CONTRACEPTIVE PILL “THE PILL”: PRESENTATION
The drug companies realized that there would be ‘gold in them there pills’, and consequently there are lots on the market. This breeds a bit of confusion among the pill takers, when they realize they are on one type of pill, and all their friends are on different ones. Are some better than others? Generally no. In fact some of the ‘different’ pills are in fact identical, but made by a different company, so have a different brand name and packaging. Some have different doses and some contain different types of progesterone, but they all work in the same way.
There are many presentations of the pill. All contain combinations of oestrogen and progesterone. Some of the commonly prescribed ones include:
• 30 microgram oestrogen—stable dose—21-day or 28-day (which includes seven ‘sugar’ tablets as well as the twenty-one hormone tablets). The idea of the sugar tablets is so the taker gets into a routine of taking a pill every day. The sugar pills do not make you fat. You don’t actually have to eat them if you don’t want to. Trade names: Microgynon 30, Microgynon 30 ED ‘every day’, Nordette 21 and Nordette 28.
• 35 microgram oestrogen—stable dose—21-day or 28-day package. Trade names: Brevinor, Brevinor-1.
• 50 microgram oestrogen—stable dose—21-day or 28-day packets. Trade names: Microgynon 50, Microgynon 50 ED, Nordette 50, Nordiol, Nordiol 28, Norinyl-1, Ovulen.
• Triphasic and Diphasic packets—21 -day or 28-day. These vary the amount of hormone taken throughout the month, but work in the same way to prevent ovulation. Some triphasic preparations have a lower overall dose of hormone when added up for the month. Trade names: Triphasil, Triphasil 28, Triquilar, Triquilar ED, Synphasic 28-day (35 microgram oestrogen), Biphasil (50 microgram oestrogen), Sequilar ED (50 microgram oestrogen).
• Preparations with other progesterones are also available. These specific progesterones may be more suitable for some people, as they are less likely to adversely affect skin (acne and hair growth). Trade names: Diane 35 ED, Marvelon.
When starting the pill for the first time, often the lower dose (30 microgram) pill, or a triphasic preparation will be prescribed. If ‘breakthrough bleeding’ occurs regularly, a higher dose may be prescribed. Breakthrough bleeding or spotting is not uncommon when first starting any pill, and will usually settle down within three months. If it doesn’t it may be worth trying a different pill.
The higher dose (50 microgram) pills may be better for people with certain problems, such as acne, breakthrough bleeding, or people taking certain medication already. Tablets for epilepsy, among others, can interfere with the effectiveness of the pill, so a higher dose is required to provide adequate contraception. If you are on a regular or frequent medication, check with your doctor about interactions with the pill. Together, a woman and her doctor can work out the alternatives. It is not uncommon for women to find they tolerate one type of pill better than another. Women may try several different ones before finding a pill they are happy with.
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