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Reproductive medicine

Reproductive medicine

How efficient are pills in protecting from unwanted pregnancy?
  • If taken perfectly regularly, 1-3 out of 1.000 women will get pregnant within a year of taking them
  • If irregular in taking them, 2-3 out of 100 women will get pregnant within a year of taking them
What are pills made of?
  • Estrogen and progestin, the two hormones that usually exist in a woman’s organism
How many women are on the pill?
  • More than 100 million women
How do pills work?
  • They prevent ovulation
  • They change the endometrium
  • They change the vaginal mucus (discharge)
  • Change fallopian tubes’ motility thus reducing sperm’s chances to swim up to the egg, should it be produced
What are the benefits of taking pills?
  • Regular, less painful and low bleeding
  • Reduce acne
  • Reduce hairiness
  • Reduce ovarian and colon cancer risk; reduce risk of endometrial cancer
  • Reduce risk of developing benign ovarian cysts and benign breast tumors
How do I take the pills?
  • The first pill is usually taken on the first day of your period which is the day from which you are protected from getting pregnant
  • You can start taking them on any other day as well, but then you should use additional protection over the following two weeks
  • They are taken either for 21 days after which a 7-day break is made and on day 8 you start with the new set (e.g. you take the last pill from one set on Wednesday, make a pause until next Thursday when you take the first pill from the new set) or for 28 days, starting the new set on day 29. In case of the second example, the bleeding begins several days before the last pill from the first set
  • Menstrual bleeding is usually less in volume or very scarce (a small amount of brown discharge) when on the pill
  • Pills are to be taken at the same time each day with a tolerance of up to 6 hours. If you are more than 6 hours beyond your pill-taking time, we consider the protection to be lowered and additional protection needs to be used over the period of the following two weeks
  • If you forget to take one pill, you should take it as soon as possible and then take the next one in the scheduled time. Again, two weeks of additional protection are advised.
  • If two or three pills are not taken, the whole set needs to be disposed of
What happens if I drink alcohol while taking pills?
  • There are no known interactions between alcohol and birth control pills. This means that the pill’s efficiency is not reduced if you drink alcohol while taking pills. Any wrongdoings will be the result of drinking alcohol.
What are the signs of thrombosis while taking pills?
  • Deep vein thrombosis occurs in one leg. That leg becomes swollen which can be measured using a soft tailor meter. If one leg is more than a centimeter thicker than the other measured at three different heights (ankles, calves, above the knees) – it is swollen. Pain appears and it doesn’t go away when you stand or walk – it gets worse. Sometimes you can observe redness of skin and feel warmth above the place where a thromb occurs.
Can I carry out the pregnancy in case I get pregnant while on the pill?
  • There is no definitive proof that the use of birth control pills in early pregnancy, when you are not aware you are pregnant, does any damage to the baby. In that sense, you can carry out your pregnancy with great chances the baby will be fine and healthy. You should stop taking pills the moment you realize you are pregnant
How long does it take until the body „clears from the pill“?
  • You can conceive immediately. There is no need to „clear from the pill“. There will be no harmful consequences for the baby.
Can I get an STD while on the pill?
  • Yes, you can be infected by all sexually transmitted diseases (STDs) because the pill does not protect you from that. Therefore, when you think there’s a risk of getting an STD you should use a condom.
Is the efficiency of the pill reduced if it is not taken at the same time every day?
  • It is considered that there is a risk of unwanted pregnancy should the pill be taken more than 6 hours after the scheduled time. This increases the possibility of ovulation in the cycle. It is hard to express this in numbers because you may or may not ovulate, and if you do, it is still questionable whether you will have sex on the exact day of such ovulation. However, 2-5 percent of patients who forget to take the pill get pregnant.
Do the pills work from the very first day?
  • Yes, they do
How do birth control pills help women with PCOS?
  • The problem in women with PCOS is in the secretion of male sex hormones in the ovary. This creates a magic circle increasing women’s risks of becoming overweight, developing high blood pressure, diabetes, endometrial cancer, etc. The pills prevent secretion of the male sex hormones and in doing so reduce the risks of developing the conditions numbered here. Women having only PCOS do not need to start taking birth control pills for that reason only because their risks are not increased.
Can acne re-appear once I stop taking pills?
  • They can, but in some women they do not.
What is the effect on the body regarding the level of hormones pills contain?
  • All birth control pills used in Croatia today contain a low dose of hormones so that there is no significant difference between them in terms of influencing the organism. In the past, contraceptives containing 50 or more mcg of ethinyl estradiol per pill were used and they increased the risk of thromboembolism.
How often do I need to make breaks while taking pills?
  • No breaks need to be made.
What are the chances a woman can get pregnant right after she gets off?
  • Nothing in particular happens to your organism. It takes different amounts of time for the organism to get back to as it was before you went on the pill.
    • Your menstrual cycle will most probably return to as it was before you got on the pill
    • It will be as regular or irregular as it had been before pills
    • Sometimes your body will take 2-3 months to adjust and return to as it was before the pills
    • Ovulation is truly unpredictable on the first month after the pill. It may occur at any time during the first cycle after the pill so you may easily get pregnant
What is the best age to start taking pills?
  • You can and may be on the pill as early as adolescent time and all the way to menopause.
Can I get pregnant if I forget to take the pill and have sex 12 hours past the pill-time?
  • In theory, yes. However, ovulation usually happens later during the cycle, if you ovulate at all. To avoid getting pregnant in case you forget to take the pill for such a long time you should use additional protection.
Am I under increased risk of getting pregnant if I throw up right after taking the pill?

Yes.

  • Should you experience vomiting or diarrhea within two hours after taking the pill, a new pill should be taken. If either vomiting or diarrhea is repeated after the second pill that day, you should stop taking pills and use additional protection for 2 weeks. If either diarrhea or vomiting does not happen again, there is no need for additional protection.
  • Should you experience vomiting or diarrhea two or more hours after you took the pill, you do not need to do anything and you do not need to use additional protection because the pill had already been absorbed.
Who shouldn't be on the pill?
  • Pregnant women and women who are breastfeeding up to 6 weeks after giving birth
  • Women diagnosed with the following conditions:
    • Active liver disease, damaged liver function or liver tumor
    • Diabetes with vascular complications
    • Breast cancer
    • History of heart attack, vascular heart disease or a complicated valvular heart disease
    • History of a stroke
    • History of thromboembolic disease
    • Uncontrolled and untreated high blood pressure
    • Migraines with neurological symptoms
    • Broken leg, or broken pelvis due to longer period of bed rest
    • Women over 35 and smokers
What tests do I have to do before and during time on the pill?
  • None, if you are young and healthy
  • If you have a history of conditions, your physician will decide what tests need to be done
  • Liver probes, lipid profile and blood sugar can be done every few years
  • There is no point in doing coagulation tests
What are the possible side effects during the first months?
  • Breast sensitivity, tenderness or pain
  • Nausea
  • Your period practically stops with the first pill
  • Spotting between periods (bleeding in spots, often in the form of brown discharge) or breakthrough (heavy) bleeding
  • Short and scarce bleeding or the lack of it
  • Increased appetite
  • Weight gain, usually 1 or 2 kilos
  • Temporarily make acne worse
  • Mild moodiness and mild depression
  • Reduced libido
How can I reduce side effects of the pill?
  • Side effects are temporary and will go away in 2-3 months
  • Pills are best taken after lunch because it reduces nausea
  • Spotting between periods or breakthrough bleeding does not reduce contraceptive protection and do not mean something’s wrong; they are only side effects. They can even last for a longer period of time, even an entire month
  • Missing a period or having a scarce one do not automatically mean you are pregnant; they are only side effects
  • You do not gain weight because of the pill, but because of the food you eat, so should your appetite increase you need to control it. Gaining 1-2 kilos happens because you retain fluids in your organism and the excess kilos go away in time. It will happen faster if you exercise and avoid salty and spicy food
  • If your libido remains reduced even after a few months on the pill, it can be resolved by switching to another contraceptive
What are common misconceptions about pills?
  • Pills are not unhealthy, their advantages surpass the risks
  • Pills do not cause hairiness, they actually reduce it in most cases
  • They do not cause infertility, but on the contrary, women who were on the pill got more fertile when they went off the pill than women who have never been on the pill
  • Only reason to pause with pills is to get pregnant
  • There is no need for menstrual bleeding. You can continuously be on the pill without any risk to your health. No pause is necessary.
When do I have to contact my physician while on the pill?
  • In case of severe pain in the abdomen that does not go away in time
  • In case of severe pain in the chest, gasping for air or coughing blood, all of which do not go away in time
  • In case of continuous severe headache
  • In case of continuous severe pain in the leg accompanied by swelling
When are pills used as medicine and not only as birth control?
  • In PCOS
  • In cases of endometriosis and adenomiosis
  • In cases of heavy bleeding and, consequently, anemia; in irregular bleedings
  • When your period is painful
  • When you have acne