Are birth control pills "sterilizing drugs" or do they make people "sexually indifferent"? Debunking four myths about birth control pills

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Oral contraceptives are a common form of contraception and an important measure for informed choice of contraceptive measures. All contraceptives are very effective if used correctly. However, many people believe that all contraceptives are harmful to the body. Taking contraceptives can cause women to gain weight, develop spots on their faces, become "sexually cold", etc. Some even believe that commonly used contraceptives can cause women to become infertile in the future. So, is this the truth?

This is not true! Birth control pills will not cause facial spots, obesity or decreased libido in women, nor will they affect women's future fertility.

analyze

How do birth control pills work?

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Oral contraceptives are divided into pure progestin and estrogen-progestin combination products. Oral contraceptives in my country are mainly combination products, and their active ingredients are estrogen and progestin. The contraceptive mechanism of contraceptives has the following four points:

① The estrogen and progesterone contained in contraceptive pills can inhibit ovulation;

②The progestogen in the drug increases the viscosity of cervical mucus to prevent sperm penetration;

③ Contraceptive pills cause the changes in the endometrium to be out of sync with embryo development, making it unsuitable for the fertilized egg to implant;

④ Contraceptive pills can change the function of the fallopian tubes, affect the movement of the fallopian tubes, and interfere with the implantation of the fertilized egg in the uterus.

What are the differences in the characteristics and effects of different contraceptives?

Combined contraceptive pills work as contraceptives through the estrogen and progesterone they contain. There are many types of contraceptive pills on the market today, the most common of which include short-acting contraceptive pills, long-acting contraceptive pills and emergency contraceptive pills.

The ingredients of combined short-acting oral contraceptives are estrogen and progesterone, but the estrogen content in short-acting oral contraceptives is low (20ug~35ug). The structure of progesterone in the third-generation short-acting oral contraceptives is close to natural progesterone. The annual contraceptive failure rate is about 1%, and nausea and menstrual disorders rarely occur. However, short-acting oral contraceptives need to be taken daily according to the menstrual cycle. Once missed, the contraceptive failure rate will increase and abnormal uterine bleeding will occur.

Long-acting contraceptive pills are composed of long-acting estrogen and progesterone. After oral administration, long-acting estrogen is absorbed by the gastrointestinal tract, stored in adipose tissue, and then slowly released. Taking the pill once can prevent pregnancy for one month. The contraceptive effectiveness of long-acting contraceptive pills is 96% to 98%. Although long-acting contraceptive pills only need to be taken once a month and have a good contraceptive effect, the large dose of hormones contained in this contraceptive pill can cause nausea, vomiting and other early pregnancy reactions and menstrual disorders. It is now relatively rare in the market.

Emergency contraceptive pills are a remedial contraceptive method used to prevent unwanted pregnancy in the case of unprotected sex and contraceptive failure. The most commonly used emergency contraceptive pill in my country is the progestin levonorgestrel preparation, which has an emergency contraceptive failure rate of 2%-4% and an effectiveness rate of about 80%. A small number of people may experience nausea, vomiting, irregular vaginal bleeding and menstrual disorders after taking emergency contraceptive pills.

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Are these 4 common birth control pill rumors true or false?

Most people are familiar with condoms, but not very well-informed about birth control pills. There are even all kinds of sensational rumors circulating on the Internet. Today, let's seek the truth one by one.

01

Myth: Birth control pills reduce your chances of getting pregnant in the future

Analysis: Rumor! Birth control pills are not "sterilization pills".

One of the mechanisms of action of contraceptive pills is to suppress ovulation during medication. After stopping the contraceptive pills, the ovaries resume ovulation and fertility will be restored. For some patients with polycystic ovaries or decreased ovarian corpus luteum function, the ovaries themselves have abnormal ovulation and function. When taking short-acting contraceptive pills, the ovaries do not ovulate and get a rest. After stopping the pills, the ovulation function will improve and the chance of pregnancy will increase.

02

Myth: Birth control pills are very harmful to women’s health

Analysis: This statement is pure alarmism!

For young women (under 35 years old), who do not smoke, have no history of hypertension, no history of thrombosis, no endocrine disease, and have good liver and kidney function, taking birth control pills will not harm their health. Moreover, the progestin in birth control pills has a protective effect on the endometrium and reduces the incidence of endometrial cancer; long-term use of short-acting oral contraceptives can also reduce the risk of ovarian cancer.

03

Myth: Birth control pills reduce women's sexual desire

Analysis: Rumor! Contraceptive pills are not to blame for sexual indifference.

Contraceptive pills can relieve the worries of couples who do not want to have children and increase the harmony and happiness of their sex life; although contraceptive pills inhibit ovulation, they do not affect ovarian function, and the secretion of sex hormones in women is normal. Therefore, contraceptive pills will not reduce sexual desire.

04

Myth: Birth control pills can cause women to become obese

Analysis: This is a misunderstanding! Current contraceptive pills do not affect body weight.

Early contraceptives had strong androgenic activity, and some women developed hyperphagia and weight gain after taking them. In recent years, with the continuous development of oral contraceptives, androgenic activity has decreased. The latest generation of oral contraceptives, drospirenone ethinyl estradiol tablets, have anti-mineralocorticoid properties, can reduce water and sodium retention in the body, and also have certain anti-androgenic activity. Cyproterone ethinyl estradiol tablets also have strong anti-androgenic activity and can be used to treat polycystic ovary syndrome.

To sum up, in other words, current contraceptives have no effect on body weight.

To use contraceptives scientifically, these issues need to be clarified

Although contraceptive pills are harmless to the human body, blindly taking them can also cause delayed menstruation, and in severe cases, amenorrhea. So, which groups of people cannot take contraceptive pills? What should be paid attention to when taking contraceptive pills? What principles should be followed to take contraceptive pills correctly and safely?

Which groups should not take birth control pills?

1. Women with unexplained vaginal bleeding or scanty menstruation. Because these women may have cervical lesions, endometrial lesions or ovarian dysfunction, they need to go to a hospital for specialist examination to clarify the specific cause. Taking contraceptives may aggravate the condition.

2. Women with benign breast tumors and uterine fibroids are relatively contraindicated from taking birth control pills. These diseases are hormone-dependent diseases, and the estrogen and progesterone components in birth control pills can stimulate the growth of breast tumors and uterine fibroids. However, if the breast tumor is small and considered benign, and the uterine fibroids are less than 2 cm, birth control pills can be taken under the guidance of a doctor.

3. Lactating women. Contraceptives taken by lactating women can enter breast milk. Moreover, the estrogen in combined contraceptives can affect breast milk secretion. Therefore, lactating women should not use contraceptive drugs to prevent the drugs from entering the baby through breast milk and causing adverse effects on the baby's growth and development.

4. People with severe cardiovascular diseases and thrombotic diseases should not use it. Estrogen in contraceptive pills can increase coagulation factors. People with thrombotic diseases and high risk of thrombosis should avoid using contraceptive pills.

5. Patients with endocrine diseases, such as diabetic patients with poor blood sugar control, should not use contraceptive drugs.

6. Women over 35 years old who are heavy smokers taking birth control pills will increase the incidence of cardiovascular disease and should not take them for a long time.

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What should I pay attention to when taking contraceptive pills?

1. After taking emergency contraceptive pills, some women will experience nausea and vomiting. Therefore, it is recommended to avoid excessive eating 2 hours before and after taking contraceptive pills, so as to avoid vomiting affecting the actual absorption of contraceptive pills and failing to achieve effective contraceptive effect. If vomiting does occur within 2 hours, the pills should be taken as a supplement.

2. After taking emergency contraceptive pills, you should not take antiviral drugs, imidazole antifungal drugs, macrolide antibiotics and other drugs immediately. Taking them at the same time may cause drug interactions.

3. Do not take it with rifampicin or sleeping pills. Rifampicin is a liver enzyme inducer, which will accelerate the metabolism of contraceptives, reduce the drug concentration in the blood, and reduce the effect of contraceptives. Phenobarbital sleeping pills will also reduce the effect of contraceptives, so it is not recommended to take them together for a long time.

4. Early pregnancy reactions. Some women experience loss of appetite, nausea, vomiting, fatigue, dizziness and other reactions similar to those in early pregnancy after taking birth control pills. Generally, no special treatment is required and the symptoms will disappear after taking the pills for several cycles.

5. Amenorrhea. If amenorrhea occurs (no menstruation for 3 consecutive months) while taking contraceptive pills, it is necessary to check whether it is an unexpected pregnancy or other pathological conditions that cause amenorrhea. If amenorrhea occurs, the drug needs to be discontinued for observation.

How to take birth control pills scientifically?

Principles of long-acting contraceptives: Because they contain large doses of hormones, they can cause nausea and vomiting, similar reactions to early pregnancy, and menstrual disorders. They are now relatively rare in the market, so long-acting contraceptives are not recommended.

Principles of short-acting contraceptives: The estrogen and progesterone components of short-acting contraceptives are relatively reasonable, with few side effects during use, and pregnancy is possible after stopping the medication. It can be used as a contraceptive option for young women. Care should be taken to avoid missed doses during use.

Principles of taking emergency contraceptive pills: Emergency contraception is only effective for one unprotected sexual intercourse, and its contraceptive effectiveness is significantly lower than that of conventional contraceptive methods, so it cannot replace conventional contraception. It is not recommended to use emergency contraceptive pills as a regular contraceptive method.

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How to stop taking birth control pills when preparing to get pregnant?

If the couple is planning to have a baby, the woman needs to stop taking the contraceptive pill in time. Combined short-acting contraceptive pills: low estrogen and progesterone content, fast drug metabolism, pregnancy can be achieved after menstruation, and will not affect the growth and development of the offspring. Long-acting contraceptive pills: pregnancy is safer after stopping the pills for 6 months.

in conclusion

Taking contraceptive pills can achieve the purpose of safe and effective contraception, but they must be used in a standardized and reasonable manner.

Author: Zhai Yan, Chief Physician of Obstetrics and Gynecology Department, Beijing Chaoyang Hospital, Capital Medical University

Review | Zou Yan, Chief Physician, National Health Commission Institute of Science and Technology

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