In this article, we'll be explaining the importance of birth control, how birth control pills work, how to take it and the different kinds of birth control pills available in Singapore.
But first, let's go straight to that burning question you've been meaning to ask:
In order to get any type of birth control (be it pill, patch or ring), you will need to see a doctor and get a prescription for it.
In addition, you will also need to be above the age of 16 in order to be prescribed birth control pills or any other birth control method.
Also known as contraception, birth control refers to any method that can be used to prevent unwanted pregnancies from happening. Birth control methods can include condoms, birth control pills, practicing the rhythm method, IUDs and tubal ligation.
It is important you use birth control if you are sexually active with your partner. In a study done by the National University Hospital (NUH) in Singapore, researchers found that 84% of couples who did not use any birth control methods got pregnant within a year and 92% of those same couples got pregnant within 2 years.
Besides pregnancy prevention, women can also use birth control for other purposes. Hormonal birth control can be taken to manage period cramps and symptoms of PMS, regulate periods and keep hormonal acne breakout under control. Hormonal birth control can also help reduce the risk of developing ovarian and uterine cancer.
Birth control pills are available in different forms, either as a combination pill (Yasmin, Yaz) or as a progestin-only pill (Cerelle, Cerazette).
Combination birth control pills work by using both estrogen and progestin hormones to prevent ovulation. These birth control pills also help to thicken the mucus present in your cervix which makes it more difficult for the sperm to reach and fertilize the egg.
As the name implies, progestin-only pills contain only progestin. Similar to combination birth control pills, progestin-only pills will prevent ovulation, thicken the mucus present in the cervix to make it difficult for the sperm to reach and fertilize the egg, and thins the uterine lining to prevent the fertilized egg from implanting itself.
It is possible for both combination and progestin-only birth control pills to achieve a 99% effectiveness rate, but only if used perfectly. "Perfect use" refers to when the birth control pill is taken at the same time every day, without fail.
"Typical use" refers to when the user occasionally forgets to take their dose of birth control pills or forgets to start a new pack of birth control pills. This is how most women will take birth control pills and while it does increase the likelihood of the birth control failing and accidental pregnancy occurring, typical use still has a high effectiveness rate of 91%.
Similar to other methods of birth control, birth control pills can make periods lighter and reduce the severity of period cramps.
You might even experience improvements to your skin if you take combination birth control pills. In a study done by the International Journal of Women’s Dermatology, researchers credited these improvements in skin quality to the hormones present in the birth control pill. These hormones were able to suppress androgen production, which in turn prevents the breakout of acne and regulates the skin's oil production.
It is important to note that while birth control pills can effectively prevent pregnancies, they will not prevent or protect you and your partner from contracting sexually transmitted diseases (STDs) like chlamydia, gonorrhea or HIV. You and your partner will need to practice safe sex and use a condom.
As different types of birth control pills will have different dosing schedules, it is important to refer to the instruction pamphlet provided. Most combination birth control packs either come in a 21-day pack or a 28-day pack (which contains placebo pills).
You will need to take your birth control pill consistently everyday, at the same time. You don't have to take your birth control pills in the morning but taking them first thing in the morning or with your coffee might be an easy way to incorporate it into your daily routine and prevent you from forgetting to take it.
It is not necessary to take birth control with food, but if you are susceptible to nausea, do have a snack or meal with it.
Here is a list of the common birth control pills available in Singapore:
Yasmin is a combination birth control pill that contains both progestogen and oestrogen.
Yasmin contains 2 hormones (a progestin hormone called drospirenone and a estrogen hormone called ethinyl estradiol) and prevents unwanted pregnancies by preventing ovulation from occurring during your menstrual cycle. Besides preventing ovulation, Yasmin also causes the fluids in your vagina to thicken which prevents the sperm from reaching the egg and fertilizing it, as well as thinning the uterine lining to prevent a fertilized egg from attaching itself to it. By preventing a fertilized egg from attaching itself to the uterus, the fertilized egg will then pass out of the body.
Diane-35 is a combination birth control pill that contains 2 active ingredients: cyproterone acetate and ethinyl estradiol. Cyproterone acetate is an antiandrogens, while ethinyl estradiol is a hormone called estrogen.
Together with cyproterone acetate and ethinyl estradiol, Diane-35 prevents pregnancies by delaying or stopping ovulation from taking place. It thickens the cervical mucus to prevent the sperm from fertilizing the egg as well as thinning the womb lining to make it more difficult for the egg to attach itself to if it gets fertilized. With the prevention of the fertilized egg being implanted in the womb, it will then pass out of the body.
Microgynon 30 is a combination birth control pill that contains 2 active ingredients: ethinylestradiol and levonorgestrel. These active ingredients are similar to the female hormones, progesterone and oestrogen, and prevent unwanted pregnancy from occurring.
Together with ethinylestradiol and levonorgestrel, Microgynon 30 prevents pregnancies by delaying or stopping ovulation from taking place. It thickens the cervical mucus to prevent the sperm from fertilizing the egg as well as thinning the womb lining to make it more difficult for the egg to attach itself to if it gets fertilized. With the prevention of the fertilized egg being implanted in the womb, it will then pass out of the body.
Mercilon is a combination birth control pill that contains 2 active ingredients: ethinylestradiol and desogestrel.These active ingredients are similar to the female hormones, progesterone and oestrogen, and prevent unwanted pregnancy from occurring.
Together with ethinylestradiol and desogestrel, Mercilon prevents pregnancies by delaying or stopping ovulation from taking place. It thickens the cervical mucus to prevent the sperm from fertilizing the egg as well as thinning the womb lining to make it more difficult for the egg to attach itself to if it gets fertilized. With the prevention of the fertilized egg being implanted in the womb, it will then pass out of the body.
When taking birth control pills daily, you might experience the following side effects:
- Weight gain
- Increased nausea
- Breast tenderness.
While most of these side effects will most likely subside over time, there is a very small possibility that birth control pills could cause you to develop cardiovascular health issues like strokes or blood clots.
If you are a regular smoker or over the age of 35, it is important that you discuss with your doctor whether birth control pills are suitable and safe for you.
It is important that you contact your doctor promptly or seek medical assistance if you begin to experience the following serious side effects:
- An increased blood pressure
- Uncontrollable movements in the legs or arms
- A decreased blood flow to your extremities.
- Vision or hearing changes
- There is a change in your vaginal bleeding (persistent spotting, missed periods or sudden heavy bleeding)
- Dark patches on your skin (melasma)
Combination birth control pills like Yaz and Estrostep can also affect your sex drive, causing either a noticeable increase or decrease.
As mentioned earlier, birth control pills can have an effectiveness rate of 91% - 99%, but this will only be possible if you take your pills as prescribed by your doctor and taken consistently everyday, at the same time. The effectiveness will diminish if you miss your dose of birth control pills.
So what should you do if you accidentally forget to take your birth control pill?
You should refer to the pamphlet of your birth control pills immediately as different types of birth control pills will have different dosing schedules and instructions on how many pills to take if you forget to take them for a full day.
If you forget to take your birth control pill at your usual time, you should take your pill as soon as you remember on the same day.
If you are unsure on how many pills to take after having missed taking your pills, do contact your doctor for further instructions.
If you do miss a dose of your birth control pill, it is highly recommended that you use a back-up non-hormonal contraceptive method (like condoms) until you finish your pack of birth control pills. If you do have unprotected as missing a dose of birth control, there is a possibility that you might need to take an emergency contraceptive pill. You should contact your doctor immediately for further advice if you think you might be pregnant.
Emergency contraception refers a birth control method that is used to prevent pregnancy after having unprotected sex. It is highly recommended that emegency contraception should be used as soon as possible after having unprotected sex as this will increase their effectiveness at preventing pregnancy. However, emergency contraception can still be used between 72 to 120 hours after unprotected sex and be effective.
Emergency contraception prevents pregnancies either by delaying ovulation or by killing the sperm before it reaches the egg and fertilises it. It is important to note that emergency contraception does not induce an abortion.
You should use emergency contraception if any of the following has occurred:
- You and your partner had unprotected sex.
- You think your birth control method has failed
- You forgot and missed taking 2 or more days of your birth control pills
Contraception Booklet - NUH | National University Hospital (Link)
Trivedi, M K et al. “A Review of hormone-based therapies to treat adult acne vulgaris in women.” International journal of women's dermatology vol. 3,1 44-52. 30 Mar. 2017 (Link)