The contraceptive pill

Synonyms in a broader sense

birth control pill, mini pill, macro pill, micro pill, contraception

Definition

The pill is the most popular hormonal contraceptive. The contraceptive pill was first introduced in the USA in 1960 and in Europe in 1961. Since then it has been one of the most widely used contraceptives.

The Pill contains the hormones estrogen and progestin as hormonal active ingredients. The hormonal components of the Pill, which were still in high doses in the past, have been increasingly reduced to the present day. This means that the side effects are now greatly reduced at just such high doses, which ensure that the Pill is effective, and the Pill can be used as a contraceptive even in young people.

Contraceptive methods at a glance

The principle of the pill is to prevent ovulation. Regular use of the pill leads to a continuous level of sex hormones (estrogens and gestagens) in the body. This continuous level of sex hormones suppresses the release (secretion) of FSH (follicle stimulating hormone) and LH (luteinizing hormone).

FSH and LH are produced in the pituitary gland (hypophysis), regulate the secretion of estrogens and progestins in a natural cycle and are no longer released into the bloodstream if the concentration of sex hormones is high enough. Taking the sex hormones by means of the contraceptive pill thus suggests to the body that there are sufficient estrogens and progestins in the body and that no more are needed, so that FSH and LH are no longer released into the blood. Ovulation cannot be triggered because the so-called LH peak, which is present in a natural cycle, is missing.

An LH peak occurs in a natural cycle just before ovulation when the concentration of LH in the blood rises rapidly, only to fall just as rapidly again. However, when the pill is taken, LH is almost constant throughout the cycle, so that no egg can jump. The consequence of not ovulating is that no mature egg cell is available for fertilization.

Pregnancy is therefore not possible. However, the pill also has other effects which make it more difficult to achieve pregnancy. For example, the cervical secretion becomes viscous during the entire cycle and thus more difficult for sperm to penetrate.

In addition, the correct build-up of the uterine mucosa is prevented (inhibition of endometrial proliferation), making it difficult for an egg to implant properly. In addition, the movement of the fallopian tube (tubal motility) is modified in such a way that sperm are transported in the direction of the uterus and not in the direction of the fallopian tube (tuba uterina), where a mature egg may be present and can be fertilised. The pill is available in different forms.

On the one hand there are so-called single-phase preparations. Each tablet contains the same amount of estrogens and progestins. A contraceptive pill that contains more than 0.036 mg of the estrogen ethinyl estradiol is called a macropill, while one that contains less than 0.036 mg of the estrogen ethinyl estradiol is called a micropill.

On the other hand, there are one- and two-phase preparations. In the case of the two-phase preparations, the first seven tablets contain only estrogens for the first seven days of use. From the eighth day onwards, tablets containing an estrogen-progestin mixture are taken.

In addition to the macro and micro pill, there is also the minipill. The special thing about the minipill is that it contains only progestins. The pill is also available in the form of graduated preparations.

The aim of graduated preparations is to reduce the amount of progestins in particular, but also estrogens in total. With two-stage preparations the progestogen content is reduced in the first 11 tablets. From the 12th tablet onwards, the remaining tablets then have a higher progestin content.

In the case of three-step preparations, the progestogen content increases in the 6th tablet, the oestrogen content in the 9th tablet and again the progestogen content of the remaining tablets in the 12th tablet. Cerazette is also a contraceptive method in tablet form. You should also consider this promising form of contraception before you decide on a variant.

The pill is also available in the form of graduated preparations.The aim of graduated preparations is to reduce the amount of progestins and estrogens taken. With two-stage preparations, the progestin content is reduced in the first 11 tablets. From the 12th tablet onwards, the remaining tablets then have a higher progestin content.