The combined oral contraceptive pill COCPoften referred to as the birth control pill or colloquially as " the pill ", effects of antibiotics and the pill, is a type of birth control that is designed to be effects of antibiotics and the pill orally by women. It includes a combination of an estrogen usually ethinylestradiol and a progestogen specifically a progestin. When taken correctly, it alters the menstrual cycle to eliminate ovulation and prevent pregnancy.
They were first approved for contraceptive use in the United States inand are a very popular form of birth control.
They are currently used by more than million women worldwide and by almost 12 million women in the United States. Combined oral contraceptive pills are a type of oral medication that is designed to be taken every day, at the same time of day, in order to prevent pregnancy.
For the first 21 days of the cycle, users take a daily pill that contains hormones estrogen and progestogen. The last 7 days of the cycle are hormone free days. Some packets only contain 21 pills and users are then advised to take no pills for the following week. Other packets contain 7 additional placebo pills, or biologically inactive pills.
Some newer formulations have 24 days of active hormone pills, followed by 4 days of placebo effects of antibiotics and the pill include Yaz 28 and Loestrin 24 Fe or even 84 days of active hormone pills, followed by 7 days of placebo pills Seasonale.
Then after 28 days, or 91 days depending on which type a person is using, users start a new pack and a new cycle. If used exactly as instructed, the estimated risk of getting pregnant is 0. Several factors account for typical use effectiveness being lower than perfect use effectiveness:. For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, forget to take the pill one day, or simply not go to the pharmacy on time to renew the prescription.
COCPs provide effective contraception from the very first pill if started within five days of the beginning of the dairy and antibiotics cycle within five days of the first day of menstruation. If started at any other time in the menstrual cycle, COCPs provide effective contraception only after 7 consecutive days use of active pills, so a backup method of contraception such effects of antibiotics and the pill condoms must be used until active pills have been taken for 7 consecutive days.
COCPs should be taken at approximately the same time every day. The effectiveness of the combined oral contraceptive pill appears to be similar whether the active pills are taken continuously for prolonged periods of time or if they are taken for 21 active days and 7 days as placebo.
Contraceptive efficacy may be impaired by: If less than 24 hours have passed, the pill is considered "late. The role of the placebo pills is two-fold: By continuing to take a pill everyday, effects of antibiotics and the pill remain in the daily habit even during the week effects of antibiotics and the pill hormones.
Failure to take pills during the placebo week does not impact the effectiveness of the pill, provided that daily ingestion of active pills is resumed at the end of the week. The placebo, or hormone-free, week in the day pill package simulates an average menstrual cycle, though the hormonal events during a pill cycle are significantly different from those of a normal ovulatory menstrual cycle. Because the pill suppresses ovulation to be discussed more in the Mechanism of Action sectionbirth control users do not have true menstrual periods.
Instead, it is the lack of hormones for a week that causes effects of antibiotics and the pill withdrawal bleed. Unexpected breakthrough bleeding can be a possible side effect of longer term active regimens.
Since it is not uncommon for menstruating women to become anemic, some placebo pills may contain an iron supplement. If the pill formulation is monophasic, meaning each hormonal pill contains a fixed dose of hormones, it is possible to skip withdrawal bleeding and still remain protected against conception by skipping the placebo pills altogether and starting directly with the next packet.
Attempting this with bi- or tri-phasic pill formulations carries an increased risk of breakthrough bleeding and may be undesirable. It will not, however, increase the risk of getting pregnant. Starting inwomen have also been able to use a three-month version of the pill. Seasonique is another version in which the placebo week every three months is replaced with a week of low-dose estrogen.
A version of the combined pill has also been packaged to completely eliminate placebo pills and withdrawal bleeds. The hormones in the pill have also been used to treat other medical conditions, such as polycystic eggs and arthritis syndrome PCOSendometriosisadenomyosisacne, hirsutism, amenorrheamenstrual cramps, menstrual migraines, menorrhagia excessive menstrual bleedingmenstruation-related or fibroid-related anemia and dysmenorrhea painful menstruation, effects of antibiotics and the pill.
FDA for the previously mentioned uses despite extensive use for these conditions. PCOS, or polycystic ovary syndrome, is a syndrome that is caused by hormonal imbalances, effects of antibiotics and the pill. Women with PCOS often have higher than normal levels of estrogen all the time because their hormonal cycles are not regular.
This overgrowth is more likely to become cancerous than normal endometrial tissue, effects of antibiotics and the pill. Both COCPs and progestin-only methods are recommended. COCPs are preferred in women who also suffer from uncontrolled acne and symptoms of hirsutism, or male patterned hair growth, because COCPs can help treats these symptoms.
This works to lessen its inflammatory effects. Surgery is the only definitive treatment. Studies looking at rates of pelvic pain reoccurrence after surgery have shown that continuous use of COCPs is more effective at reducing the recurrence of pain than cyclic use .
Similar to endometriosis, effects of antibiotics and the pill, adenomyosis is often treated with COCPs to suppress the growth the endometrial tissue that has grown into the myometrium. Oral contraceptives are sometimes prescribed as medication for mild or moderate acne, although none are approved by diabetes and hairloss U.
FDA for that sole purpose. Although the pill is sometimes prescribed to induce menstruation on a regular schedule for women bothered by irregular menstrual cycles, it actually suppresses the normal menstrual cycle and then mimics a regular day monthly cycle.
Women who are experiencing menstrual dysfunction due to female athlete triad are sometimes prescribed oral contraceptives as pills that can create menstrual bleeding cycles. Oral contraceptives should not be used as an initial treatment for female athlete triad.
While combined oral contraceptives are generally considered to be a relatively safe medication, they are contraindicated for people with certain medical conditions. COCPs are also contraindicated for people with advanced diabetes, liver tumors, hepatic adenoma or severe cirrhosis of the liver, effects of antibiotics and the pill. People with known or suspected breast cancer or unexplained uterine bleeding should also not take COCPs.
Women who are known to be pregnant should not take COCPs. Postpartum women who are breastfeeding are also advised not to start COCPs until 4 weeks after birth due to increased risk of blood clots. It is generally accepted that the health risks of oral contraceptives are lower than those from pregnancy and birth,  and "the health benefits of any method of contraception are far greater than any risks from the method".
Different sources note different incidences of side effects. The most common side effect is breakthrough bleeding, effects of antibiotics and the pill. On the other hand, effects of antibiotics and the pill, the pills can sometimes improve conditions such as pelvic inflammatory diseasedysmenorrhea, effects of antibiotics and the pill, premenstrual syndrome, and acne,  reduce symptoms of endometriosis and polycystic ovary syndrome, and decrease the risk of anemia.
Combined oral contraceptives increase the risk of venous thromboembolism including deep vein thrombosis DVT and pulmonary embolism PE. The overall absolute risk of venous thrombosis perwoman-years in current use of combined oral contraceptives is approximately 60, compared with 30 in non-users.
Based on these studies, in the FDA updated the label for drospirenone COCPs to include a warning that contraceptives with drospirenone may have a higher risk of dangerous blood clots.
A systematic review in did not support an increased overall cancer risk in users of combined oral contraceptive pills, but did find a slight increase in breast cancer risk among current users, which disappears 5—10 years after use has stopped.
COC decreased the risk of ovarian cancerendometrial cancer and colorectal cancer. The risk reduction for both ovarian and endometrial cancer persists for at least 20 years. A report by a International Agency for Research on Cancer IARC working group said COCs increase the risk of cancers of the breast among current and recent users cervix and liver among populations at low risk of hepatitis B virus infection.
Cervical cancer risk in those infected with human papilloma virus is increased. A Cochrane systematic review found that studies of combination hormonal contraceptives showed no large difference in weight when compared with placebo or no intervention groups.
COCPs may increase natural vaginal lubrication. The study found that women experienced a significantly wider range of arousal responses after beginning pill use; decreases and increases in measures of arousal were equally common. A study of pre-menopausal women measured sex hormone binding globulin SHBGincluding before effects of antibiotics and the pill after discontinuation of the oral contraceptive pill.
Women continuing use of oral contraceptives had SHBG levels four times higher than those who never used it, and levels remained elevated even in the group that had discontinued its use. A study found the pill can have a negative effect on sexual attractiveness: Low levels of serotonina neurotransmitter in the brain, have been linked to depression. High levels of estrogen, as in first-generation COCPs, and progestin, as in some progestin-only contraceptives, have been shown to lower the brain serotonin levels by increasing the concentration of a brain enzyme dilantin side and low blood pressure reduces serotonin.
Progestin-only contraceptives are known to worsen the condition of women who are already depressed. Bradykinin lowers blood pressure by causing blood vessel dilation. Certain enzymes are capable of breaking down bradykinin Angiotensin Converting Enzyme, Aminopeptidase P. Progesterone can increase the levels of Aminopeptidase P AP-Pthereby increasing the alpha-lipoic acid and diabetes of bradykinin, which increases the risk of developing hypertension.
Other side effects associated with low-dose COCPs are leukorrhea increased vaginal secretionsreductions in menstrual flowmastalgia breast tendernessand decrease in acne. Side effects associated with older high-dose COCPs include nauseavomitingincreases in blood pressureand melasma facial skin discoloration ; these effects are not strongly associated with low-dose formulations. Excess effects of antibiotics and the pill, such as from birth control pills, appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.
One study claims that the pill may affect what male body odors a woman prefers, which may in turn influence her selection of partner. Combined oral contraception decreases total testosterone levels by approximately 0. Some drugs reduce the effect of the pill and can cause breakthrough bleedingor increased effects of antibiotics and the pill of pregnancy.
These include drugs such as rifampicinbarbituratesphenytoin and carbamazepine. In addition cautions are given about broad spectrum antibiotics, effects of antibiotics and the pill, such as ampicillin and doxycyclinewhich may cause problems "by impairing the bacterial flora responsible for recycling ethinylestradiol from the large bowel" BNF Combined oral contraceptive pills were developed to prevent ovulation by suppressing the release of gonadotropins.
Combined hormonal contraceptives, including COCPs, inhibit follicular development and prevent ovulation as a primary mechanism of action. Progestogen negative feedback decreases the pulse frequency of gonadotropin-releasing hormone GnRH release by the hypothalamuswhich decreases the secretion of follicle-stimulating hormone FSH and greatly decreases the secretion of luteinizing hormone LH by the anterior pituitary. Decreased levels of FSH inhibit follicular development, preventing an increase in estradiol levels.
Progestogen negative feedback and the lack of estrogen positive feedback on LH secretion prevent a mid-cycle LH surge. Inhibition of follicular development and the absence of an LH surge prevent ovulation. Estrogen was originally included in oral contraceptives for better cycle control to stabilize the endometrium and thereby reduce the incidence of breakthrough bleedingbut was also found to inhibit follicular development and help prevent ovulation.
Estrogen negative feedback on the anterior pituitary greatly decreases the secretion of FSH, which inhibits follicular development and helps prevent ovulation.
Another primary mechanism of action of all progestogen-containing contraceptives is inhibition of sperm penetration through the cervix into the upper genital tract uterus and fallopian tubes by decreasing the water content and increasing the viscosity of the cervical mucus.
The estrogen and progestogen in COCPs have other effects on the reproductive system, but these have not been shown to contribute to their contraceptive efficacy: Insufficient evidence exists on whether changes in the endometrium could actually prevent implantation.