GYN CHRONICLES
Contraception:
Combined Oral Pill
(COC’s)
By Dr. Maureen Owiti
W
elcome to Gyn Chronicles
once again, and walk with me
as we delve into the issue of
contraception! Pills are a very interesting
form of contraception and I believe the
ideal form of contraception, except if
some of you are like me doing something
every day gets a bit difficult. But for
the disciplined lot, who don’t have any
contraindications this is a pocket friendly
and very effective form of contraception.
As mentioned in my previous article on
the coil or intrauterine contraceptive
device (IUCD), some communities are
quite averse to the term contraception and
prefer words like birth spacing. Whatever
is more comfortable for you the goal is to
help the woman achieve her ideal family
size and it would shock most of us: it
ranges from zero to as many as the Lord
will give us before we stop giving birth.
I always give a caveat and my opening
statement when aiding women to choose
a method is always “There is no method
that is 100% i.e. even on a very effective
method there is still a possibility of
pregnancy!!!!” This then leads to the
question why bother using a method at
all? Well the chances of getting pregnant
i.e. having an unintended pregnancy is
much higher if you are not using anything
so better safe than sorry!
Quick reminder on the various forms of
contraception: They are largely grouped
into permanent and non-permanent/
reversible methods. I usually deal with
the permanent first as they are just two:
Bilateral Tubal Ligation (BTL) for
women that involves cutting a segment
of both fallopian tubes and vasectomy
for men that involves cutting a segment
of the vas deferens that is responsible for
the transport of sperm and again on both
sides.
In the reversible methods we broadly
categorize them into hormonal and
non-hormonal methods. Non hormonal
methods range from withdrawal method
As mentioned in my previous article on the coil or
intrauterine contraceptive device (IUCD), some
communities are quite averse to the term con-
traception and prefer words like birth spacing.
Whatever is more comfortable for you the goal
is to help the woman achieve her ideal family size
and it would shock most of us: it ranges from zero
to as many as the Lord will give us before we stop
giving birth.
22 MAL22/18 ISSUE
(coitus interruptus), fertility awareness
methods, spermicides, male and female
condoms to the use of an intrauterine
contraceptive device (IUCD) or coil as it
is commonly referred to.
In the hormonal methods we again divide
them into progestin only methods, usually
associated with change in menstrual cycle
and combined i.e. they contain both
estrogen and progesterone. These are
hormones found in both men and women
but generally higher concentration in
women. The combined methods will
usually result in regular menstrual flow.
Pills and injections are found in both
groups but the implant e.g. jadelle or
implanon are only available as progestin
only and the contraceptive patch and ring
only come as combined methods.
So from the classification combined oral
pills are a hormonal pill that contain both
estrogen and progesterone and generally
result in cyclic bleeding (regular menstrual
flow). A lot of women are terrified of using
the pill because they tend to forget to take
them. Some solutions lie with ourselves as
I believe everyone reading this article is
digital and can easily put a daily reminder
or alarm. Other ways include putting pills
near your toothbrush and taking them
before or after brushing your teeth as I
also don’t believe there is anyone here who
won’t brush their teeth at least once a day
or link the pill to a daily activity.
How do you take the pill?
Most pills follow the 21 day protocol
whereby the client takes active pills for