This question opens the door to soooo much information, so let’s take it one bit at a time.
First of all, to know if you’re taking your pill correctly, we need to know why you’re taking a birth control pill.
There are two primary reasons that women take birth control pills:
- Contraception – to prevent pregnancy
- Cycle control – to control the amount/timing of uterine or menstrual bleeding, hormonal fluctuations, etc.
Preventing pregnancy is pretty straightforward – the package insert will tell you when the contraceptive effect begins after starting a pill (we’ll get back to this), what to do if you missed a pill or two, and which medication interactions might render them ineffective.
Cycle control is straightforward up to a point… and then it gets pretty complicated. Birth control pills cause a tremendous number of Taharas HaMishpacha shaylas, and probably resolve an equal number! We’ll talk the basics in an upcoming post, but just realize that when we talk about birth control pills and the impact of hormones on the body, we’re pitting some aritifically introduced hormones against the body’s naturally occuring ones, i.e. there’s a lot going on in there.
But wait! Before we unpack either of those topics, let’s quickly review the two categories of birth control pills.
- Progesterone only pills (aka the minipill)
- Combined oral contraceptive pills (containing both progesterone and estrogen)
(Just an FYI – there are both progesterone-only and combination pills that are NOT birth control pills and will not prevent pregnancy. We’re not going to be talking about those with this question.)
Progesterone and estrogen work together to build and support the uterine lining. An imbalance or inconsistency can lead to irregular bleeding (including very short or very long cycles) and breakthrough bleeding. (They also impact ovulation, but more on that later.)
You’ll hear both estrogen and progesterone described as “stabilizing” the uterine lining. Tricky. How exactly do they work together? Analogies abound, but I think today I’ll go with a wall made with rebar and cement. The estrogen is what builds up the uterine lining, giving it true form – we’ll call it the rebar. Progesterone holds the uterine lining in place; it keeps it from shedding, and at the same time prevents it from growing out of control. We’re going to call it the cement, which essentially turns the rebar into a wall or structure. Without cement to give rebar a purpose, you just have a jungle of metal (sounds unsafe, no?). Without rebar, a cement wall can easily crumble.
Different pills will have different amounts of the hormones (and there are a number of different artificial progesterones used in pills, which vary from country to country). “The best pill” will be different for different women for any number of reasons, including why they’re taking it and how they personally respond to artificial hormones.
Ok – that was all introductory stuff. Don’t worry, I don’t think I’ve answered the question yet either! Stay tuned for another post. 😉
P'nima Wellness 