Every woman has the right to choose what contraceptive method to use. On our end here at Cosmo.ph, there are no judgments if you personally don't want to take the Pill; we respect that. We're advocates of learning more about birth control options and making informed decisions.
Below is a list of your concerns about the Pill. Obstetrician/gynecologist Dr. Gemma Datu-Fulgado debunks the myths and clarifies some issues you may have about it. So if you're interested in being on it after reading this, we suggest you see your doctor to know which is the right one for you.
Q: Will being on the Pill for a long period of time make it harder for me to get pregnant later, when I already want kids?
A: One of the advantages of oral contraceptive (OC) formulations is its rapid reversibility. There is little, if any, effect of duration of OC use on the length of delay of subsequent conception. On an average, women who stop taking oral contraceptives have only a two-week delay in return of ovulation.
Q: Will taking the Pill make me gain weight?
A: The weight gain perceived during the use of combined oral contraceptives (COC) is mainly due to the estrogen component. Estrogen increases the release of aldosterone, which causes the body to retain fluid. Others, in the same way, experience increased sizes in the breasts, hips, and thighs as estrogen also causes increase in the size of the adipose cells (hypertrophy). In these situations, one can switch to a pill with anti-mineralocorticoid activity (mild diuretic effect) and lower estrogen and progestin levels (low-dose OCPs).
But keep in mind: A healthy diet and regular exercise are the keys to achieve and maintain a healthy weight.
Q: Will the Pill make me psychologically/mentally/emotionally unstable?
A: Several studies have verified that there is no increase in the risk of mood swings and clinical depression in women using COCs. Although some may experience increase in depressive symptoms, moodiness, and emotional "outbursts," it is important to identify when in her cycle these symptoms appear. A decrease in the hormone doses or discontinuation of the pill may help, but often any of these would not be adequate.
If you're worried about an underlying psychological, mental, or emotional disorder, these conditions deserve an evaluation (and treatment) of an expert.
Q: Will the Pill ruin my sex drive?
A: Occassionally, women may complain of decreased sex drive or libido on a particular type of pill. This is especially true for progestin-only pills; it can alter vaginal secretions making sexual intercourse less pleasurable and sometimes even painful. Women who complain of this symptom may opt to change to a more estrogenic COC or may use lubricant to solve the problem. The decrease in sex drive is not permanent and it often disappears when a woman stops the pill.
Q: Will taking the Pill now cause birth defects on my future child?
A: There is very little evidence that use of oral contraceptives causes major congenital malformations. A large-scale study recently published in the British Medical Journal has concluded that oral contraceptives taken just before or during pregnancy do not increase the risk of birth defects.
Q: Will taking the pill cause cancer?
A: For ovarian cancer: There is a 34 percent protection from certain types of ovarian cancer observed among OCP users compared to non-OCP users. The use of monophasic formulations for at least 10 years reduces a woman's risk of ovarian malignancy as high as 80 percent. Large scale studies showed that the protective effect begins within 10 years of first use and continues for at least 30 years after the use of OCs end.
For endometrial (uterine) cancer: COC use for at least one year has shown to reduce a woman's risk of developing uterine malignancy by about 40 percent. And if it's used for a decade, the risk is only one fifth of that of non-pill users.
For breast cancer: The World Health Organization concluded that long-term use of COCs causes a small and temporary increase in breast cancer risk. A decade after stopping COCs, the risk returns to its baseline. Several studies supported that women with a strong family history of breast cancer do not increase their risk by taking pills.
Q: Does the Pill encourage promiscuity?
A: There are no available studies or researches yet that would prove nor disprove this statement. The root cause of this public concern is complex. It may be an interplay of behavioral, social, or cultural influences. One can choose to be promiscuous even without the Pill, and on the other hand, one can take the Pill without being promiscuous. I believe that behavioral self-check and appropriate motivation should be strong prior to use of any contraception.
Q: Are oral contraceptives meant to depopulate the Philippines and other Third World countries? And if that's their purpose, is the health of each woman sacrificed on this end?
A: In 2010, the maternal mortality rate in the Philippines has reached 99 deaths per 100,000 live births. Unwanted pregnancies leading to induced abortions contribute to the slowly decreasing maternal death rates. The use of oral contraceptives does not aim to depopulate but to eliminate unplanned pregnancies and aid in reproductive health research to improve women's health.
Q: Why should I consult my doctor first before buying the Pill over the counter?
A: Oral contraceptive formulations differ not only by the type and amounts of their main hormone/s, but also by the patterns of those amounts within the Pill pack (monophasic versus multiphasic formulations). Each formulation is uniquely designed for a specific woman's need. Therefore the Pill should be taken with the guidance of a doctor and with prescription.
Q: There are risks in taking the Pill. Should women avoid it altogether?
Editor's Note: We came across an article in FilipinosForLife.com criticizing this story we wrote about Fallan Kurek, who died due to alleged complications from taking oral contraceptives. In the article, we mentioned how the risk of taking the Pill is small, citing several sources to back up this claim. Unfortunately, FilipinosForLife.com misunderstood our statement as a "disregard for the health of Filipino women," which is the exact opposite of our advocacy as a brand. So, we asked an expert once and for all: Should women avoid the Pill altogether?
A: Oral contraceptives provide women with safe and effective control of fertility. It also improves women's quality of life. OCs are used to decrease many of the menstruation-related problems like cramping, heavy menstrual bleeding, irregular cycles, and premenstrual syndromes. It also provides women with many general health benefits like a decrease in risks of endometrial and ovarian cancer, and benign breast condition. Skin problems like acne and hirsutism (abnormal growth of hair on the face and body) can also be treated.
For safe COC use, doctors select a pill based on the hormonal dose and the woman's clinical picture, her preference, past experiences with other COCs, and even the cost. There are over 70 COCs available that doctors can choose from. Our job is to prescribe a pill that will give a woman the maximum desired effect and the least possible adverse effect.
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