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Contraception > Hormonal contraception

The birth control pill

The birth control pill has several forms ... pills containing chemical variants of hormones secreted by the body: estrogen and progesterone. These hormones prevent the start of ovulation.

Most pills combine these two hormones, but certain contain only progesterone. Your doctor will determine which pill and the hormonal dosage which is best for you.

Micro progestative pills: all the pills are the same color and dose. They are taken at the same time every night without exception. Forgetting and/or taking it late can mean pregnancy...
Classic pills: you can take them at night or in the morning, without varying the routine once you have chosen one or the other. Most boxes contain 21 pills corresponding to 4 weeks: in other words, the pill should be taken for 3 weeks (3 times 7 days with a break the fourth week (7 days). In general, the days are written on the blisters (placket) as a reminder. In case you forget: no matter when you remember, you should take the forgotten pill immediately and then start the cycle again normally (even if the forgotten pill was taken one hour earlier...). Being late less than 12 hours is probably not risky ... Between 12 and 24 hours, the risk of becoming pregnant is theoretically weak (be careful anyway). More than 24 hours and it's a good idea to use another means of protection (condom for example) for 7 days for each forgotten pill. There is the possibility of spotting if you forgot your pill for more than 24 hours: don't confuse it with your period ...

Reliability: safe contraceptive method, as long as you absolutely follow the rules (rigorous respect for the pill-taking protocol).

Advantages: most women have no problems; there exists a variety of pills adapted to various situations. Once you are used to taking the pill at a regular time (for example, taking the pill in the evening after brushing your teeth), relations with your partner are stress-free.

Inconveniences: smoking is not recommended. Depending on the person, there may be certain side effects, but they are rare and relatively harmless: nausea and tender breasts (which stop after several cycles), weight gain (curable during the first months by an effort to eat healthier and do sports), sometimes no period in the 4th week (which can be worrisome of course). If there is spotting between periods, consult a doctor (without an organic cause verified by a check-up, it might be necessary to change the pill). Other side effects are listed on the product information sheet in each box: the list is too long to be repeated here! But their occurrence is rare. However, you should stop taking the pill if you suffer from headaches which resist classic treatment (aspirin, ibuprofen ...), unusual migraines, or blurred vision possibly accompanied by a rise in blood pressure. Don't forget that the pill, like any other medication taken over a long period of time require regular medical monitoring.

The Norplant® implant

The Norplant® system is made up of six soft capsules, contained in a Silastic® tube filled with a synthetic progestin (Levonorgestrel). The capsules are inserted under the skin in the woman's upper arm during a minor surgical intervention. What Norplant® implants do is to change the endometrium by thickening the cervical mucous making it difficult for the spermatozoids to pass through, and stop ovulation in about half the menstrual cycles after the first year.

Implant Norplant®

After the implant, be careful that the area remains dry and clean for at least 48 hours. The incision can get infected if the area gets wet when you bathe. Leave the bandage tightened with the gauze in place for 48 hours and then replace it with a Band-Aid until the incision is healed (about 3 to 5 days). The area around the incision will be bruised, swollen or sensitive for several days. That's normal. You can return to work immediately. Avoid bumping it, carrying heavy things or pressing too firmly on the incision area. Once healed, the area of the incision can be touched and washed as usual (even pressure).

It is necessary to remove the capsules 5 years after their insertion but new capsules can be inserted immediately if you wish.

Reliability: Norplant® implants assure a highly efficient contraception for up to 5 years. The contraceptive effect of the implants starts once the capsules are inserted and continue until they are removed (can stay for up to 5 years starting from their insertion).

Advantages: the relations with your partner are stress-free: no fear of forgetting! The implant doesn't require a specific monitoring but you still need to go for regular visits to your gynecologist ...

Inconveniences: changes in the menstrual bleeding (especially irregular periods) are common, especially during the first 6 to 12 months following the insertion. These changes are rarely a health risk. Certain medicines (Rifampicine® and most antiepileptic medicines) can decrease the efficiency of the implants. That is why you should advise your doctor if you start taking new medication. Other minor side effects are weight gain, small headaches and sensitive breasts. The symptoms aren't dangerous and disappear progressively.

Attention: If you wait longer than 5 years to have the capsules removed, the risk of becoming pregnant is increasingly high and the risk of an extra-uterine pregnancy increases greatly.

Warning signs for implant users:
# late menstruation after several months of regular cycles (can be a sign of pregnancy)
# sharp pains in the lower stomach (can be a symptom of extra-uterine pregnancy)
# heavy bleeding (twice as long or twice as heavy as usual) or prolonged bleeding (more than 8 days)
# pus or bleeding at or near the capsules' insertion
# expulsion of a capsule
# migraine (vascular headaches), frequent and very severe headaches or blurred vision.
Contact your doctor if you notice one if the above mentioned problems.

Never forget: only condoms and Fémidom® protect from AIDS!

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