HEALTHNET

How many types of oral contraceptive are available in the market?

Oral contraceptives can be classified into two broad categories: combined oral contraceptives and Progestin-Only oral contraceptives.

(Posted on 22 March 2007)

Q1. How many types of oral contraceptive are available in the market?

A1. Oral contraceptives can be classified into two broad categories: those containing a combination of estrogen and progestin (combined oral contraceptives) or those containing only progestins (Progestin-Only oral contraceptives).

1.Combined oral contraceptives (OC's)

Since there are several kinds of estrogens and progestins, different dosages in various combinations used by different manufacturers result in many brand names. The simplest form of OC is a package of 21 active pills to be taken daily, followed by a 7-day hormone-free period to allow for withdrawal bleeding. Most women find it easier to remember to take a daily tablet. Some manufacturers therefore add in 7 placebos (inactive dummy pills) to fill up a 28-day monthly packet.

The trend is to use the lowest effective dose of estrogen for contraception. Theoretically we can decrease side effects further by varying the amounts of estrogens and progestins to mimic the natural fluctuations of a woman's hormone levels throughout the month. They are somewhat less convenient because the 21 active pills are not identical.

2. Progestin-Only oral contraceptives

Unlike combined OC's, progestin-only pills must be taken continuously without a hormone-free period. They are slightly less effective than combined OC's, and can cause irregular menstrual patterns. Progestin-only pills are offered to women who must avoid estrogens, for example those who have hypertension, who are breastfeeding, or who are at risk of developing blood clots.

Q2. What are the side effects of oral contraceptives?

A2. The most common side effects of oral contraceptives include:

Nausea, vomiting or stomach ache
Irregular breakthrough bleeding and spotting
Headaches
Bloating, weight gain and/or water retention
Breast tenderness
Darkened spots in the skin

The above symptoms may be common but are often minor, and usually disappear after 2-3 cycles after the body has adjusted to the hormone change. Studies have also shown that the chance of having blood clots is slightly increased with the use of oral contraceptives, especially in smoking women over 35 years of age. There are controversial reports showing a possible link between the use of oral contraceptives and the risk of having breast cancer. However, these are based on the older generation of contraceptives which uses higher estrogen dosages. Discuss with your doctor if you suspect that you are suffering from side effects after taking oral contraceptives.

To lower the incidence of side effects, the estrogen content of modern oral contraceptives is very low. If you are taking other drugs concurrently, such as certain antibiotics, their effectiveness may be compromised. If you are on oral contraceptives, tell your doctor before taking any medications. Ask if a backup method of birth control is necessary.

Q3. My friend says she is taking contraceptive as it is effective in curing acne problem. Is the argument valid and safe to do?

A3. We know that acne is related to sebum production, and sebum production is increased if there is excess male hormone in the body.

Combined oral contraceptives contain two categories of female hormones: estrogens and progestins. After taking oral contraceptives, the amount of active male hormones in the body may be reduced, because estrogens can increase the concentration of a protein that binds with male hormones. However, progestins have certain properties akin to male hormones and can stimulate sebum production. That's why some women may experience a flare up of acne after taking oral contraceptives.

"Third generation progestin" - a new type of progestin has been shown to be better in this aspect. It does not stimulate sebum production. A brand of combined oral contraceptive with third generation progestin as one of the constituents has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne in women and adolescent girls. Two to four months of therapy may be required before improvement is seen, and relapses are common after the medication is discontinued. You should consult with your doctor rather than experimenting on yourself since acne needs to be targeted on from different fronts.

Source: Quality HealthCare