The oral contraceptive pill (OCP) is the most widely used method of contraception globally by women for delaying pregnancies. In today’s world, the pill has become a boon for many career oriented women and it is truly called the best discovery of this millennium. It helps them to pursue their careers, manage their professional and sexual lives without the fear of becoming pregnant every time they are sexually active.
The benefits of using the OCP other than avoiding pregnancy include regularizing irregular periods, reducing heavy periods, getting rid of painful periods, suppression of endometriosis (a condition in which the inner lining of the uterus develop outside the uterus, mainly in other pelvic organ), and controlling the unwanted hair growth and acne in young girls with polycystic ovarian syndrome. The pill also plays a protective role against uterine, ovarian cancer and pelvic inflammatory disease. Even though the OCP has so many benefits, yet there are many myths surrounding it. If you search on the internet, various sites with different pill talks and advices are available. Each woman on a blog has a different opinion regarding the OCP’s. Thankfully, there is enough scientific data to support the benefits of the OCP.
Counseling for proper use of contraceptives has become a routine and part of the daily practice in the life of a gynecologist. There are two common questions each gynecologist is asked while prescribing the OCP to her/his patient:
– Will the pill affect my future fertility?
– Will it cause cancer?
Most of the questions stem from the fact that older women today have seen complications following use of high dose OCPs when they were young and the pill was first introduced i.e. in the 1960s. Gradually, the dose has been brought down to a very low dose which is greatly effective with minimal side effects. High dose OCPs containing formulations are no longer used and contemporary clinical practice frequently employs the lower dose estrogen containing pill. In case of continuous pill use, for many years, various studies have evaluated the return of ovulation following long term use, even 8 years of continuous use. Studies have shown that women ovulated by Day 25 and returned to menstruation by Day 33, suggesting that there is no statiscally significant association between time to conception and duration of OCP use. The difference is mainly observed in the first three months following OCP cessation. However, at the end of 12 months, the conception and birth rates are comparable to the general population trying to conceive since a year. The time taken for returning to fertility was found to be greater only in older women, women with poor ovarian reserve, and women with high prolactin levels.
Hence it is important that every woman who is on continuous use of the OCP, should be investigated prior to commencing the pill and regularly on an annual basis to make sure that there is no harm in her continuing with the pill. The relation of delivery and return of ovulation has been studied. For women who have given birth, the return of fertility was comparatively quick as compared to those who have never had children and more so, if they were elderly too. There are different types of pills and all pills have similar conception rates as compared to the combined OCP.
It is reassuring that fertility rates in past pill users are comparable to those seen in the general population and to those who use other contraceptive methods.
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