Love has always been in the air and with all the things the past year has brought everyone, there are more reasons to celebrate love! Whether you made plans to go out (following safety protocols) or just staying at home, being in charge of your reproductive health is imperative. For couples and single women alike, having access to family planning and reproductive health information and tools will help decrease the number of unplanned pregnancies and other related concerns. For women, understanding how their bodies work can empower them to make informed decisions for themselves.

Understanding the Menstrual Cycle and Pregnancy

The Menstrual Cycle is a monthly cycle experienced by women in which the body prepares for pregnancy. During this time, a woman’s hormone levels (estrogen and progesterone) change, producing menstrual symptoms. Typically, a cycle lasts for 28 days but may be shorter or longer depending on each individual. A cycle is counted from the first day of menstruation to the first day of the next.

There are four phases of the menstrual cycle:
  1. Menstruation - the purpose of monthly bleeding experienced by women is to discard the build-up of the uterine lining when pregnancy did not occur.
  2. Follicular phase - starts on the first day of menstruation and ends during ovulation, the body produces follicles with immature eggs, however, usually, only one follicle matures into an egg. As follicles develop, estrogen levels increase triggering the release of the egg when it matures.
  3. Ovulation - in which the mature egg is finally released awaiting fertilization by sperm. The egg is viable for fertilization for only around 24 hours, otherwise, it dies.
  4. Luteal phase - ruptured follicles that released the egg release progesterone and estrogen prompting the lining of the uterus to thicken. Raised levels of progesterone also make the cervical mucus thicker following ovulation preventing sperm to permeate easily. If the egg is fertilized, it implants itself in the uterine lining. If that is not the case, hormone levels eventually decrease, and the menstrual cycle starts again.
What is birth control and how does it work?  

Birth control, also known as contraception, means preventing pregnancy. For a lot of women, this is mainly used to plan or prevent a pregnancy. Here are a few reasons why someone would like to control when they will or will not get pregnant:
  • Not wanting children at all or want to have children at a later time
  • Socioeconomic reasons e.g., financial stability, housing situation, occupation
  • For families, space the timing of births of children
  • Age-related reasons, being too young or old for a pregnancy
  • Health-related issues that make pregnancy not safe for the mother and/or child
At present, there are several birth control methods such as:
  • Preventing sperm from meeting the eggs by using barriers such as condoms, caps, etc.
  • Stopping the release of the egg for fertilization by using contraceptive hormone pills
  • Using an Intrauterine device (IUD) for long term prevention of sperm-egg fertilization
  • Sterilization for irreversible contraception
  • Oral contraceptive pills
According to the National Center for Health Statistics, in 2017-2019, 65.3% of women of reproductive age in the United States use contraceptives. In the same survey, the most common type of reversible contraceptive method used is oral contraceptive pills (14.0%).

Oral Contraceptive Pills (OCPs) 

One of the most popular reversible methods of contraception is the use of Oral Contraceptive Pills (OCPs). This method is preferred by most women because it is fairly easy to use and does not need any special procedures or instructions to use. It is as simple as taking a pill every day. It is also readily available in most places: get a prescription and purchase from drugstores. OCPs contain estrogen and progestin (a man-made hormone similar to progesterone). When taken, these hormones maintain a constant level in the body hence preventing the body from actually producing hormones needed for ovulation. In particular, progestin is mainly responsible for contraception. When progestin levels are high, the body thinks it has already ovulated thus preventing the release of the hormones responsible for triggering the development of follicles and the release of the egg. When follicles do not mature into eggs and no egg is released, the menstrual cycle progresses guaranteeing menstruation. Another function of progestin is by thickening the cervical mucus making it unsuitable for sperm to traverse and fertilize the egg.

Types of Oral Contraceptive Pills

Combination pills - contain both Estrogen and Progesterone. These pills are taken for three weeks or 21 days and stopped for 7 days to allow menstruation to happen. They usually come in 21-day or 28-day packs. The 28-day pack contains 21 active pills and 7 inactive pills. The inactive pills serve as reminder pills to help women in tracking and maintaining their contraceptive pill intake.

Examples of combination pills are:    
    • Ethinyl estradiol + Cyproterone (Diane-35)
    • Ethinyl estradiol + Levonorgestrel (Aviane)  
    • Norgestimate + Ethinyl estradiol (Ortho Tri-cyclen 777)
    • Drospirenone + Ethinyl estradiol (Yasmin, Yaz)
    • Norethindron + Ethinyl estradiol (Loestrin)
Progestin-only pills - these types of pills, also called mini-pill, only contain progestin. They are for women who cannot tolerate high levels of estrogen due to health problems or when breastfeeding. Progestin-only pills are all active and taken continuously which means menstruation may or may not happen.
    • Norethindrone (Camila) is an example of a progestin-only pill. 
Emergency contraceptive pills - these pills are meant to be taken right after sexual intercourse. They work by delaying ovulation hence no egg will be readily released for fertilization. Due to the delay of ovulation, the sperm cells that may have reached the fallopian tube would eventually die. It is important to note that emergency contraceptives only work if taken within a short time frame after sexual intercourse and they do not cause abortion.
    • Levonorgestrel (Plan B) is an example of an emergency contraceptive pill.
How effective are Oral Contraceptive Pills?  

If taken correctly and consistently, OCPs are very effective in preventing pregnancies. OCPs should be taken daily without missing a dose and preferably at the same time every day. Assuming ‘perfect use’, OCPs are 99% effective. However, due to human error, some doses may be missed. According to the CDC, with ‘typical use’ (contraceptives were not fully used correctly), an error rate of 7% is observed.  

Certain medications that may limit the effectiveness of OCPs are:  
  • Antibiotics e.g., Amoxicillin, Penicillin, and Rifampin  
  • Anti-HIV drugs  
  • Antiseizure drugs e.g., Carbamazepine and Phenobarbital  
  • Antifungals e.g., Ketoconazole and Griseofulvin  
  • Supplements and herbal medicines e.g., Modafinil and St. John’s wort  
It is also important to note that no method of contraceptives is 100% effective. Using more than one method will greatly increase the effectiveness of contraception.  

Common side effects and Risks in using Oral Contraceptive Pills

Though OCPs are generally safe, some women may experience the following:  
  • Nausea
  • Bloating
  • Headaches
  • Breast tenderness
  • Elevated blood pressure
  • Breakthrough bleeding or spotting
  • Decrease in libido
In general, side effects are mild and usually go away after using the pill or stopping for some. Taking OCPs may also cause blood clots especially in women with high blood pressure, obesity, and/or on bed rest for extended periods. Although the risks of blood clot occurrences are low, it is important to talk to your doctor before taking any OCPs.  

If you are interested in getting on any form of birth control, schedule an appointment with your doctor to learn more about which option would be best for you. Visit Canadian Prescription Drugstore for the best deals on oral contraceptive pills. We have a good range of affordable and quality OCPs to choose from.