Show MEDICALLY Y SPEAKING PEA I Iy ny Dr nr David Evans Vernal Family Health Center Did you forget to take your pill The doctor may prescribe either a day 21 or a day 23 regimen The day 21 regimen requires that a pill pilI be taken daily dally for 21 days The normal menstrual period usually begins In 23 3 days after discontinuing the pill pili The woman must then count five days after the beginning of her menstrual period and then start taking the pill pili again repeating the cycle The day 28 pack requires taking the pill daily dally The last seven pills in the pack are usually inert However sometimes they contain iron to prevent anemia How Do They Work There are several possible mechanisms most pills contain both estrogen and progesterone Estrogen prevents ovulation while progesterone prevents implantation implantation im plantation of the egg Progesterone theoretically also decreases the mucous secretions of the cervix alters the wall of the uterus and also can prevent ovulation Thus fertilization is inhibited When one begins to take the pill it should be remembered that during the first month other means of birth control should be utilized in order to prevent pregnancy What About Forgotten Pills and Missed Periods If IT one pill pili is forgotten it should be taken as soon as remembered The patient should remain protected from unwanted pregnancy However if two or more pills are forgotten some other means of birth control should be utilized It is common for women to occasionally miss a period If this should occur occur occur go go ahead and start taking the pills for the next cycle on the proper day Side Effects Everything ingested can cause side effects if enough is ingested for example aspirin sugar alcohol and salt There is never a question about medications causing side ef ef- ef They can Rather there is isa isa isa a series of of questions How frequent Does the benefit justify the risk Will the side effects be dangerous or merely annoying What are the consequences consequences con con- sequences if the medication is withheld With over six million American women taking the pill side effects readily become apparent Not all side effects are un un- un- un desirable For example regularization of menstrual cycles relief from menstrual pain and a feeling of well being can occur There has been some evidence that certain types of birth control pills have been linked with an increase in en- en cancer They have been taken off the market The Pill fill and Blood Clots A clot that is loose and circulating circulating cir cir cir- is called an embolus which can potentially cause sudden or complete blockage of ofa a blood vessel Deaths related to the pill have been attributed to blood clots in the vessels of the brain and lungs However evidence has appeared Indicating indicating indi Indi- cating that estrogen based oral contraceptives increase the frequency of heart attack in heavy smokers obese patients patients with high blood pressure and diabetes Of course the latter two conditions alone predispose the patient to a higher risk The incidence of blood clots and death is 54 per in pill users in the 39 20 year range whereas for the same group of nonusers 30 per become pregnant or have child childbirth childbirth childbirth birth complications However some of the studies available are contradictory and find the incidence of blood clots and pill U users ers to be equal The incidence of myocardial infarction in the 39 30 year range is estimated to be 11 per in pill pili users and 4 per In n pill non users There are many annoying but not life threatening side effects for example nausea breast tenderness and weight gain which will usually resolve after three cycles The other common side effects are headache hair thinning decreased sexual interest depression and exacerbation of diabetes These symptoms usually can be relieved by changing pills or discontinuing the pill Two other common side effects ef ef- ef feels are breakthrough bleeding and the mask of pregnancy is caused by deepening of skin pigmentation pigmentation pigmentation tation in irregular patchy areas about the face If d a woman develops and wants to get rid of it It she Ehe should stop taking the pill However stopping estrogen intake may not clear the condition Jaundice is also known to occur occasionally If it does the pill should be discontinued Estrogen intake may also elevate the blood pressure which will return to normal if the pill is discon discon- Some advantages include decreased incidence of anemia menstrual problems and the occurrence of ovarian cysts It ItIs Itis Itis is the opinion of scientists physicians and researchers that the risk incurred by the pill is offset by the benefits |