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Making sense of the lingo for birth control pills

Approximately 65% of women 15 to 49 years old use some form of contraceptive method. Among this group, the oral contraceptive pill (OCP) and female sterilization are the two most used birth control methods. OCP is simply a medicine with hormones. It is very effective when taken as prescribed — usually every day at the same time. It has other benefits such as reducing acne, lightening periods and easing menstrual cramps. While OCP is safe, it can have side effects that can be managed by being on the right pill. There are nearly a couple of hundred pill brands available.

While OCP is very effective when used as prescribed — having perfect adherence — its effectiveness is substantially reduced with poor adherence, i.e., missing one or more pills here and there. Fortunately, there are remedial steps the manufacturer labels provide when one or more pills are missed. The problem is that it is not always easy to remember to take the pill on time or take it at all. It is also not easy to remember what the remedial steps are 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 helps women use their pills effectively. It also provides tools for tracking adherence and side effects, as well as supporting timely refills and doctor visits. Ginger-U is available to download on the Apple App Store and the Google Play Store.

There are two types of oral contraceptive pills:

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

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 pill 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.

The mini-pill or progestin-only pill on a card have the same amount of progestin. 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 mini pill as it is proven to interfere with breast milk less. However, the mini pill must be taken at the same time everyday; if one is late for more than 3 hours, she needs to use a backup contraceptive method for the following two days.

There are a few different types of combination OCPs:

1. Monophasic
2. Multiphasic
3. Extended Cycle
4. 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.

By now 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 important 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!


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