Oral Contraceptive Pill: The Basics

Have you wondered why your pharmacists prefer to address ‘Morning After Pill’ as ‘Emergency Contraceptive Pill’ (ECP)? That is because ECP should only be used as the last resort (after an unprotected sex) and not routinely. This is because:

1. The emergency contraceptive pill does not work as well as other contraceptive methods such as regular oral contraceptive pills
2. ECP cause side effects such as bleeding between periods and nausea

Two Main Types of ECP

Ulipristal Acetate

The most effective ECP. Ulipristal Acetate is effective up to 120 days (5 days)

Levonorgestrel

This type works best when taken within 72 hours (3 days)

Which ECP Is Right For You?

• How long it has been since you had unprotected sex

Levonorgestrel pills do not work as well after 72 hours (3 days). No matter when you take it, ulipristal acetate is more effective than levonorgestrel.

• How much you weigh

Levonorgestrel works less well for those weighing more than 70kg (155 pounds). Ulipristal works well for women up to 88.5kg (195 pounds)

• Whether you are breastfeeding

Levonorgestrel does not affect breast milk. Lactating mother needs to pump and discard breast milk for 36 hours after taking ulipristal acetate. 

This brings us to the main focus of this article: Oral Contraceptive Pill (OCP)

Two Main Types of Oral Contraceptive Pills 

Combined Oral Contraceptive (COC)

Combined Oral Contraceptive pills contain two hormones: Estrogen and Progestin 

Progestin-Only Pills (POP)

As the name suggests, Progestin-Only Pills contain only Progestin

Which OCP Is Right For You?

Generally, COC is preferred because COC allows less strict adherence to dosing times. A COC pill is considered ‘missed’ when you do not take it for 24 hours or more after you were supposed to. POP only allows 3 to 12 hours (depending on the type of POP) window to take your pill. COC also benefits women with acne problems.

However, POP might be the choice over COC for women with the following conditions:

1. Risk of blood clots: COC use is associated with elevated risk of venous thromboembolism
2. Migraine: Especially in Migraine with Aura (Aura refers to sensory disturbances such as visual disturbances or sensitivity to light and sound)
3. High blood pressure
4. High Risk of Heart Disease: COC use is associated with increased risk of heart attack and stroke
5. Breastfeeding: COC has adverse effect on milk volume

There are different formulations of COC and POP available. COC, as an example, comes in different pack sizes (21 to 28 tablets), different doses (20 to 35 micrograms of ethinylestradiol) and different types of progestin (Desogestrel, Drosperinone, Levonorgestrel). Be sure to check with your pharmacist on which oral contraceptive pill is the best for you!