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Mga Contraceptive

The Effectiveness of Oral Contraceptives

Oral contraceptives are a popular and highly effective method for preventing pregnancy. Available in two main types—the progestin‑only pill (POP) and the combined oral contraceptive pill (COC)—these pills work by regulating hormones to prevent ovulation and create conditions that make it harder for sperm to reach an egg. Understanding how each type works and their effectiveness can help Filipinas make informed choices about family planning.

What are oral contraceptives?

Oral contraceptives are daily pills taken by women to prevent pregnancy. They come in different formulations—but two common ones are the progestin-only pill (POP) and the combined oral contraceptive (COC).

  • The POP contains only progestin (no estrogen), which makes it suitable for certain populations (for example, breastfeeding mothers).
  • The COC contains both estrogen and progestin, and works through a few mechanisms: preventing ovulation, thickening cervical mucus, and altering the uterine lining.

How effective are they?

Progestin-Only Pill (POP):
With perfect use, the pill is about 99% epektibo (meaning about 1 in 100 women might get pregnant in a year). With typical use (which allows for missed pills, timing issues), the effectiveness is about 91% (so about 9 in 100 may get pregnant in a year) for the POP.

Combined Oral Contraceptive (COC):
The COC is equally effective as the POP, with perfect-use effectiveness around 99% and typical-use effectiveness around 91 %. The COC may also offer additional benefits, such as more regular menstrual cycles, reduced cramps, and improved acne, but it may not be suitable for women with certain cardiovascular risks or those over 35 who smoke.

What this means practically:

  • If you always take your pills exactly as prescribed (same time each day, no missed doses), your risk of unintended pregnancy is very low (<1%).
  • In real life, missing pills, taking at variable times, vomiting/diarrhea (which can reduce absorption), or interactions with other medications can increase that risk—hence typical‐use figures (~9 in 100 per year) are higher.
  • Effectiveness also depends on user consistency, timing, and ensuring there are no interfering factors (e.g., certain medications, gastrointestinal issues, etc.).

Key factors influencing effectiveness

  • Timing & consistency: With any daily pill method, taking it at the same time every day is important. For POPs, especially older formulations, the “window” (how late you can take it) may be narrower.
  • Missed pills or delay: Even one missed pill or taking late can reduce protection and may require use of a backup method (e.g., a condom) for a few days.
  • Interacting conditions or medications: Some medications (e.g., certain anticonvulsants, antibiotics, herbal supplements) or vomiting/diarrhoea can reduce pill effectiveness.
  • Breastfeeding / postpartum period: POPs are often recommended during breastfeeding because they don’t contain estrogen, which may affect milk supply less.
  • Health risks & contraindications: COCs contain estrogen, so for women who smoke and are over age 35, or have certain cardiovascular risks, the risks may be higher. POPs may be safer in those contexts.

So what should someone choosing an oral contraceptive pill keep in mind?

  • Match the method to your lifestyle: If you’re confident you can take a pill on time every single day, either POP or COC may work. If your schedule is hectic, you might consider methods with less reliance on daily adherence (such as mga injectable or IUDs).
  • Have a discussion with your healthcare provider: They can help assess your health history (smoking status, age, risk for blood clots, whether you’re breastfeeding, etc.) and pick the most appropriate pill type or other method.
  • Be aware of what “typical use” means: Real-world effectiveness is lower than ideal due to human factors (missed doses, late doses, etc.). Understanding that and planning for backup measures helps.
  • Use backup if needed: For example, if you miss a pill, or vomit/diarrhea within 2–3 hours after taking a pill, use condoms as a backup method for 7 consecutive days.
  • Monitor and follow up: If you experience side effects, dislike your pattern of bleeding, or change medications or health status, revisit with your provider.

Oral contraceptive pills—both progestin‐only and combined estrogen-progestin types—are highly effective when used correctly, with perfect‐use effectiveness approaching or exceeding 99%. Under typical real‐world use, effectiveness drops (to about 91 % in many sources) mainly because of human factors like missed or late pills. Choosing the right pill, using it consistently, and managing risks with professional guidance makes a big difference.

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References

Department of Health Philippines, & World Health Organization Philippines. (2023). The Philippine family planning handbook (2023 ed.). https://cdn.who.int/media/docs/default-source/wpro—documents/countries/philippines/reports/phfphandbook-compressed.pdf

TRUST. (n.d.). Progestin-Only Pill. https://trust.ph/methods/progestin-only-pill/

TRUST. (n.d.). Combined Oral Contraceptive (COC). https://trust.ph/methods/combined-oral-contraceptive/

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