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What are Birth Control Pills?
"The pill" is a generic term that refers to the most popular type of
birth control. There are many different brands, and they typically come in
packs of 21 or 28 pills. One pill is taken every day. The first 21 pills have a
combination of synthetic estrogen and progesterone hormones. The last 7 pills
of a 28-day pack are placebos or sugar pills and have no hormones in them –
they are there primarily to keep you in the habit of taking a pill once a day.
The Seasonale pill works on the same
principle, but works for 12 weeks, with the 13th week being the placebo/sugar
pills. The new Lybrel pill is a continuous-use pill that was approved for
use in 2007. Lybrel prevents you from having menstrual periods for as long as
you continue to take the pills.
The "mini-pill" is a
progestin-only birth control pill that is usually prescribed for women who
cannot tolerate the additional estrogen in their systems, who are over 35, or
who are breast-feeding.
How effective are they?
With
consistent, correct usage, the pill is more than 99.7% effective at preventing
pregnancy. With typical use, they are approximately 92% effective. (1)
"Typical" is used to describe the situation where some women forget
to take their pills correctly (see below). The pill does not protect
against disease transmission.
How
can I get them, and how much do they cost?
You need to
have a prescription for birth control pills, typically provided by your
gynecologist or family doctor. You can buy the pill at just about any
pharmacy, including those in department or grocery stores. Exact prices
vary by brand, but you can expect to pay around $30 - $40 a month if you're not
using insurance. Seasonale will cost approximately $120 for a three-month
supply (without insurance). Lybrel is expected to cost roughly the
same. Many insurance plans cover hormonal birth control - check with your
parents or plan provider to find out if yours does.
You do NOT need your parents' permission to obtain the pill in the vast
majority of states (Use the State Law Information Center to find out what the law is in your
state). You can go to a Planned Parenthood or similar clinic, or your
local public health department to obtain a prescription and/or low-cost birth
control pills (the actual cost is usually based on your ability to pay). Title X requires doctors treat contraceptive
services for you with confidentiality, even when it comes to your parents, so
you can discuss the subject with your doctor without fear of your parents
finding out (if the doctor tells your parents, he has violated federal and in
some cases even state laws)
In some areas,
pharmacists and doctors are allowed to impose their morality on women and
refuse to prescribe or honor prescriptions written for birth control as if they
should be the ones who decide if you get pregnant or not. If you are going to be using a pharmacy that
isn’t a part of a major national chain, you should contact the pharmacy to
ensure that they carry and dispense birth control. Be sure and consult with a doctor about
his/her position on birth control before you select him/her as a primary
provider under your insurance programs.
Many states
have programs that fund birth control for women who do not have sufficient
means to pay for it on their own. This
often includes teenagers and other young women who are not employed or cannot
otherwise afford to pay the full costs of the medication. Contact your local Planned Parenthood or
public health clinic for further information.
Many schools (mostly colleges, but in some states even high schools)
have access to contraception through in-house health or medical clinics.
How does the pill work?
There are two primary types of pills – combination pills, which contains both
estrogen and progestin, and a “mini” pill, which contains only progestin.
The combination
pill works through two primary mechanisms.
The first is to prevent ovulation through the suppression of ovulation
through a chemical process that inhibits the release of Leutenizing Hormone
(LH) and Follicle Stimulating Hormone (FSH).
These two hormones are released in the body each month to begin the
process of maturing and releasing an egg in preparation for being fertilized. If left unchecked, the ovaries will release
at least one egg in the middle of your menstrual cycle. The hormones in the pill prevent that from occurring.
Additionally,
progestin in the pills cause a thickening of the mucus in the cervix and the
endometrium of the uterus, inhibiting the ability of sperm to move themselves
to the Fallopian Tubes to reach the egg.
It is believed that this thickening of the uterine lining also would
inhibit the implantation of a fertilized egg, though this has never been
demonstrated in a laboratory.
In the
mini-pill, the progestin works in much the same way, and may also work to
inhibit ovulation. Combination pills are
by far the most common type – mini pills are used only for those women who are
unable to tolerate estrogen or have some other condition that suggests estrogen
is not a viable or suitable alternative for them.
Let’s explore
each of these and how they are used in a bit more detail.
(1) Contraceptive Technology, 18th
Edition, 2004
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