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Some Facts Before We Get Started

  • The birth control (BC) pill  is 91% effective on its own. The US Department of health has this nice infographic if you want to know more.
  • After 1 year of typical use, 9 in 100 women on the BC pill will fall pregnant. Over 10 years of typical use, that number rises to 61 in 100. Check out this article for more on that.
  • There are two basic types: combination and mini-pill. The latter has a lower dosage than the former. Read about that here.
  • It works by: (1) tricking your body into thinking you’re pregnant, thereby stopping you from releasing egg cells, (2) thickening the cervical mucus so the sperm can’t enter, and (3) keeping the lining of your uterus thin so that a fertilized egg can’t attach to it even if it gets through the first two mechanisms. Check this out for more on that.
  • You can get BC pills for as low as 45 PHP at any drugstore so it’s one of the cheapest forms of hormonal BC.
  • Standard PSA: They do not protect you from STDs.

Trial and Error Phase

Birth control pills are definitely not for everyone. Hormones can do all sorts of strange things to your body and they can aggravate existing medical conditions. That’s why it’s important to consult an OB-GYNE before you start taking them. The doctor will be the best person to recommend a birth control method for you, and if you decide on BC pills, you will go through a trial-and-error phase with their advice. You can report any and all side effects to them to make sure that you’re okay. That said, I’ll tell you about how I didn’t consult before taking pills. Back when I was 21, I figured it would be a great time to experiment with pills. I was always obsessed with birth control because I’m tokophobic — we’ll talk more about that in a later post. Before work one day I just went ahead and bought a pack of Trust pills from a drugstore. No, they didn’t ask me for a prescription.

  • Trust by Pond’s Chemical is a combination pill with 21 ochreous tablets (ethinyl estradiol 30 mcg, levonorgestrel 125 mcg) and 7 brown tablets (ferrous fumarate 75 mg equivalent to 24.75 mg elemental iron).
  • It’s less than 45 PHP at Mercury, a little less at TGP or other generic drugstores.

Now this first month with the pill coincided with a very difficult time in my life so I honestly can’t tell you if the pill somehow affected how depressed I was. I’ve read that the pill can cause mood swings in some women, but I can’t give you any real feedback on this. I didn’t gain any weight, I know that’s what some people are afraid of. This is different for everyone though. I took it at 9 am each day, which was easy to remember because that’s when I get to work. The thing with Trust those first few months was that at day 23, when the hormones were leaving my body and I was about to menstruate, I would get these crippling headaches. But that was fine by me, since I knew those were just withdrawal symptoms. At around the third month, I noticed that my stomach was a bit bloated. I weigh less than 100 pounds, even the slightest bloating is very obvious. This was when I went to the OB-GYNE. The OB, we’ll call her Dr. I, spent a good five minutes gently scolding me about my little experiment. I completely agree, I shouldn’t have done that. Then she gave me a prescription for a pill with a different dosage called Althea, to see if this would work better. Remember, finding the right BC pill for you can be a long process.

  • Althea is a combination pill (21 pills with cyproterone acetate 2 mg, ethinyl estradiol 35 mcg).
  • No 7 reminder pills.
  • IIRC it costs around 350 PHP at Mercury.

Althea did not work for me, at all. I felt worse than when I was on Trust and this wasn’t just bloating. I had joint pains and I still don’t even know how that’s possible. After a month, I went back to Dr. I and got a different prescription, this time for Blush. It worked perfectly. I got lighter periods, no withdrawal headaches, and basically it was like I wasn’t even taking pills at all.

  • Blush has the exact same formulation as Trust, but it’s manufactured by Cyno Sure Healthcare.
  • IIRC it costs around 150 at Mercury.

Good things never last. Blush got pulled out for low sales and after yelling why, why at the clerk at the Mercury counter, they gave me the closest thing… Yes, Trust. So I went back to it, and for some reason, the side effects were gone too. I’ve been on this one for over two years and we’re getting along well. Here are three more pills that have worked for people I know.

  • Micropil by Dyna Drug (mini-pill type): norethisterone 400 mcg, ethinyl estradiol 35 mcg. You have to be more careful with the time when it comes to mini-pills by the way. 45 PHP.
  • Nordette by Pfizer (combination type): ethinyl­ estradiol 30 mcg, levonor­gestrel 150 mcg. Fun fact! Nordette can be used as a Plan B (emergency contraception). Read about how to do that here. Make sure to do it within 120 hours though. 100+ PHP.
  • Gynera by Seville Pharmaceuticals (combination type): gestodene 75 mcg, ethinyl estradiol 30 mcg. 500+ PHP.

Weight Gain, Acne, and Other Things You May Have Heard Of

Short answer: IT DEPENDS.

It depends on your metabolism before you started taking the pills, on your diet, on how much water you drink everyday, how prone you are to breakouts, etcetera. In my case, no weight gain, no acne breakout. As I said, the biggest side effect I had was bloating during Trust and joint pains during Althea. There was also the small matter of my (looks around uncomfortably) mammary glands feeling firmer during certain times of the month.

Long answer: Go Ask Alice or learn more about How Stuff Works.

Notes on Menstruation

When you’re using the pill correctly, the lining of your uterus doesn’t thicken and there’s basically no need for you to menstruate at all. Every period you will have while on the pill is just withdrawal bleeding triggered by the drop in hormones. There’s an interesting history as to why pills were made to mimic the natural cycle. It’s related to the Catholic Church and their stance on contraception, which you can read about here. So now that we know that the period is “fake”, what are the implications on your monthly period?

  • You know exactly when it’s gonna happen: 3 – 5 days after you take your last active pill. If it doesn’t happen, stay calm. Sometimes it normal for a fake period to skip while the body is adjusting. If you’re the paranoid kind, take a p-test immediately. The active ingredients in birth control pills don’t affect the test.
  • Periods are much, much lighter because you’re not shedding your uterine lining. Goodbye heavy flow pads!
  • You can opt to menstruate anywhere from once a month to… Well, never. You can also delay your “period” by a few days if it’s going to interfere with, say, a swimming trip. Read this and talk to your OB-GYNE about it.

I also have to mention one other thing, which is breakthrough bleeding. It’s basically unscheduled bleeding, which can happen for a number of reasons. You could be adjusting to the pill, which is perfectly normal, or you could be drinking medicine that is disrupting your hormone levels. Personally though, I’ve never experienced this.

“Will they ask me for a prescription?”

Some drugstores do, some don’t. Those that do will ask you either, “May prescription po ba?” or if you say you don’t have it with you, “Ginagamit na po ba dati?” You can always lie, that’s up to you, no judgment. But you should have a prescription because like I said this is tricky stuff. If you can’t go to an OB-GYNE because you can’t afford it or you just don’t like doctors for some reason, you can probably still get a pack. Of course they won’t sell it to you over-the-counter if you’re like twelve or something, and in which case girl you and I need to talk.

Tips for Taking the Pill

  • Same time, every day. Same time, every day. Same time, every day. Make a phone alarm. Synchronize with friends or officemates who take pills so you can check on each other. I don’t know how, but make sure that you take it at the same time, every day. This is a matter of life and death people!
  • Missed a pill? Check out this guide. Basically, if you missed one, take it as soon as you remember and carry on as usual. It gets more complicated the more you miss.
  • Do not go for the full 7 days without hormones. That’s one big reason why pills fail. Whether you have the iron supplements or not, go without hormones for 5 days only. Day 21 is the last hormone pill, you menstruate on day 24 or 25, you take the next one on day 27.
  • Use back up methods for the first month. I know they usually say back up is only needed for a week, but I feel like that’s tempting fate.
  • The more methods you use, the better it works. So obviously, you’d be a lot less likely to fall pregnant if you use condoms and withdrawal at the same time. Or heap spermicides on top of that!
  • For condoms, 86 in 100 women fall pregnant over ten years of typical use. For withdrawal, that’s 92 in 100 over ten years. This is my favorite resource for this because it shows the difference between typical and perfect use during clinical trials.
  • You can’t use calendar or basal body temperature methods along with the pills because if you’re doing it right, you’re not ovulating.
  • Go to your OB-GYNE and get a pap smear and a TVS once a year just to make sure everything’s right.
  • If for some reason you don’t want people to know that you’re sexually active but they interrogate you about your pills, you can say that you have Polycystic Ovarian Syndrome (PCOS), some sort of hormonal imbalance, severe dysmenorrhea, or you’re using it to treat acne. Again, it’s your life so no judgment.

Other Hormonal BC Methods, with CDC Stats

The pill is the only one you have to take at the same time every single day. That’s why a lot of people don’t like it. If you’re one of these people, there are others you can check out.

  • Injectables (ex. Depo-Provera), repeat injections every 3 months (94% effective)
  • Patch (ex. Evra Patch), stick one on for a week every 3 weeks (91% effective)
  • Ring (ex. NuvaRing), leave in place for 3 weeks at a time (91% effective)
  • Diaphragm, insert before intercourse; replace device every two years (82% effective)
  • Hormonal IUD (ex. Mirena), requires minor procedure at the OB-GYNE; replace after 5 years (99.8% effective)

Hope this helps. Feel free to leave comments, and I’m definitely open to suggestions for other topics to discuss. Stay safe everyone!

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