Approximately 65% of women aged between 15 and 49 use a contraceptive method. The oral contraceptive pill (OCP) and female sterilization are the two most used birth control methods among this group. OCP is simply a medicine with synthetic hormones. It is very effective when taken as prescribed—usually every day at the same time. In addition, it has other benefits, such as reducing acne, lightening periods, and easing menstrual cramps. Though OCP is generally safe, it can have side effects. However, being on the right pill significantly minimizes the risk of side effects. There are hundreds of pill brands available.

OCP has an excellent success rate, which largely depends on perfect adherence. Poor adherence, i.e., missing one or more pills, substantially reduces OCP's efficacy. Fortunately, there are remedial steps on the labels that inform the patients about steps to take when they miss one or more pills. The problem is that it is not always easy to remember to take the pill on time or at all. It is also not easy to remember the remedial steps when one or more pills are missed.

Ginger-U is a free app to help women learn about their pills and support their adherence. In other words, it allows women to use their pills effectively. It also provides tools for tracking adherence and side effects and supporting timely refills and doctor visits. Ginger-U is available to download on Apple App Store and Google Play Store.

There are two types of oral contraceptive pills:

• Progestin-only pill (sometimes called “mini-pill”), which has only progestin
• Combination pill (simply “the pill”), contains the hormones estrogen and progestin

The mini-pill or progestin-only pill on a card has the same amount of progestin every day. The progestin dose in the mini pill is lower than that in any combination pill. The mini pill slows an egg's journey through the fallopian tubes, thickens cervical mucus, and thins the endometrium; these effects help prevent sperms from reaching the eggs. Breast-feeding women often prefer to take a mini pill as it is proven to interfere with breast milk less. However, the mini pill must be taken at the same time every day; if one is late for more than 3 hours, she must use a backup contraceptive method for the following two days.

The hormonal composition of combination pills may vary over the intended period, i.e., each day has its designated pill. Combination pills prevent the ovaries from releasing eggs. They also cause cervical mucus to thicken to keep sperms from reaching the eggs. Women on combination pills get non-contraceptive benefits like relief from premenstrual syndrome, reduction in menstrual cramps, and shorter/lighter periods. Side effects of combination pills include spotting, breast tenderness, headaches, nausea, and bleeding.

There are a few different types of combination OCPs:

• Monophasic
• Multiphasic
• Extended Cycle
• Continuous Cycle

Before discussing phases, let us talk about active and inactive pills. Every pill card has a combination of active and inactive pills (also called placebo pills). Active pills contain the hormone(s), while the inactive pills are hormone-free. Since humans are creatures of habit, the placebo pills are intended to maintain the one-pill-a-day regimen even on days that a hormonal pill is not needed. Taking the placebo pills is optional and does not affect the efficacy of the regimen. Most pill cars come in a 4-weeks/28-pills format, with 21 active pills and 7 placebo pills.

Monophasic pills contain the same amount of each hormone in their daily dose for the 21 days of active pills, followed by 7 days of placebo pills. Multiphasic pills contain two or three different levels of hormone for the 21 days, followed by 7 days of placebo pills. In 2003, the extended cycle pill was introduced with 84 days of active pills, followed by 7 days of placebo pills. While the monophasic and multiphasic OCPs cause monthly period-like bleeding, the 91-day extended cycle OCP causes less period-type bleeding. In 2007, the continuous cycle pill was introduced with no placebo pills to help women with menstrual disorders or discomfort.

You may be asking, what is the right pill for me? The answer to this question is best determined by discussing it with your doctor. Once you are on a pill, it is essential to maintain good adherence and keep the line of communication track side effects (if any) to discuss with your doctor. Ginger-U is an indispensable discrete assistant to support your journey on the pill. Download it now!