The birth control pill (BCP) is one of the most significant discoveries of the 20th century, especially for women. However, many of those who take it, and even more of their mates, lack complete understanding of how it works and what to expect from "the pill". This explanation goes beyond what the packaging paperwork does and answers your most commonly asked questions about the birth control pill.
Ovulation While Taking Birth Control Pills
Birth control pills actually work by preventing ovulation. Those taking the pill according to the directions should not have midcycle ovulation. That is because the combination of synthetic estrogen and progesterone found in most BCPs stops follicles from developing in the ovaries. Sometimes BCPs are even given to women who are prone to ovarian cysts in order to stop them from developing cysts because of the same effect.
In a study of BCP users, it was found that 97% of women had no ovulation at any point in their cycle. Amongst those who appeared to ovulate, no pregnancy resulted.
The exception to this is if you are taking the mini Pill which only contains progestin. In studies of mini Pill users, a mere 29% had no ovulation. However the mini Pill causes other changes in the body such as a thinning of the uterine lining and thickening of cervical mucus which prevents pregnancy.
Placebo Week Protection
You are actually protected from ovulation during your placebo week because of the design of the ingredients in birth control pills. The synthetic progestin and estrogen were designed to have a long "half-life", so that they keep on working for a period of time after you stop taking them. This ensures protection from pregnancy even if a pill is missed or taken late.
When starting the Pill it is now recommended to begin taking it on the first day of your cycle to increase the chances of protection even in the first month. It used to be recommended to start on the first Sunday but this newer method means no need for back-up protection during the first month.
In a study done on BCP users, women began their new package of pills 3 days later than they should have. Blood tests and ultrasounds determined that ovulation did not occur despite being without the hormones for a total of 10 days. Many of the women however did get enlarged ovarian follicles. This suggests that ovulation becomes more possible as levels of estrogen in BCPs dips. Protection is optimal when no more than 7 days of placebos are taken.
The Return of Your Cycle
In a study done of low dose BCP users, almost 99% of them had had a spontaneous period or pregnancy within a 3 month period following cessation of the Pill. These users had taken it for one year and most had even gotten their period within 32 days of finishing their last BCP. These results may be different with a higher dose BCP. If you have a history of irregular cycles or missing periods, your chances of a delayed return of your cycle is increased. Less than 1% of women have post-Pill amenorrhea or no period for more than 6 months following cessation of the Pill. The brand of Pill and the length of time on it have no effect on the return of your cycle.
Conception After The Pill
Studies of women who had used low dose BCPs show that their conception rate is in line with that of women in general. 57% of users got pregnant within 3 months of going off the pill. Likewise 57% of couples in general conceive within 3 months of actively trying. 81% of former BCP users were pregnant within 1 year. In the general population 85% have conceived within 1 year of unprotected sex.
Birth Control Pills and the Effects of Smoking and Drinking
Studies have shown that both smoking and drinking have the possibility of impacting the effectiveness of BCPs. Smoking has been proven to increase the chances of blood clots resulting in heart attack or stroke. It can also decrease the level of estrogen in the blood. A pack a day smoking is enough to trigger this decrease. For birth control pill users the problem is when low dose pills have estrogen levels decreased to an ineffective level by nicotine and ovulation is not prevented. Because of these risks, those taking BCPs should definitely quit smoking.
Drinking alcohol, even just one serving, raises different estrogen levels in the body. Surprisingly grapefruit juice has reportedly been shown to have the same effect.
For more information on the birth control pill you are taking or plan to take, talk with your doctor.
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