Preemptive Birth Control Pills: Key Questions Answered

Emergency contraceptive pill

Hello, doctor.
I have some questions regarding oral contraceptives.
I am 20 years old and have a fibrocystic breast condition, which my doctor said is benign and common among many women, and I just need regular follow-ups.
However, my mother has a history of breast tumor removal (not sure if it was breast cancer).
Is it suitable for me to take oral contraceptives?
Secondly, when should I start taking the pill for the first time? I’ve read that some say to start on the first day of my period while others say the fifth day.
Should I just follow the instructions on the medication? I actually want to consult a gynecologist for my first prescription, but I’m worried that my parents might see the medical records when filing taxes (or will it not be listed?).

Thirdly, after completing the 21 days of pills, I need to take a 7-day break.
After those 7 days, regardless of which day of my menstrual cycle it is or if my period hasn’t started, should I begin the second pack? Should I adhere to a fixed “days off from the pill” or start based on a specific day of my cycle?
Lastly, if I catch a cold and see a doctor, and I find it inconvenient to disclose that I am taking oral contraceptives (since my parents usually accompany me), will it have a significant impact? Thank you!

Qing, 20~29 year old female. Ask Date: 2018/06/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the groups that are not suitable for using oral contraceptives include those who are pregnant, have breast cancer, circulatory diseases (such as venous or arterial embolism, ischemic heart disease, or intracerebral hemorrhage), coagulation disorders that predispose to thrombosis, liver diseases, systemic lupus erythematosus, hemolytic uremic syndrome, smokers over the age of 35, hypertension (blood pressure higher than 140/90 mmHg), and diabetes.
Fibroadenomas are less likely to be affected.
Each type of contraceptive pill is designed differently, and the timing for starting the medication varies, so it should be taken according to the instructions in the package insert.
If it is a 21-pill pack, after completing the 7-day break, you should start the next pack.
Cold medications may potentially affect the efficacy of contraception.
Other medications include: 1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol) - may reduce the gut flora that aids in absorption, thereby decreasing the effectiveness of contraceptives.
2.
Sedatives (Barbiturates) - increase the metabolism of contraceptives, reducing their effectiveness.
3.
Antiepileptic drugs (Primidone, Phenytoin, Carbamazepine) - increase the metabolism of contraceptives, reducing their effectiveness.
4.
Tuberculosis medications (Rifampicin, Isoniazid).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid - may inhibit the metabolism of estrogen, leading to increased concentrations in the body and a higher incidence of side effects.
7.
Oral contraceptives can affect the action of anticoagulants.
Thank you! Wishing you peace and health, Dr.
Zhang.
8.
Smoking - increases the metabolism of contraceptives, reducing their effectiveness.

Reply Date: 2018/06/19

More Info

When it comes to understanding preemptive birth control pills, it's essential to address your concerns with accurate information and guidance. Here are the answers to your questions based on medical knowledge and practices:
1. Fibroadenoma and Birth Control Pills: Fibroadenomas are benign breast tumors that are quite common among women, especially in their reproductive years. If your doctor has confirmed that your fibroadenoma is benign and that you are under regular monitoring, it is generally considered safe to take birth control pills. However, given your family history of breast tumors, it is crucial to discuss this with your healthcare provider. They can evaluate your specific situation, including your medical history and any potential risks associated with hormonal contraceptives.

2. When to Start Taking Birth Control Pills: The timing for starting birth control pills can vary. If you are starting the pill for the first time, you can begin taking it either on the first day of your menstrual cycle or on the first Sunday after your period begins. Starting on the first day of your period provides immediate contraceptive protection, while starting on a Sunday may require using backup contraception for the first week. It’s best to follow the instructions provided with your specific medication. If you have concerns about privacy regarding your medical records, remember that many clinics have confidentiality policies in place, and you can discuss your concerns with the healthcare provider.

3. The 7-Day Break: After completing a 21-day course of birth control pills, you will typically take a 7-day break during which you may experience withdrawal bleeding (similar to a period). It is important to start your next pack of pills after the 7-day break, regardless of whether your period has started or not. This means you should not wait for your period to begin; instead, you should resume taking the pills on the same day of the week that you started your previous pack. This consistency helps maintain hormonal levels and ensures effective contraception.

4. Informing Healthcare Providers About Birth Control Use: If you are concerned about discussing your birth control use during medical visits, especially when accompanied by parents, it is important to know that you have the right to confidentiality regarding your reproductive health. If you feel uncomfortable disclosing this information, you can ask the healthcare provider to speak with you privately. However, it is crucial to inform any healthcare provider about all medications you are taking, including birth control pills, as this can affect treatment decisions, especially if you need medications that may interact with hormonal contraceptives.

In summary, it is advisable to consult with a healthcare provider regarding your specific health conditions and concerns about taking birth control pills. They can provide personalized advice and ensure that you make informed decisions about your reproductive health. Remember, your health and comfort are paramount, and seeking professional guidance is always a wise choice.

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