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How Do Oral Contraceptives Work & How Safe and Effective is it?

Introduction to Oral Contraceptives (Birth Control Pills) —Some Brief Facts

  • Oral contraceptives, also known as birth control pills, are used to control your menstrual cycle, in order to avoid or prevent pregnancy. It is a much less invasive option than abortion. Contraceptive Pills or Birth Control Pills are usually a combination of hormones. Some oral contraceptives contain only progesterone, while the others are a combination of estrogen and progesterone. There are a few reasons why birth control pills are important.
  • Oral contraceptives are an effective way to prevent pregnancy. You just need to take the pill according to the way your doctor has prescribed.
  • Women prefer oral contraceptives over abortion. If you want to avoid unwanted pregnancy, you can just take one emergency oral contraceptive within 72 hours of unprotected sex.
  • You can use condoms as well as birth control pills to get the best results. Oral contraceptives do not save you from Sexually Transmitted Diseases (STDs), but condoms do. There are both, male and female condoms available.
  • You can plan your family by using oral contraceptives. You just need to stop taking them when you want to have kids. Oral contraceptives won’t cause any problems with your pregnancy.
  • Oral contraceptives can help in making your sex life better without causing any sort of problem.

How Do Oral Contraceptives Work?

How Do Oral Contraceptives Work?

It is important to note that oral contraceptives or birth control pills are a combination of hormones. They contain estrogen and progesterone, which help to change your menstrual cycle according to your needs. Combinations of such hormones in oral contraceptives help to stop the release of Luteinizing Hormone (LH). It also helps to stop the release of Follicle Stimulating Hormone (FSH). These hormones play a very important role when it comes to pregnancy. LH and FSH help to release the egg and prepare the uterus for the zygote to develop. Thus, inhibiting their release prevents pregnancy. Progesterone helps to make the mucus around the egg thick so that the sperm has difficulty in fertilizing the egg. In some cases, Progesterone helps in preventing ovulation or releasing of the egg.

What are the Types of Oral Contraceptives?

Oral Contraceptives or Birth Control Pills can be of several types. They are usually prescribed according to your needs and health condition by your doctor. It is highly recommended to consult your doctor before starting on oral contraceptives, as each person is different. What may work for someone else might cause a problem when it comes to you. There are several types of oral contraceptives.

There are many oral contraceptives, also known as combination pills. Combination pills can be classified into 3 groups.

  • Monophasic Pills are used in case of one-month cycles. Each of the pills which are active gives you the same amount of dose. During the last week of the cycle, you have to take inactive pills, which will result in you getting your period.
  • Biphasic Pills provide you with the same level of estrogen in the first 21 days of your cycle. The levels of estrogen and progesterone are kept low in the first half of the cycle so that the endometrium wall gets thickened. During the second phase, the ratio of progesterone and estrogen is higher, so that the endometrium layer sheds and you get your period.
  • Triphasic Pills are used for varying the progesterone and estrogen ratio throughout your menstrual cycle.

Emergency Oral Contraceptive Pills. There are emergency oral contraceptive pills, which you can take within 72 hours of unprotected sex to prevent pregnancy. Emergency oral contraceptive pills are also known as “Morning After Pills.”

Are Oral Contraceptives Safe?

You might be concerned with the safety of oral contraceptives or birth control pills. Oral contraceptives can produce some amount of side effects; however, are considered to be safe nevertheless. It is important that your doctor should approve of them before you start taking oral birth control pills. To ensure your safety when taking oral contraceptives, make sure to take oral contraceptives pills which are approved by FDA.

It is important to go through all the advantages, as well as the disadvantages of using oral contraceptive pills. Thus, it is advisable to consult your doctor first as he or she will help you decide.

What are the Advantages of Oral Contraceptives?

There are several benefits of oral contraceptives or birth control pills. The benefits of oral contraceptives depend on the type of pill that you are using and also differs from person to person. Some of the advantages of oral contraceptives are:

  • Oral Contraceptives Prevent Unwanted Pregnancy: Oral contraceptives provide protection against pregnancy. Thus, you can enjoy your sex life without having any kind of worries about unwanted pregnancy.
  • Oral Contraceptives Are More Effective: They are more effective than any other method of birth control. They help you to regulate your cycle according to your own needs.
  • Oral Contraceptives help in Regulating Periods: Women use birth control pills for several other reasons as well. Women who suffer from irregular periods or heavy periods take birth control pills, as they want to regulate their menstrual cycle.
  • Oral Contraceptives Are Reversible: Oral contraceptives are reversible in nature. This indicates that you can get pregnant after you stop taking them. Oral contraceptives won’t cause a problem with your pregnancy.
  • Oral Contraceptives Protect Against Other Diseases: There are several other uses of the oral contraceptive pills. Some combination pills may also provide protection from acne, anemia, severe menstrual cramps, endometrial cancer, ovarian cancer, ectopic pregnancy, thinning of bones and non-cancerous breast growths.
  • Oral Contraceptives Are Flexible: Some birth control pills have only progesterone and they provide other benefits for women, as these progesterone only pills are effective for women who cannot take estrogen therapy.

Are There Any Risks of Using Oral Contraceptives?

Though birth control pills are an effective method to prevent pregnancy, there are some risks involved as well. There may be some side effects with the use of birth control pills. However, these differ from person to person.

  • Oral Contraceptives Do Not Provide Protection Against STDs: One of the major disadvantages of using oral contraceptives is that they do not provide any protection against STDs.
  • Oral Contraceptives Need To Be Taken Daily: You always need to be careful about your pill-taking routine. Even if you miss one dose, there is a high chance of you getting pregnant if you engage in sexual intercourse. You always need to keep the pill packs ready. If there is any kind of delay, you might get pregnant easily.
  • Oral Contraceptives Have Some Side Effects: There are certain side effects that are accompanied by birth control pills. You might experience a reduced sex drive if you take oral contraceptives. Some women experience nausea if they take oral contraceptives. You might experience some amount of bleeding in between your periods. Breast tenderness and weight gain are also some of the important side effects of oral contraceptives.
  • Oral Contraceptives Also Carry Some Serious Risks: Other risks which are associated with oral contraceptives is that they increase the risk of blood clots. This can lead to deep vein thrombosis, stroke, heart attack and pulmonary embolism. However, this only happens to some women. According to the doctors, 10 out of 10,000 women can get blood clots because of oral contraceptives. The risk of getting blood clots is higher in case of women who are obese. Women who have high blood pressure can also suffer from this condition if they take oral contraceptives.

How Effective Are Oral Contraceptives?

Oral Contraceptive Pills are highly effective as they can prevent you from getting pregnant. There have been several types of research regarding the efficiency of oral contraceptives pills or birth control pills. The efficacy of oral contraceptives can be charted as follows.

If oral contraceptives are used properly, they can be 99 percent effective, according to several studies. However, they are 91% effective if you forgot to take it on time. Thus, 9 out of every 100 pill users get pregnant. The chances of you getting pregnant after using the pill are pretty low.

For oral contraceptive pills to be more effective, pills which contain progesterone should be taken within the same 3 hour period of time every day. There should be no change in the routine.

If you take certain medications, they can also decrease the effectiveness of the oral contraceptives. If you are suffering from diarrhea, it might decrease the efficiency of oral contraceptives.

What are the Medications To Avoid When You Are Using Oral Contraceptives?

Oral contraceptives are highly effective, but their efficiency can be reduced if you are using any other kind of medication, which interferes with their function. Some medicines can create a problem if you are a pill user and thus you should consult with your doctors first before taking any oral contraceptives.

  • Certain Antibiotics. Antibiotics like Rifadin, which is used to treat Tuberculosis, is known to decrease the efficiency of oral contraceptives. Rifadin causes irregular periods at times, thus messing up your menstrual cycle.
  • Certain Medicines. Certain medicines which are used to treat patients who suffer from HIV also interfere with the use of oral contraceptives. Prezista, Kaletra, Sustiva, and Viramune are the medicines which decrease the efficiency of birth control pills.
  • Anti-fungal medications can also decrease the efficiency of oral contraceptives. Griseofulvin, which is used to treat skin infections like athlete’s foot, and Ketoconazole can cause problems when they are used along with birth control pills.
  • Anti-seizure drugs can increase the breakdown of birth control pills. This decreases the efficiency of oral contraceptives. Drugs like carbamazepine, felbamate, oxcarbazepine, primidone, topiramate, and phenytoin can cause such an issue.
  • Modafinil, which is used to treat sleeping disorders, can decrease the efficiency of oral contraceptives. If you are using this drug, you need to find other methods of birth control.
  • Herbal Medicines. Herbal medicines like St. John’s Wort do not gel well with birth control pills. St. John’s Wort is used to cure depression and sleeping disorders. There is a risk of excessive bleeding and breaking down of estrogen in your body if you have both the medicines at the same time. Garlic pills which are taken for heart diseases; flax seeds which help in digestion; alfalfa, which is used to treat kidney problems; and Saw Palmetto which decreases hair loss can also decrease the effectiveness of oral contraceptives.

What are the Alternatives to Oral Contraceptives?

There are several alternatives for Oral Contraceptives or Birth Control Pills. If you don’t want to face the risks that are associated with oral contraceptives or you are taking certain medications which decrease the efficiency of Oral Contraceptives then you can use these methods.

  • Barrier Methods. There are barrier methods which help in preventing pregnancy. This includes male condoms, female condoms, diaphragms which do not let the sperm meet with the egg.
  • Other Hormonal Contraceptives. You can also go for hormonal methods if you don’t like oral contraceptives. These methods help to regulate the hormone levels inside your body and prevent ovulation or release of the egg. Vaginal ring, hormonal shots, contraceptive patches can be used in such cases.
  • Intrauterine Devices. Intrauterine Devices (IUDs) can also be used if you want an alternative to oral contraceptives. It helps by changing the lining of the uterus or preventing the sperm to fertilize the egg. The IUDs are placed in the uterus to prevent pregnancy.
  • Spermicides. Spermicides are also used by several women as they can prevent pregnancy. They can come in several forms, which include foams, jellies etc. These are chemicals which kill the sperms or disable it before it meets the egg.
  • Celibacy. Abstinence from sex is also a good method if you want to prevent pregnancy.


There are several birth control pills, which are available in the market. But the one which is ideal for you depends on a lot of factors. In order to find the best option for yourself, you need to consult with your doctor. Your doctor can examine you and decide whether or not you should be using oral contraceptives. Even though there are a few risks involved with oral contraceptives, there are some major benefits of birth control pills. While it is extremely important to indulge in protected sex, oral contraceptives have certain health benefits. Whether you want to use oral contraceptives or not boils down to your requirements and what you want for your body. These contraceptives must only be used under prescription, as your body might not have the adaptability to the contraceptive you choose. It is essential to take your doctor’s advice before starting oral contraceptives otherwise you can make yourself prone to drug interactions and complications in your body, which cause you distress.


  1. Mayo Clinic. (2022). Combination birth control pills. https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282
  2. Planned Parenthood. (n.d.). Birth control methods. https://www.plannedparenthood.org/learn/birth-control

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 28, 2023

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