Combination pills

Combined contraceptive pills, often called “the pill”, is a type of oral contraception that combines two hormones – estrogen and progestin. The progestin is mainly responsible for the contraceptive effect and the estrogen for controlling the cycle. Thus, these hormones act synergistically to prevent pregnancy by inhibiting ovulation, thickening cervical mucus and altering the lining of the endometrium.

Estrogens

Ethinylestradiol (EE) is a high-potency synthetic estrogen that forms part of the composition of most combined hormonal contraceptives. The dose of estrogens is an important factor, as it is related to the risks and adverse effects.

Progestatives

Currently in Portugal, the progestatives used in contraception are derivatives of 19-nortestosterone, 17 OH-progesterone and spironolactone. Progestatives can be classified into “generations” according to when they entered the market.

– Ovulation inhibition: the oestrogen component inhibits the release of an egg from the ovary;

– Thickening of the Cervical Mucus: the progestative thickens the cervical mucus, making it difficult for the sperm to penetrate;

– Alteration of the endometrial lining: the combined hormones alter the lining of the uterus, making it less receptive to a fertilized egg, making implantation impossible.

– Highly Effective: When taken as directed, they are a reliable method of contraception;

– Regulation of menstrual cycles: The pill can help regulate menstrual cycles by reducing the frequency and intensity of periods, thus preventing anemia;

– Reduction in menstrual cramps: Many women experience a reduction in menstrual cramps;

– Improves acne: Treats symptoms of hyperandroginism (acne and hirsutism);

– Reduction of abnormal uterine bleeding associated with some types of uterine fibromyoma;

– Reduction in the appearance of follicular and luteal cysts.

Oral contraceptives can be started at any stage of the cycle, preferably on the day of counseling, after pregnancy has been ruled out. They can also be started on the 1st Sunday after menstruation or on the 1st day of the menstrual cycle.

If it is taken in the first 5 days of the menstrual cycle, it is not necessary to use an additional method to prevent pregnancy. Whenever you start taking it outside the first five days of your cycle, an additional contraceptive method should be recommended for the first 7 days of taking it.

If you miss 1 pill, take the missed pill as soon as possible. If you miss 2 or more pills in the 1st or 2nd week, you should use additional contraception for the next 7 days and if you had unprotected sex, you should use emergency contraception.

If you don’t take 2 pills in the 3rd week, you should finish the pack and immediately start another and use additional contraception for the 1st 7 days.

You can find more information about contraception on this page.

Editorial Note: This page and all other contents present in
lifewell.pt
are prepared and reviewed by medical experts in Portugal.