HEALTH SERVICES

The pill

What is it?
"The pill" is the common name for oral contraception. There are two basic types — combination pills and progestin-only pills. Both are made of hormones like those made by a woman's ovaries. The pills usually work by preventing a woman's ovaries from releasing eggs (ovulation). They also thicken the cervical mucus, which keeps sperm from joining with an egg.

How effective is it?
92–99.7%

Upside

• Easy to use

• Shorter, more regular periods

• Fewer menstrual cramps and lighter periods

• May prevent acne

Downside

• Can cause temporary irregular bleeding, and nausea

• Must be taken daily

• Does not offer any protection against sexually transmitted infections

Possible complications
Serious problems do not occur very often. In general, using the pill is much safer than pregnancy and childbirth. Combination-hormone users have a slightly greater chance of certain major disorders than nonusers. The risk is increased by being age 35 or older, smoking, and by having conditions associated with heart attack, such as diabetes, high blood pressure, or high cholesterol, and certain inherited conditions that increase the risk of blood clotting.

The most serious complication of combination pill use is having a blood clot in the legs, lungs, heart, or brain. It is important to tell your surgeon that you are using the combination pill when planning a major operation. Follow your clinician's advice about when you can take the pill again.

Serious problems usually have warning signs.
Report any of these signs to your clinician as soon as possible:

• Eye problems such as blurred or double vision

• Pain in the abdomen, chest, or arm

• Severe headaches

• Sudden shortness of breath or spitting up blood

• Unusual swelling or pain in the leg

• Worsening depression

• Yellowing of the skin or eyes (jaundice)

• A new lump in your breast

• Unusual heavy bleeding from your vagina