Birth Control Pills

Birth control pills, also referred to as oral contraceptive, are hormone drugs that are taken to hinder unplanned pregnancies. They control the conception by hindering the ovulation and complicate the passage of sperms from the cervical os. They contain the hormones estrogen and progesterone, which are normally synthesized in women, in varying amounts.

How are birth control pills used?

The first pill is taken within the first three days of the period. One pill is taken at exactly same time of every day. There are various commercially available preparations that contain 28 and 21 tablets. 28-tablet preparations are used without any interruption, while one week should elapse after a 21-tablet preparation is used before the new preparation is started.

Side Effects of Birth Control Pills

Transient and mild side effects are nausea, intermenstrual bleeding, headache, poor libido, sensitive breasts and mood alterations. In this case, you need to consult your doctor and if they persist, your doctor may advise switching either to another birth control pill or another birth control method.

The serious risk arising out of the birth control pills is the increased risk of coagulation. Clot formation may result in deep vein thrombosis, heart attack, stroke and pulmonary embolism. However, this risk is quite low. The risk may be increased by obesity, hypertension, sedentary lifestyle, smoking, family history of clot formation and genetic factors. You should, therefore, get a pelvic exam and be advised by your doctor before you start to take any birth control pill.

Do Birth Control Pills Delay the Period?

They do not delay the period if properly used. You are expected to menstruate within one week when all pills of 21-day preparations are taken or while taking the last 7 tablets in 28-day preparations. If your period has delayed, you should necessarily consult your doctor.

Coil (Intrauterine Device)

Intrauterine device (IUD) is one of the birth control methods and it is colloquially referred to as coil. The intrauterine device, measuring approximately 2 to 3 centimeters in length, is a coil- or T-shaped device made of metal or plastic. The conception is hindered by the copper wires wrapped around the coil.

The coil occupies the intrauterine cavity and hinders implantation of the egg, even if it is fertilized. Thus, unplanned pregnancies are hindered and the birth control is ensured.

How is the coil used?

It is usually recommended to place the intrauterine device at the end of the menstrual cycle. Since the cervix will be wider during the period, the coil can be easily inserted. However, it can be used for women, for whom pregnancy is ruled out with a pregnancy test, even if the woman is not in the period. Placement of an intrauterine device takes several minutes. Uterine structure and position is evaluated with a pelvic exam and an ultrasound scan before the procedure. If there is no contraindication for an intrauterine device, a speculum is inserted and the cervical os is cleaned with antiseptic solution. The cervix is grasped with a surgical instrument, called tenaculum, to place the uterus in optimal position and the intrauterine device is safely inserted with the applicator. The wire of the intrauterine device is shortened to 0.5 to 1 cm and the procedure is ended. A woman may feel a mild contraction and cramp-like pain in the groin while inserting the coil. Painkillers may be advised to be taken before the procedure in order to prevent such conditions. Very mild bleeding may be observed in the cervical os, after the intrauterine device is placed.


Effects of Intrauterine Device

Placement of an intrauterine device does not cause a side effect in most cases. However, potential side effects are inguinal pain, prolonged menstrual pain, long periods and intermenstrual bleeding.

How long can an intrauterine device be used?

The contraceptive effect of the intrauterine device starts immediately after it is inserted and terminates when it is removed. The intrauterine devices commercially available in our country offer 5- to 10-year contraception.


Pregnancy Estimation Methods

Although the exact time of conception is almost never known, the first day of the last menstrual period is used to estimate the gestational age (week) of the fetus. The estimated due date relative to the last menstrual period is 280 days or 40 weeks, also colloquially called 9 months and 10 days, from the first day of the last menstrual period. For women with irregular menstruation or who cannot remember the first day of the last menstrual period, it is not possible to estimate the gestational age and therefore, the gestational age is determined with an ultrasound scan within the first three months (trimester) of the pregnancy and thus, the estimated due date is clarified.