How do birth control pills work?

The history of the contraceptive pill

Although the contraceptive pill is now part of everyday life for a large proportion of women, it wasn't until 1956 that the first birth control pill was developed by an American biologist, Dr. Pincus. Behind this invention was the courage of an American nurse and feminist activist, Margaret Sanger. Working in the slums of New York at the time, she had a front-row seat to the suffering of impoverished women: repeated pregnancies, illegal abortions, and all the associated consequences. She dreamed of an accessible oral contraceptive that could improve women's health. 

It took almost 10 years, from the marketing of the first birth control pill to its decriminalization in the Criminal Code. Today, several birth control methods are available.

Contraceptive pills: A popular birth control method

Oral contraceptives, also known as birth control pills, quickly became a huge success with women and are still among the most widely used contraceptive methods worldwide.

How do birth control pills work to prevent pregnancy?

Most contraceptive pills contain two hormones: estrogen and progestin. The combination of these hormones prevents the ovaries from releasing an egg each month (ovulation) and modifies the cervical mucus, which can then not receive sperm.

What is the minipill?

Unlike combined oral contraceptives, some birth control pills contain only progestin. These are sometimes referred to as "minipills." These are generally prescribed for women with contraindications to estrogen or for breastfeeding women, as milk production is less affected than with contraceptives containing estrogen. Some of these "minipills" can be unreliable if not taken at the same time each day. Be sure to set a regular reminder if you do take a minipill.

What should I do if I forget to take one or more birth control pills?

As a general rule, you need to take one pill at the same time each day to benefit from the optimal efficacy of your oral contraceptive. Ideally, the pill prevents pregnancy with an efficacy rate of around 99.7%. However, this rate drops when certain factors, such as possible oversights.

There are a few things you can do to reduce the risk of forgetting. For example, setting an alarm on your cell phone to remind you when your pill is due is a trick that works for many people. 

Even so, if you have missed one or more pills, certain actions may be necessary to ensure the effectiveness of your birth control pill and avoid the risk of unwanted pregnancy. Since recommendations vary greatly depending on the length of time you've forgotten to take your pills as well as the period of your cycle, be sure to contact your pharmacist to find out about the procedure specific to your situation. Your pharmacist may prescribe emergency oral contraception if necessary.

What are the advantages and disadvantages of the pill?

As well as preventing unwanted pregnancy, taking a birth control pill has other benefits. These include regulating your menstrual cycle, reducing or eliminating cramps associated with menstruation, calming premenstrual symptoms, curtailing acne, and lowering the risk of certain cancers.

However, as with any medication, some women may experience side effects, such as spotting (blood loss at different times of the cycle), breast tenderness, water retention and nausea. These effects vary greatly from one person to another. What's more, tolerance to the different pills on the market can vary considerably. The same principle applies to different contraceptive methods. Some may find the birth control pill works best for them. For others, an IUD will ultimately be the best option. 

A three-month trial period is usually recommended when starting a new oral contraceptive, as side effects often disappear after this time. However, if side effects persist over time, don't hesitate to discuss them with your pharmacist, who will be able to advise you or suggest different contraceptive alternatives. 

What about continuous use? Shouldn't we menstruate every month?

Contrary to popular belief, you don't have to have your period every month. In fact, there are certain advantages to taking the pill continuously. For example, it increases contraceptive efficacy. Taking the pill continuously also gives you greater control over your menstrual cycle since you can choose when to take a break and have your period. By reducing or eliminating menstrual periods, continuous dosing reduces their impact on women's quality of life. Indeed, many women experience physical and psychological symptoms during their periods, such as stomach aches, migraines, heavy blood loss that can contribute to anemia, mood changes, fatigue, etc. In sum, some women can benefit from continuously taking birth control pills.

Other considerations

Although very rare, some complications require prompt medical attention. In the event of severe headaches, difficulty in breathing, pain and/or swelling of a leg, numbness or weakness on one side of the body, you should seek prompt medical attention. Smoking cessation reduces the complications associated with oral contraceptives.

How can I protect myself against sexually transmitted infections?

It's important to remember that the pill is not a means of protection against sexually transmitted infections (STIs). To be protected, you need to use a condom. Your healthcare professional will be able to inform you about barrier methods and STI screening recommendations.