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Birth Control: The Birth Control Pill

The good old birth control pill is still the most popular contraceptive in this country, especially for women in their 20s and 30s, and stays a safe choice for healthy women into their 40s if they don't smoke.

The hormones in the pill work by preventing ovulation, thickening cervical mucus and thinning the lining of the uterus. Many women benefit from positive side effects such as less cramping, lighter periods and some formulations that can help reduce acne. But not all side effects are good ones: some pill users complain of breast tenderness, headaches and nausea or vomiting usually within the first few months of taking the pill. It can also be a slightly less effective option for women who are overweight  - when you have a higher body mass and blood volume the amount of hormone might not be concentrated enough for you.

The pill is 99% effective at preventing pregnancy when taken at the same time daily. Most women can get pregnant as soon as they stop taking the pill or within a few months. The time frame depends on how quickly you start to ovulate again. .

There are more than 50 brands of birth control pill on the market, some generic, which makes them less expensive. It could take a few tries before you find the one that best suits your lifestyle and has the least negative side effects.

The pill comes in three types of formulations:

?Combination pills, the most used and most effective form, contain the hormones estrogen and progestin. One pill is taken daily for 28 days with a period occurring sometime in the last week (this is when you're taking placebo pills with no hormones in them). For some women they can help protect against ovarian and endometrial cancer. Estrogen is not recommended for women who smoke and can increase the risk of complications from diabetes or high blood pressure; in migraines with auras estrogen can increase the risk of blood clots, leading to a heart attack or stroke. It's also not ideal for breastfeeding moms since estrogen can reduce milk supply.

?Continuous dosing pills require you to take one pill for 84 days, then take 7 days off during which time you will get your period. It's a good option for women who only want to deal with the side effects of menstruation 4 times a year. Eventually, most women who take these types of pills will not get periods at all, but breakthrough bleeding is common when first starting this type of pill.

 ?Progestin-only pills, or minipills, have no estrogen, which makes them an option for women who might not be able to take the combination form, although they are considered a less effective form. You should ask your doctor if progestin-only pills are an option for you. Pills come in packs of 28 active pills and a period happens in the last week of the pack. Some women complain this type of pill causes acne, weight gain, excess hair growth and depression.

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