PILLS - ORDINARY CONTRACEPTIVE PILLS

ORDINARY CONTRACEPTIVE PILLS

 pills             

General information 
There are two types of pills here in Kenya 

• Combined Oral Contraceptive pills i.e contains oestrogen and progesterone (common in Kenya)
• Progesterone Only pill i.e  contain only progesterone ( new in Kenya , have listed it because it fall under pills but otherwise it should be listed under Progesterone Only Contraceptives  

 Combined Oral Contraceptive pills

• Being that they are the most common they are commonly called pills
• The Pill comes in packets of 21 or 28 tablets. In the 28-pill packet,only the first 21 pills are active pills (i.e.,they contain hormones).The remaining seven pills are not active and usually contain iron.
• Common examples include Microgynon,  Lo-Femenal, Nordette, Marvelon, and Yasmin 
• Other example include  Logynon, Trinordial,Biphasil, Ovanon,and Normovlar.

 Advantages of  "pills" Combined oral Contraceptives                                                                             

• Pills are highly effective when used properly
• Pills are safe for the majority of women.
• Pills are easy to use.
• Pills can be provided by trained non-clinical service providers.
• A pelvic exam is not required to initiate use pills

 Health Benefits of " Pills " Combined Oral Contraceptives ( COCs )

Apart from contraception '' pills" COCs also have other significant health benefits. In some cases, they are
used purely for these benefits, even where contraception is not required. For example, COCs are frequently prescribed to alleviate

• Menstrual disorders, including dysmenorrhoea (painful periods),
• Irregular cycles
• Premenstrual mood syndrome.
• To treat acne or hirsutism,
• Reduction of menstrual fl ow (lighter, shorter periods)
• Improvement and prevention of anaemia
• Protection against ovarian and endometrial cancer
• Possible protection from symptomatic pelvic inflammatory
  disease

Side Effects and Limitations of " pills " Combined Oral Contraceptives( COCs )

• Effectiveness of pills might be decreased when taken concurrently with certain drugs (e.g., certain anti- tuberculosis, anti-epileptic, and antiretroviral drugs).
• Effectiveness could be lowered in the presence of gastroenteritis, severe vomiting, and diarrhoea.
• Pills do not prevent STls,  hepatitis B, HIV.
•  Minor side effects include the following:
  • Nausea (more common in the first three months)
  • Spotting or bleeding in between menstrual periods, especially if a woman forgets to take her pills or takes them late (more common in the first three months)
  • Mild headaches
  • Breast tenderness
  • Slight weight gain
  • Mood change

Side effect that warrant Medical consultation

• Abdominal pains
• Chest pain or shortness of breath
• Headaches
• Eye problems
• Severe calf muscle pain

 Ladies, Women Who Can Use " pills " Combined Oral Contraceptives (COCs) without Restrictions

Any lady,women  including those who have never given
birth

• Those who feel they can follow a daily routine of pill taking
• Post-abortion women (should be taken within five days of abortion for immediate effectiveness)
• Those with severe dysmenorrhoea
• Those with a history of ectopic pregnancy
• Women who suffer from headaches (can initiate pill use but if headaches continue, consult seek medical intervention
• Women with AIDS but not on antiretroviral (ARV) therapy, or
  those receiving ARVs that do not interfere with effectiveness of
  COCs
• Women with any of the following conditions:
  – Malaria
  – Non-pelvic TB
  – Thyroid disease
  – Iron-deficiency anaemia
  – Benign breast disease
  – Endometrial or ovarian cancer
  – Cervical ectropion, uterine fibroids without cavity distortion
  or endometriosis
  – Abnormal vaginal bleeding patterns: irregular, heavy,
  or prolonged bleeding
  – Chronic hepatitis, carrier state or mild cirrhosis
  – Vaginitis, current purulent cervicitis, chlamydia
  or gonorrhoea or current PID
  – Other STIs excluding HIV and hepatitis B

Seek medical consultation before using  pills  for any of below conditions

• Women over 40 years of age
• Unexplained vaginal bleeding
• Women who have migraines without aura and are less than 35 years of age
• Those who suffer from obesity,
• Women with undiagnosed breast lumps
• Women with sickle cell disease
• Women who smoke and are less than 35 years of age
• Uncomplicated diabetes (no vascular disease or diabetes of less than 20 years duration)

Those who shall NOT use pills

• Women with current or previous history of DVT or pulmonary embolism (PE), acute DVT/PE, DVT/PE and on anticoagulant therapy, or known thrombogenic mutations
• Women who have had major surgery with prolonged immobilization
• Women with acute viral hepatitis or flare
• Women with severe (decompensated) cirrhosis liver disease
• Women on ARV therapy who are receiving ritonavir or ritonavir 
• Women on TB therapy who are on Rifampicin or Rifabutin

Direction of use( how to use ) pills combined Oral Contraceptive

• start using pill at any time if are you certain you are not pregnant.If you begins using pill within five days after the start of her your monthly bleeding, you will not need a back-up contraceptive method.
• If you begins using pill more than five days after the start of your monthly bleeding, during the first seven days when you takes pills you should also use a backup method.(preferably condom)
• One or two days missed or started new pack one or two days late---- Take a pill as soon as possible. Little or no risk of pregnancy.

• Three or more days in a row missed in the first or second week, or started new pack three or more days late----Take a pill as soon as possible. Use a backup method for the next seven days. If  yuo had sex in the past five days consider ECPs.------Take a pill as soon as possible, fi nish all hormonal pills in the pack (if 28-pill packs are used, throw away the 7 last non-hormonal pills) and start a new pack the next day without a break. Use a backup method for the next seven days. concider ECP if you had sex in the past five days.
• Three or more days in a row missed in the third week
• Severe vomiting or diarrhea----If s vomits within two hours after taking a pill, take another pill from pack as soon as possible, then keep taking pills as usual.If  vomiting or diarrhea for more than
  two days, follow instructions for one or two
  missed pills, above

END ORDINARY CONTRACEPTIVES

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