Myths and facts of combined oral contraceptive (COC) pills

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Currently, there is a wide selection of contraceptive methods available to suit the various reproductive needs of couples. Despite these, there is still a huge unmet need with regards to contraception. There are 123 million women around the world who are not receptive to contraception. In the 2015 United Nations Population Fund (UNFPA) report, 15 million adolescent girls in developing countries gave birth and 13 million lacked access to contraceptives. WHO estimated that approximately 214 million women of reproductive age, in developing regions, who want to avoid pregnancy are not using a modern contraceptive method and between 2015 and 2019, almost half of all pregnancies were unintended.

The combined oral contraceptive (COC) pills are readily available in the markets and yet women avoid them due to their belief in the myths surrounding them. Following are some common myths regarding the combined oral contraception pills and the facts to dispel them.

Myth: Comments often heard from women were “ I am afraid to go on the pills because many of my friends who were on the pills developed acne and some of them even put on weight”.
Fact: Not all pills are the same. Some pills may contain an older generation progestogen which may cause acne or weight gain. There are many other modern pills that have progestogen that may in fact improve acne or general skin complexion.

Different locations of fibroids

Myth: Women who have fibroids should not take COC pills.
Fact: Not true. Women with fibroids can take the pills and may even derive benefits from it. The pills with a more dominant progestogen effect should be chosen. This type of pill may in fact delay further growth of the fibroids and reduce menstrual bleeding associated with the fibroids.

Myth: COC pills lower the chances of having children later in life.
Fact: The use of birth control pills will not affect your chances of getting pregnant after you stop taking them. If you were fertile prior to starting the pills, taking it does not affect your ability to have children later.

Myth: All types of COC pills can cause weight gain.
Fact: Women who gained weight while on the pills will always blame it on the pills. There is no direct link between weight gain and contraceptive pills. Likewise, many women who are not on the pills do gain weight as they age. If you are concerned about gaining weight, discuss this issue with your doctor. There are many types of pills that have no effect on weight and one of these may be appropriate for you.

Myth: Significant reduction of menstrual flow as a result of the pill is not good, due to potential accumulation of the retained menstrual blood in the body.
Fact: The pills have the effect of reducing menstrual blood loss. Some women may report that their period is much lighter than normal and may only have staining while they are taking the pills. This is just a normal variation of the woman’s womb response to the effect of the pills and does not affect the general health of the woman.

Myth: You should take a break from the pills every once in a while to give your body a break.
Fact: There is no need to do this. The pills can be taken for 5 or even up to 10 years. Taking a break will not give any added health benefits. In fact, this may cause unintended pregnancy.

Myth: There must be a break between every pill packet.
Fact: The break or pill-free interval is only for withdrawal bleeding. There will be menstrual bleeding during the seven days pill-free interval. The onset of bleeding is reassuring for many women. However, if the women prefer less menstrual bleeding, two or three packets of the pills can be taken continuously. The bleeding will only come when there is a break between the next packet. Such a practice does not affect the health of women. It may even be beneficial in women with significant period pain and in some gynaecological conditions such as endometriosis and adenomyosis.

Myth: A couple should not make love during the 7 days between pill packets.
Fact: Not true. This period is safe, provided the woman has taken all the pills in the preceding packet and is planning to start the next packet on time.

Myth: The pills can cause birth defects.
Fact: Taking the pills has not been linked to causing birth defects or affecting the health of future children. Even if you are accidentally pregnant while on the pills, the risk of birth defects is not higher than the background population rate. The woman can continue with the pregnancy.

Myth: The pills can cause cancer.
Fact: There is no direct link between pill taking and increased risk of cancer. Some studies report a slightly increased risk of breast cancer among pills users but the overall risk is still very lowIn fact, evidence has shown that combination oral contraceptive pills provide protection from cancers of the ovary, uterus, and colon. For ovarian cancer, there is a decrease in lifetime risk by about 50 percent with the use of combined oral contraceptive pills, and the protection continues up to 10 years or more after stopping

Myth: Women should stop taking the pill when reaching 40 years of age
Fact: Women who are healthy and who do not smoke can continue to take the low dose pills until menopause. In fact, a continuation of the pills beyond this age may bring additional health benefits in healthy non-smoking women.

Myth: Taking the pills will delay menopause.
Fact: Not true. The use of the pills will not delay or cause early menopause.

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