Author: Fang Jian, deputy chief pharmacist of The Third Class A Hospital
Speaking of contraceptives, as the name suggests, it is a drug to avoid unwanted pregnancies, which is to achieve the purpose of contraception by inhibiting or blocking the corresponding links in the reproductive process. [1]
Contraceptives are commonly used, and various rumors about it have been constant. Are these rumors true or false? Solve them one by one today.
Question1：
Does long-term use of contraceptives increase cancer risk?
There are rumors that combined contraceptives contain estrogen and progesterone, and long-term use will increase hormone levels in the body and increase the risk of hormone-related gynecological cancers, such as ovarian cancer, cervical cancer or breast cancer.
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Numerous studies have found that changes in estrogen levels and their receptors are the triggers for cervical cancer, and from this perspective, birth control pills do increase the risk of cervical cancer, but this is not the main risk factor, because it is now clear that high-risk human papillomavirus (HR-HPV) infection and sexual behavior are highly associated with cervical cancer incidence [2].
For breast cancer, different study results have inconsistent conclusions, but it is basically clear that the cause of breast cancer is mainly related to genetic factors, and the study found that it is caused by BRCA1 and BRCA2 gene mutations, while the combination contraceptive pill can slightly increase the risk of breast cancer in women carrying BRCA1 mutation genes, but has no effect on carrying BRCA2 genes, and even slightly reduces the risk of breast cancer.
In addition, studies have also found that combined contraceptives can reduce the risk of ovarian cancer, the earlier and longer the first dose, the lower the risk of ovarian cancer, and this effect can last for 30 years even after the combination contraceptive pill is discontinued [3].
Question2：
Do birth control pills reduce female fertility?
Many female friends believe that taking emergency contraceptives can cause menstrual disorders and even cause amenorrhea, which in turn will affect future fertility.
Emergency contraceptives, by inhibiting ovarian function and play a contraceptive role, so its dosage is also relatively large, in the short term may indeed cause menstrual disorders, but after stopping use, women's menstrual cycle will generally return to normal.
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According to statements issued by the World Health Organization and the American Association of Obstetricians and Gynecologists, even if emergency contraception is repeatedly used in the short term, there is currently no conclusive evidence that it will reduce women's fertility. [4]
Conventional contraceptive medication, it is generally recommended to choose short-acting contraceptives, the components of short-acting contraceptives are low-dose estrogen and progesterone, the same is to inhibit ovulation, generally from the day of menstruation from the 5th day to take, even take 22 days, contraception for 1 month, but will not accumulate in the body, will not affect the fertility of women.
Question3：
Do birth control pills increase the risk of cardiovascular disease?
The controversy over whether contraceptives increase the risk of cardiovascular disease has existed since the 1990s, and in general, the occurrence of cardiovascular disease is the result of a multi-factor combination.
Available evidence suggests that contraceptives increase the risk of developing disease in women with cardiovascular risk factors such as smoking, obesity, hypertension, dyslipidemia, and a history of thrombotic disease, but are absolutely at very low risk for women without risk factors. [3]
Therefore, instead of worrying that contraceptives will increase the risk of cardiovascular disease, it is better to actively correct the modifiable cardiovascular risk factors to minimize the risk.
Question4：
Accidental pregnancy after taking birth control pills, can the baby want it?
This is one of the most asked questions in hospital obstetric clinics, and any contraceptive pill is not 100% reliable, so contraceptive failures can also occur.
Many couples will be very conflicted: can a baby who accidentally becomes pregnant after taking medication still want it?
They worry about whether your baby will be teratogenic due to the effects of the drug. In fact, the doctor can answer you this question with certainty: "Of course the baby can want it."
In simple terms, since the contraceptive pill has been taken but is still pregnant, it proves that the contraceptive pill has been invalidated, and in the early stages of pregnancy, the baby is mainly differentiated from single cells to multiple cells, and it is far from the stage of organ development, if you want to say that the contraceptive pill may have an impact on the baby, it may also cause natural abortion, but it will not cause teratogenicity.
Question5：
Why do doctors prescribe birth control pills to 17-year-old sexless teenage girls?
Although the "main business" of the contraceptive pill is to avoid accidental pregnancy, in fact, it also has many "side jobs"!
Clinically used to treat many gynecological diseases, such as abnormal uterine bleeding, premenstrual syndrome, female acne and hirsutism, endometriosis, adenomyosis, dysmenorrhea, pelvic inflammatory disease, uterine fibroids and endometrial polyps.
So as long as these diseases exist, even seventeen-year-old sexless girls can take contraceptives under the guidance of doctors.
Question6：
What are short-acting, long-acting and emergency contraceptives?
Short-acting contraceptives are combined contraceptives that are mainly based on small doses of progesterone, supplemented by estrogen compatibility, and are taken from the 5th day of menstruation, and can be used for 1 month.
Long-acting contraceptives, which are made up of long-acting estrogen and progesterone, can be taken once a month according to regulations, can be contraceptive for 1 month, and the efficiency can reach more than 98%, but due to the large estrogen content, side effects are also more, and it has been used less.
Emergency contraception, as an after-the-fact remedy, is only a means of emergency rescue, and the method of use is also different from the first two contraceptives, it only has a contraceptive effect on unprotected sex within 72 hours before taking the drug, so it is not recommended to take it regularly.
Question7：
Emergency contraceptives, it is recommended to take only three times a year?
There are rumors that emergency contraception can only be taken three times a year, otherwise it carries a risk of infertility or cancer.
In fact, there is no limit to the number of times the emergency contraceptive pill is used.
It is true that emergency contraceptives are not recommended for routine use, but the World Health Organization has long stated: "There is no evidence that repeated use of emergency contraceptives can cause infertility or cancer." ”
Compared to the physical harm caused by an abortion in an unintended pregnancy, the risk of injury is much lower even if the emergency contraceptive pill is repeatedly taken afterwards.
Question8：
Can boys take birth control pills to treat acne?
Most acne occurs due to excessive androgen secretion in the body, and birth control pills contain estrogen and progesterone, which have an anti-androgenic effect, so it can indeed be used to treat acne.
However, we cannot only focus on the therapeutic effect of drugs, and its adverse reactions cannot be ignored.
For boys, if they take birth control pills for a long time to treat acne, they may gradually become feminine, and some physiological functions of boys will be reduced, such as impotence, thinning of the voice, and reduced beard.
And there are a small number of acne that have nothing to do with androgens, at this time even if taking contraceptives has no effect, so if boys want to use contraceptives to treat acne, it is best to use it under the guidance of a professional doctor.
Question9:
Are there male contraceptives?
In August, researchers from the Research Council of the Indian Medical Association said the agency had successfully completed clinical trials of RISUG, the world's first injectable male contraceptive pill, and had submitted it to the Indian Medicines Authority for approval.
Male contraceptives, can be divided into hormonal contraceptives and non-hormonal contraceptives, hormonal contraceptives are mainly by giving exogenous androgens or combined androgens and progesterone, feedback on the hypothalamus and pituitary gland, thereby inhibiting the release of gonadotropin-releasing hormone, follicle-stimulating hormone, luteinizing hormone and play a role.
Non-hormonal contraceptives can be divided into different types such as sperm production and sperm motility, in addition to acting on human epididymocyte protein 6, adrenergic receptors and P2X1 purine receptors. [5]
According to the Global Network, researchers in the United States have also developed a new formula of male contraceptives, and Australian researchers are also developing a new hormone-free oral male contraceptive. It is believed that with the development of science and technology, there will be more and more types of male contraceptives.
There are many points of knowledge about contraceptives, and with the development of science, the safety of new contraceptives is getting higher and higher, so everyone does not need to worry too much when using them.
However, it should be emphasized that condoms are always the safest, reliable and inexpensive form of contraception compared to contraceptives.
bibliography:
Yang T, Gong Chun'ai, Qiang Lei, et al. Research progress on the application of female contraceptives[J]. Shandong Medical Journal, 2019, 59(006):111-114.
LI Ying. Research progress on the safety of compound oral contraceptives[J].Journal of Practical Obstetrics and Gynecology,2014,30(7):481-483
[3] "Chinese Expert Consensus on the Clinical Application of Compound Oral Contraceptives"
Cheng Linan. Safety of emergency contraceptives[J].Journal of Practical Obstetrics and Gynecology,2014,30(7):488-490
[5] Yan Yu,Zhao Ran,Xu Yimei,et al. Male contraceptive drug research and its progress[J].International Journal of Reproductive Health/Family Planning,2016,35(6):519-523
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