Diseases

Side effects - pill

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High contraception, but not free from Side effects: pill is very likely to prevent pregnancy, but often causes side effects such as nausea, weight gain or headache. Sometimes it comes to life-threatening blood vessel obstruction (thrombosis). Read more about different generations of the pill, side effects, and what signs to consult with the doctor.

Four generations of anti-baby pill

Side effects of medications can never be ruled out. This also applies to the contraceptive pill. After being launched on 18 August 1960 for the first time, its composition and dosage has been constantly evolving. The aim of the development was and is to reduce the risk of possible side effects such as life-threatening occlusions.

There are now four different generations of pills on the market, which differ in the amount, type and composition of the synthetically produced hormones. As a result, more than 50 contraceptive products are available that provide additional benefits such as less bleeding, less menstrual migraine, and improved acne. Despite the good effect and beneficial side effects, the drug is also known for its sometimes very dangerous side effects.

Pill: Low to severe side effects

The pill may have fewer serious side effects, usually less than a few months after the first dose.

If the pill contains the hormones estrogen and progestogen ("combination preparation"), the following side effects are possible:

  • circulatory disorders
  • bloating
  • nausea
  • increase in weight
  • mental disorders such as depressive moods
  • breast tenderness
  • a headache
  • dry vagina
  • less desire for sex

If the pill contains only progestin (mini-pill) the following side effects are possible:

  • circulatory disorders
  • Cysts on the ovaries
  • acne
  • weight changes
  • a headache
  • breast tenderness
  • bloating
  • less desire for sex
  • Masculinization like facial hair or deeper voice

Dangerous side effects

Pill, like most highly effective drugs, can cause serious, sometimes life-threatening side effects, albeit rarely. This includes:

  • Thrombosis (occlusion of the blood vessels)
  • Heart attack
  • sudden circulatory disorders (apoplexy) with, for example, stroke as a consequence
  • Cervix or breast cancer
  • Decrease in bone density

For decades, it has been researched to what extent the pill increases the risk of these side effects. Since there is not one type of pill, but more than 50 different preparations and the risks depending on the age of the women, the duration of use and the living conditions (such as smoking or obesity), there are countless scientific studies on this. The experts are currently not all agree on the probability of the pill causes side effects such as the closure of the blood vessels. Although such unwanted effects are relatively rare, users should be aware of it.

Pill: cardiovascular diseases such as thrombosis

The rare but possible side effects of the estrogen plus progestin pill include cardiovascular diseases such as blood vessel obstruction (thrombosis), heart attack or circulatory disorders. Especially in women with obesity, high blood pressure, diabetes mellitus and smokers, the risk is increased by the pill. Even long-haul flights in combination with the pill promote blood vessel closures. As the woman ages (over 35 years), the general risk of developing thrombosis as a result of the pill increases. Regardless of age, the risk of a blood clot in the first year of taking combined drugs is increased. Overall, however, the risk of thrombosis is lower than during pregnancy and in the first three months after delivery.

Estrogen (usually ethinyl estradiol) in high concentrations increases the risk of blood vessel obstruction. Therefore, in recent decades, the dose of estrogen in the pills has been lowered. However, not only is estrogen responsible for thrombosis, but also progestogen. This hormone is included in the pills as, for example, levonorgestrel (2nd generation), drospirenone (3rd and 4th generation), desogestrel (3rd and 4th generation) or cyproterone acetate (4th generation). Levonorgestrel is considered safer. In France, therefore, the costs for the pills of the 3rd and 4th generation are no longer taken over by the health insurance companies.

In Germany, however, there is agreement that these pills can also be prescribed for young and healthy women: The European Supervisory Authority EMEA and the Federal Institute for Drugs and Medical Devices (BfArM) note that the benefits of safe family planning outweigh the risk of side effects. The risk of thrombosis is one of the rare side effects.

Pill: cancer risk and bone density

The influence of hormone preparations on the development of cancer has not been conclusively explored. Overall, women who have taken the pill appear to have a slightly increased risk of breast cancer. However, the use of hormonal contraceptives is not discouraged.

The pill reduces the risk of getting ovarian and cervical cancer. It is unclear to what extent the pill has an influence on the development or prevention of uterine or colon cancer.

Women who take a pill containing estrogen and progestin (combination preparation) have a lower bone density than women who do not take the pill.

Responsibility of the medical profession

Because taking the pill is associated with potentially life-threatening cardiovascular disease, physicians should carefully weigh the benefits and risks for each individual patient before prescribing. Then he will choose the individual most appropriate pill type - one with high contraceptive protection and the lowest possible side effects.

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