Pre-Pill Contraceptives: Common Concerns and Effects

Regarding emergency contraceptive pills?

Hello Doctor, I have some questions regarding my first-time use of the contraceptive pill - Aivee (24+4 regimen):
1.
I started experiencing bleeding on the 15th day of taking the pill, and it has continued for 3 days now, with the amount similar to a light menstrual flow.
Is this normal? Should I continue taking the pill? Will this affect its contraceptive effectiveness? If I have unprotected intercourse, is there a risk of pregnancy?
2.
I usually take magnesium (Puritan's Pride Magnesium) at bedtime, either 250mg or 500mg.
Will taking this alongside the contraceptive pill affect its effectiveness?
3.
I have a habit of tracking my basal body temperature, and I’ve noticed that my average basal temperature is higher since starting the contraceptive pill.
Is this normal?
Thank you for your patience in reading my questions!

Yu, 20~29 year old female. Ask Date: 2022/12/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the first dose of medication is usually taken on the first day of menstruation or within a few days after the onset of menstruation.
Different products may have slight variations in their usage instructions.
Additionally, oral contraceptives must be taken continuously for at least seven days to achieve contraceptive effectiveness.
During the usage period, if menstruation occurs or bleeding happens, there is no need to stop taking the medication; it should be taken according to the schedule.
Once the body adapts to the contraceptive, irregular bleeding should cease.
However, if irregular bleeding persists for more than three months or if there is heavy bleeding, it is advisable to consult a physician.
Medications that may interact with oral contraceptives include:
1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol, Doxycycline) may reduce the effectiveness of oral contraceptives.
When taking these medications, alternative contraceptive methods should be employed, as they may decrease the gut flora that aids in absorption, thereby reducing the effectiveness of the contraceptive.
2.
Sedatives (Barbiturates) may increase the metabolism of contraceptives, reducing their effectiveness.
3.
Antiepileptic drugs (Primidone, Phenytoin, Carbamazepine) may also increase the metabolism of contraceptives, reducing their effectiveness.
4.
Tuberculosis medications (Rifampicin, Isoniazid).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid (Vitamin C) may inhibit the metabolism of estrogen, leading to increased concentrations in the body and a higher incidence of side effects.
7.
Oral contraceptives may affect the action of anticoagulants.
8.
Smoking may increase the metabolism of contraceptives, reducing their effectiveness.
9.
Long-term consumption of tea or certain herbs may have additive or subtractive effects with oral contraceptives.
Furthermore, any medication should be taken with water and not with tea, coffee, or other beverages, as this may affect the medication's efficacy.
Therefore, if you need to take any of the aforementioned medications while on contraceptives, it is best to implement additional contraceptive measures for seven days.
Additionally, due to the presence of progestin in contraceptives, they may affect basal body temperature.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2022/12/07

More Info

When starting a new contraceptive pill like the one you mentioned (Aiwei, a combination pill), it's common to have questions and concerns about its effects and interactions with other substances. Let's address your questions one by one.

1. Breakthrough Bleeding: Experiencing bleeding around the 15th day of your pill cycle is not uncommon, especially during the first few months of starting a new contraceptive. This is often referred to as "breakthrough bleeding" and can occur as your body adjusts to the hormones in the pill. As long as the bleeding is not excessively heavy or accompanied by severe pain, it is generally considered normal. You should continue taking your pill as prescribed, as stopping it can disrupt your cycle further. Breakthrough bleeding typically does not affect the contraceptive effectiveness of the pill, so if you have been taking it consistently and correctly, the risk of pregnancy remains low even with the bleeding.

2. Magnesium Supplementation: Taking magnesium supplements, such as Puritan's Pride Magnesium, should not affect the efficacy of your contraceptive pill. There is no evidence to suggest that magnesium interacts negatively with hormonal contraceptives. However, it's always a good practice to consult with your healthcare provider about any supplements you are taking, especially if you are on medication, to ensure there are no potential interactions specific to your health situation.

3. Basal Body Temperature Changes: It is normal for your basal body temperature (BBT) to be slightly elevated when you are on hormonal contraceptives. The hormones in the pill can cause a rise in BBT, which is a common physiological response. This increase is due to the progesterone-like effects of the pill, which can mimic the post-ovulatory phase of your menstrual cycle. If you are tracking your BBT, you may notice this change, but it should not be a cause for concern unless you experience other symptoms that might indicate a problem.

In summary, the bleeding you are experiencing is likely a normal adjustment to the pill, and you should continue taking it as directed. Your magnesium supplementation does not interfere with the pill's effectiveness, and the changes in your basal body temperature are also expected. If you have any further concerns or if the bleeding becomes heavy or is accompanied by severe pain, it would be wise to consult your healthcare provider for personalized advice. Always remember that individual responses to hormonal contraceptives can vary, and your healthcare provider is the best resource for addressing your specific health needs.

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