any over-the-counter (nonprescription) drugs, prescription medications, and herbal supplements may lower the effectiveness of the pill, and the pill may interfere with another drug’s effec­tiveness. When you take medications, you should always let your healthcare provider know that you are on birth control pills. Drugs that interact with oral contraceptives in­clude the following:


Acetaminophen (Tylenol)

Alcohol (beer, wine, mixed drinks, etc.)

Anticoagulants (Heparin, Coumadin, aspirin)

Antibiotics (Amoxicillin, Tetracycline, Ampicillin) Antidepressants (Prozac, Paxil)

Antifungal medications (Grisactin)

Barbiturates (Seconal, Nembutal)

Vitamin C

St. John’s wort (Hypericum)


In addition, women who take oral contraceptives should avoid Orlistat (drug developed to block fat absorption) be­cause it has been shown to reduce absorption of oral con­traceptives. Women should also avoid eating more than 10 to 50 gm a day of black licorice, which may increase blood pressure and water retention while on oral contraceptives.

Source: Hatcher et al., 2004.


Decreases effect of pain relief.

Increases effect of alcohol.

Decreases anticoagulant effect. Aspirin may be less effective when used with oral contraceptives.

May decrease effectiveness of oral contraceptives.

Increases blood levels of antidepressant.

Can cause breakthrough bleeding and spotting.

Decreases effectiveness of oral contraceptives.

May increase estrogen side effects in daily doses of

1,0 mg or more.

Decreases effectiveness of oral contraceptives.

May reduce caffeine metabolism.

have an increased risk for breast cancer. Furthermore, birth control pills may offer some protection from ovarian and endometrial cancers, and may reduce the risk of breast and uterine fibroids and/or cysts (Deligeoroglou et al., 2003; Hatcher et al., 2004).

Effectiveness Effectiveness rates for combination birth control pills range from 92% (typical use) to 99.7% (perfect use). To be effective, the pill must be taken every day, at the same time of day.

Advantages If used correctly, oral contraceptives have one of the highest effec­tiveness rates; do not interfere with spontaneity; reduce the flow of menstruation, men­strual cramps, and premenstrual syndrome; increase menstrual regularity; and reduce the likelihood of ovarian cysts, uterine and breast fibroids, and facial acne. Oral contracep­tives also provide important degrees of protection against ovarian and endometrial can­cers, pelvic inflammatory disease, and benign breast disease (Hatcher et al., 2004). In addition, use of oral contraceptives may increase sexual enjoyment because fear of preg­nancy is reduced and they are convenient and easy to use. The pill offers rapid re­versibility, and the majority of women who go off the pill return to ovulation within 2 weeks (Hatcher et al., 2004).

Disadvantages Oral contraceptives must be taken daily, offer no protection from STIs, and put all the responsibility for contraception on the female. They can be ex­pensive and their effectiveness is decreased when certain other medications are used. In addition, they may also contribute to increased risk of STIs because birth control users tend to be poor users of condoms. Women who are overweight may experience lower ef-

fectiveness rates using oral contraceptives (Holt et al., 2004). In addition, women who smoke cigarettes should not use birth control pills. Heavy smokers who take birth con­trol pills have been found to increase their risk of heart attacks (Rosenberg et al., 2001).

Подпись:Подпись:Cross-Cultural Use Birth control pills have been used by more than 100 million women throughout the world (Hatcher & Nelson, 2004), and in many countries— including Australia, Argentina, Austria, Botswana, Brazil, Canada, Costa Rica, Cuba, Denmark, Finland, France, Germany, Hong Kong, Italy, Mexico, the Netherlands, Norway, Puerto Rico, Spain, Sweden, Switzerland, and the United Kingdom—they are the most popular contraceptive method (Francoeur & Noonan, 2004). In Costa Rica, Hong Kong, and Mexico, birth control pills are available over the counter without a pre­scription (Arroba, 2004; Ng & Ma, 2004).

In some countries, birth control pills are used, but they are not the most popular contraceptive choice. This would include countries such as the Czech Republic, Korea, China, Greece, India, Israel, Kenya, Nepal, Russia, Turkey, and Japan. In Russia, birth control pills are thought to be unsafe and unreliable (Kon, 2004). Prior to the pill’s ap­proval in 1999, it was not available for contraceptive use in Japan (Goto et al., 1999). Approval didn’t come easy, and the restrictions on pill use are strict. For example, con­traceptive pill users in Japan are required to have gynecological exams every 3 months and are expected to pay for all of their contraceptive pill expenses (with no insurance coverage). As in the United States, when safety reports about contraceptive pill use are issued, usage rates tend to decrease outside the United States.

Drugs and Herbs That Interact With Oral ContraceptivesQuestion: Last week I lost my pack of birth control pills and did not have time to go to the student health center. My roommate let me take a few of her pills. Is this okay?

This is not a good idea. Because there are many different types of pills, with different levels of hormones in them, your roommate may not be taking the same kind of pill. Also, with the new triphasil pills, if you took someone else’s pills and they were not the same, you could be at risk of get­ting pregnant. The best idea would be to make time to refill your own prescription and use another method of contraception until you start a new pack of pills.