as a 13-week cycle. Active pills are taken for 12 weeks followed by a week of inactive pills.
Unlike combined contraceptive pills, the progestin-only pill consists only of progestin. This type of OC pills contains only active pills and should be taken at the same time every day. While on the progestin-only pill, a female gets menses after 4 weeks, faces spotting between the cycle or does not get it at all. In any case, progestin-only pills should not be stopped till one wants to avoid pregnancy.
Emergency contraceptive pills
Unlike daily contraceptive pills, emergency contraceptive pills are taken after sexual intercourse, within the first 72 hours and not daily. They are taken to prevent unwanted pregnancy when a female forgets to take a daily pill or failure of the contraceptive method like slipping or breaking of a condom.
- Levonorgestrel (LNG): LNG is a synthetic progestin-only pill and is usually taken in a single dose of 1.5 mg.
- Ulipristal acetate: It is a selective progesterone receptor modulator. It is taken as a single dose of 30 mg.
- The Yuzpe method: This is similar to that of combined daily pill. It includes estrogen combined with levonorgestrel. It is taken in 2 divided doses with estrogen (100–120 mcg ethinylestradiol) and progestin (either 0.50–0.60 mg levonorgestrel or 1.0–1.2 mg norgestrel).
Effectivity of contraceptive pills
Daily contraceptive pills: They are almost 100% safe if taken as directed, and the chance of pregnancy is 0.1%. However, it is seen that some females forget to take pills sometimes, and accounting for the missed days, the chance of pregnancy while on the daily contraceptive pill is about 8% per year.
Emergency contraceptive pills
- Levonorgestrel (LNG): Efficacy of this pill is 95% when taken within 24 hours of intercourse with a pregnancy rate of only 0.4%. The efficacy of LNG drops to 85% and 58% if taken between 25-48 hours and 49-72 hours respectively after unprotected sex while the pregnancy rate raises by 1.2% and 2.7% respectively.
- Ulipristal acetate: Efficacy and pregnancy rate is the same as that of LNG
- The Yuzpe method: Efficacy of this method is 77% if taken within 24 hours of intercourse with a pregnancy rate of 2 %. However, the efficacy reduces to 33% and 31% when taken after 25 and 49 hours respectively of intercourse. Pregnancy rate increases to 4.1% and 4.7% respectively.