MYTHS ABOUT CONTRACEPTIVES!

Prof. Teksen Çamlıbel, M.D. Obstetrician and Gynaecologist Contraceptives have significantly developed in parallel with the developments in medicine. Studies are underway to develop a pill with the highest protection and lowest adverse effect. Contraceptives have been in use for nearly fifty years in the world and they have been used in our country for years. However, we observe that people still lack sufficient information about the adverse effects of contraceptives. A lot of women avoid these medications even in cases where they are necessary. Our aim, therefore, is to evaluate the latest medical studies through the questions we often hear from our patients and the very same questions that cause them to discontinue contraceptives. - Do contraceptives interfere with the hormones? Contraceptives contain oestrogen and progesterone to some extent. These have been developed throughout the years and synthetically produced with an aim to act similar to human hormones and affect hormonal activity. On the contrary, they bring a certain balance to women with hormonal disorders. Should they be taken by patients with irregular menstrual bleeding, they help with regular bleedings. They also help decrease the amount of bleeding -which is not a side effect. In this way, they prevent massive bleedings in some patients. Contraceptives on the market are very similar though each contains different hormones. Your doctor will help you decide the most suitable one. - Do contraceptives cause weight gain? We acknowledge that contraceptives cause an increase in appetite and a slight weight gain due to water retention in the early stages; however, it is agreed that they do not cause weight gain in the long run. So please do not discontinue your medication due to such changes in the first months without consulting your doctor and while taking your pills make sure you have a healthy diet and an active life. - Would contraceptives cause ovarian cysts? Ovarian cysts can be caused by many things but follicle cysts -which develop if the sac (the follicle) including the egg does not break open and release the egg- are benign. Should they be monitored for a few months they would regress automatically. Doctors often prescribe contraceptives so that follicle cysts regress or disappear. Therefore contraceptives would not cause ovarian cysts, on the contrary, they can be useful for treating some. - Do contraceptives cause unwanted hair growth? Contraceptives contain hormones and repress hormones that cause unwanted hair growth. They do not cause unwanted hair growth. On the contrary, contraceptives are taken by some women who suffer from unwanted hair growth to prevent it. - Taking contraceptives do I have a lower chance of pregnancy? The effects of contraceptives are limited to their time of use only; in other words, they are ineffective after you discontinue the medication. But 1% of women taking contraceptives may suffer from amenorrhoea which will disappear after a certain time. To summarise we can say that contraceptives will not cause any lower chance of pregnancy or menstrual irregularities after you discontinue. - Do contraceptives cause cancer? To answer this question we need to discuss each female genital organ: ENDOMETRIAL CANCER: Studies have shown that women taking contraceptives have a lower risk of endometrial cancer compared to women not using any. As contraceptives contain a regular and balanced amount of oestrogen and progesterone hormones, they help endometrium grow and discharge regularly therefore the risk of cancer is lower. OVARIAN CANCER: Contraceptives are effective by repressing ovulation, in a way they help ovaries rest. Studies have shown that contraceptives lower the risk of ovarian cancer. CERVICAL CANCER: Some studies have proved that contraceptives slightly increase the risk of cervical cancer. However, when we reevaluate the studies we see that those women are already included in the risk group. Oral contraceptive use is associated with cervical cancer risk, particularly with longer use. Cervical screening should follow the recommended schedule for the person’s age and screening history. BREAST CANCER: The effects of contraceptives on breast cancer is still a controversial issue, but we acknowledge today that they do not increase the risk of cancer. On the contrary, it is a well-known fact that contraceptives prevent benign breast diseases from further developing. - Do contraceptives cause headaches? Contraceptive suitability depends on the method and migraine type. Estrogen-containing combined contraception should not be used with migraine with aura. New or changing headaches should be assessed before deciding whether to continue a method. - For how long can I take contraceptives? Some contraceptive methods can be used during perimenopause, depending on age, health and the method. The combined pill is generally not recommended from age 50; a clinician can advise when contraception can be stopped or changed. - Should I take a break from contraceptives? You do not need to take a break from contraceptives. Hormonal contraceptives alter the menstrual cycle; combined pills usually prevent ovulation. There is no study to confirm that a break is needed with an aim to give the organs a rest. While taking contraceptives some women may suffer from amenorrhoea, we recommend you to consult your doctor in such a case. It may either be caused by pregnancy or mostly by the fact that the low dosage of medications keep the endometrium thin, so withdrawal bleeding may not occur. - Can women with hypertension take contraceptives? People with hypertension should discuss contraceptive options with their clinician; combined hormonal contraceptives are generally not recommended even when hypertension is controlled. - Who should not take contraceptives? First, any woman must consult a doctor before taking contraceptives. But here we will address conditions that are not favorable for contraceptives:

Women with blood coagulation disorders or advanced varicose veins and women who have a tendency to varicose veins,
Smokers over the age of 35 (more than 15 cigarettes a day). It is okay for current non-smokers who have once been smokers to take them,
Women with liver diseases,
Women with severe migraines.