Low Dose Oral Contraceptive Pills

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Low Dose Oral Contraceptive Pills Myths and
Realities
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• May 9th, 1960
• US-FDA approved the first Combination OC Pills

• Nothing else in the century perhaps not even
  winning the right to vote made such an
  immediate difference in womens lives

Social conventions change slowly, but
technological changes can change the way we live
very fast
- Ladies Home Journal - 1990
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(No Transcript)
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• Rumour travels on wings and facts take the slow
  ride home

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MYTH

• The pill causes infertility
• when it is stopped

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Reality

• MOST WOMEN RETURN to normal fertility two to
  three months of stopping the pill
• More than 12,000 pregnant ex pill users, after at
  least five years of use, were statistically less
  likely than nonusers to have any delay in
  conceiving...!
• The pill does not cause miscarriages or birth
  defects
• Even if given accidentally during the early part
  of pregnancy, studies suggest that there will be
  no risk of birth defects

Farrow et al (J Hum Reprod, 2002)
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It is healthy to take a break from the pill.
MYTH
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Reality

• With low dose pills and estrogen free pills no
  gap is necessary

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MYTH

• The pill has only harmful side effects and is
  generally bad for health

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Risks People Take Mortality per Million Women
per Year
Reality
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Reality
Beneficial Side Effects of the Pill

• Brilliant at its main job (reversible
  contraception)
• Menstrual benefits
• Especially less painful and lighter periods
• Less dysmenorrhoea
• Regular periods

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Reality
Beneficial Side Effects of the Pill

• Less Risk of cancer of . . .
• ovary
• uterus
• bowel
• Less incidence of . . .
• pelvic infection
• ovarian cysts
• benign breast disease
• anemia
• Some pills, reduce Acne and hirsuitism
• POP can be used safely in breast feeding mothers

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Reality
Minor Side Effects Seen Occasionally

• Acne
• Mood changes
• Breast tenderness
• Headaches
• Nausea

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Reality
Risks with OC Pills

• Venous disease
• Arterial disease
• ?? breast cancer
• ??? cervical cancer

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MYTH

• The pill leads to heart attacks, strokes and
  thrombosis

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Reality

• There is a slight increase in the risk of getting
  deep venous thrombosis (DVT) or pulmonary
  embolism (PE)
• However, for those not prone to having
  thrombosis, this risk is negligible
• the risk is actually less than that incurred by
  pregnancy
• Heart disease associated with the Pill is linked
  to individuals with independent risk factors, esp
  smoking and high BP
• A World Health Organization study found no
  increased risk of heart attack among healthy Pill
  users.
•   - WHO LANCET 1995
• These patients at risk can always be given
  estrogen
• free pill safely

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MYTH

• The pill causes cancer

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Cancer and the Pill
Reality
BENEFITS Endometrium (50) Ovary (35) Colorectal
(45)
RISKS ? Liver ? Cervix ??? Breast
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MYTH

• The pill cannot be taken after 35 years of age

Reality
With selective progesterone like Desogestrel it
can be continued till menopause in certain women
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Pill and Breast feeding
MYTH
Contraindicated in breast feeding mothers
Reality

• Estrogen - free pill / progesterone only pill
• Can be safely taken while breast feeding.
• Does not affect the babies growth and quantity or
  the quality of breast milk

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MYTH

• The pill causes weight gain

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Reality

• Perceived weight gain
• Increase in breast size
• Premenstrual bloating
• Among users of two 20 mcg Oestrogen-containing
  pills, in a one-year trial
• 13 Lost gt 2 kg ,
• 74 Stayed at same weight
• 13 did gain gt 2kg.

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Take Home Message

• Myths related to the OC pills prevent widespread
  use
• Education and effective counseling can dispel
  myths regarding
• Fertility
• Cancer
• Weight gain and other side effects
• In reality the COCP
• Provide effective contraception
• Have many non contraceptive benefits
• Provide cafeteria approach and encourage informed
  choices

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The Pill

• It is known simply as the pill. Millions of
  women around the world today, take it daily
  without a thought to the social changes it
  unleashed 40 years ago. All that the little
  hormone tablet does is to temporarily prevent
  pregnancy, yet the transformation of womens
  lives since the pill was introduced has been
  nothing short of breathtaking

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Concept Dr. Duru Shah

• Editors
• Dr. Sangeeta Agrawal
• Dr. Reena Wani

• Contributors
• Dr Mandakini Parihar

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We acknowledge the efforts of our

• Coordinators
• Dr. Sangeeta Agrawal - Central
• Dr. Narendra Malhotra - North
• Dr. Hema Divakar - South
• Dr. P. C. Mahapatra - East
• Dr. Uday Thanawala - West
• In bringing the FOGSI YOUTH EXPRESS to your
  city.

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This Youth Express has been possible through an
educational grant from

• Charak Pharma Pvt. Ltd
• CIPLA Ltd.
• Emcure Pharmaceuticals Ltd
• GlaxoSmithKline Pharmaceuticals Limited
• Glenmark Pharmaceuticals Ltd.
• Metropolis Health Services (India) Pvt.Ltd.
• Organon India Ltd
• Roche Pharmaceuticals Ltd.
• Sandoz Private Limited
• USV Limited
• Wyeth Limited