Combined oral contraceptives (COCs) are pills that are taken once a day to prevent pregnancy. They contain two hormones similar to the natural hormones in a woman’s body---an estrogen and a progestin. These are also known as birth control pills.

These contraceptive pills stop ovulation i.e. release of eggs from ovaries; thicken cervical mucus, making it difficult for sperm to pass through; and do not work by disrupting existing pregnancy.

Advantages

Increased sexual enjoyment because no need to worry about pregnancy
Monthly periods are regular; lighter monthly bleeding and fewer days of bleeding; milder and fewer menstrual cramps
Can be used at any age from adolescence to menopause
Can be used as an emergency contraceptive after unprotected sex
Safe and 99% effective if used consistently and correctly
Reversible, rapid fertility return
Pills do not interfere with intercourse
Have beneficial non-contraceptive effects

Disadvantages

Requires daily use
Have common side effects such as nausea, breakthrough bleeding, mood changes and dizziness.
Spotting or bleeding between menstrual periods, especially if woman forgets to take her pills or takes them late
Breast tenderness
Slight weight gain
Not recommended for breast feeding women because they effect quality and quantity of milk
Do not protect against sexually transmitted diseases (STDs)

When to start?

The first day of the menstrual bleeding is best.
Any of the first 7 days after menstrual bleeding has already stopped
After stopping breast feeding or 6 months after child birth
3 to 6 weeks after childbirth.

Helps to prevent

Ectopic pregnancies
Endometrial cancer
Ovarian cancer
Ovarian cysts
Pelvic inflammatory disease
Benign breast disease

Who should not use COC’s

Women who have conditions like pregnancy, breastfeeding, during first six weeks of postpartum, unexplained vaginal bleeding, current breast cancer, liver tumors, active hepatitis or severe cirrhosis, age of 35 or older, who smoke heavily, blood pressure of 180/110 and higher, diabetes with vascular complications, and stroke symptoms should avoid these contraceptive pills.