علامات أنك تستخدمين حبوب منع الحمل الخاطئة

How to tell if your contraceptive pill isn't right for you

You're still experiencing side effects after three months

Different types of حبوب منع الحمل contain different quantities and combinations of the hormones oestrogen and progestogen, which in turn affect different women differently. So, if you're struggling with side effects, it's worth considering whether the contraceptive pill you're being prescribed is really the right pill for you.

Dr Caroline Cooper, a spokesperson for the Faculty of Sexual and Reproductive Healthcare (FSRH) explains: "I see so many women who say: 'Oh I don't get on with the pill', after only trying one - and then they just come off it and think their experience applies to all pills."

"The first thing I would say to women is that, if they have any sort of side effects when they start taking a pill, they should carry on for at least three months because it's really common when you first start it," she adds. "Often women will get things such as nausea, and they might get headaches or leg cramps, and that's usually just your body getting used to the hormones."

إذا كنت لا تزال تعاني من آثار جانبية بعد ثلاثة أشهر - وبالتأكيد بعد ستة أشهر - فمن المؤكد أنه يستحق النظر في نوع مختلف، أو حتى تغيير الطريقة التي تتناولها بها.

You're experiencing mood swings

One of the biggest side effects talked about with the contraceptive pill is the potential impact on mental health.

27-year-old Catherine was prescribed combined pill Microgynon four years ago, and says: "I had the worst reaction to it in terms of mood swings. I could literally feel my mood swinging, so I would be super high and then super low. It was terrible, and made me feel awful. I had three months worth and then begged them to change it."

الآن على حبوب منع الحمل التي تحتوي على البروجستيرون فقط سيريل، تقول كاثرين: "إنها أفضل بمليون مرة ولدي آثار جانبية أقل بكثير. يبدو حقًا أنه تجربة وخطأ - عندما عدت إلى عيادة الصحة الجنسية بشأن تقلبات مزاجي مع ميكروجينون، قالوا 'يجب أن تحتاجي إلى مستويات مختلفة من البروجستيرون' وجربوني على الحبة الصغيرة. لحسن الحظ، إنها مناسبة تمامًا!"

Her experience tallies with research carried out in the 1990s by Dr Cynthia Graham, Editor of The Journal of Sex Research and Professor of Sexual and Reproductive Health at the University of Southampton.

"There's very little research on this, but what we found in our placebo controlled study was that women in the progestogen-only group did better than women on the combined pill, in terms of both mood and sexual side effects. We still don't really understand why this is," Graham explains.

Like Catherine, 29-year-old Rachel experienced mood swings on Microgynon, but it was switching to Yasmin - a different combined pill, which uses a newer form of progestogen - that worked for her.

"I was on Microgynon for a year and came off after a break-up. It was only then that I realised the huge effect it had had on me, and I started to feel like myself again," she says. "When I went back on the pill six months later, I told them Microgynon had made me feel awful, and they said they'd switch me to Yasmin instead. I've been on it for nine or ten years now, and my moods feel settled for the most part."

What to know about changing pills

When it comes to changing pills, you can either opt for a pill with a different dose of oestrogen, or a different type of progesterone, or switch from a combined pill to a البروجستيرون فقط (the mini pill), or vice versa.

"Doctors would look at the symptoms you're experiencing, and say 'that's likely to be due to oestrogen', or 'that's likely to be due to progestogen'," Cooper explains. "The side effects associated with oestrogen are nausea, headaches, breast tenderness or pain, and the progesterone ones tend to be things such as acne, mood changes, and bloating."

Different women respond very differently to different hormones, so what works brilliantly for someone else might be wrong for you. Sadly this can mean some trial and error to find the pill that suits you best.

Changing the way you take the pill

Another possible option for tackling side effects, besides changing the type of pill, is simply to change the way you take it. "A lot of women find that side effects related to the pill - particularly things such as headaches or heavy bleeding - can be lessened either by تناول الحبة بشكل مستمر ,، دون انقطاع بين العبوات، أو فقط الحصول على فترات راحة أقصر لمدة أربعة أيام،" يقول كوبر.

"بعض هذه الآثار الجانبية تحدث بالفعل بسبب الانسحاب الذي تشعر به عندما تتوقف عن تناول الهرمونات لمدة سبعة أيام. في الواقع، نحن لا نحتاج إلى تلك الاستراحة لمدة سبعة أيام، وتناول الحبة بشكل مستمر - وهو الطريقة الأكثر حداثة لتناولها - يمكن أن يساعد بعض النساء حقًا في التعامل مع آثارهن الجانبية"، تضيف.

فهم العلامات التجارية الأكثر شيوعًا

When it comes to the combined pill, Cooper says, there are three basic types, or 'generations', of pill you could try. "The one that is generally used as the starter pill in the UK is Rigevidon, Microgynon, or Ovranette. A lot of people will get on with that, but it's more of a progestogen pill so sometimes people will get mood changes or acne," she explains.

"If you have those sorts of symptoms with the Rigevidon, you would want to change to ones such as Millinette, Gedarel, and Femodene, which have slightly newer progestogens and either a 30 or 20 microgram dose of oestrogen," she adds. "Then there's the newest generation, for example, Yasmin and Eloine, which use the newest progestogens with either 30 or 20 microgram doses of oestrogen."

Alternatively, you could try progestogen-only pills such as Cerazette (or Cerelle), Noriday, and Norgeston, which don't contain any oestrogen and can be particularly beneficial if you get migraines or can't take the combined contraceptive pill for other medical reasons.

Coming off the pill

Of course, as Cooper adds: "By the time you've tried one for six months, another for three months, you might quite rightly feel you've had enough of it and be ready to change." Most importantly though, don't come off the pill without having an طريقة بديلة لمنع الحمل lined up.

"هناك بعض الأدلة على أنه مع المخاوف المتعلقة بحبوب منع الحمل، تتوقف بعض النساء عن تناول الحبوب وتلجأ إلى طريقة أقل فعالية بكثير، أو لا تستخدم أي طريقة على الإطلاق، لذلك أعتقد أنه من الجدير بالتأكيد محاولة التغيير"، يؤكد الدكتور غراهام. "لا تزال الحبوب فعالة جدًا، لكن لا توجد أدلة كافية ونعرف القليل جدًا حقًا عن أي منها سيكون الأفضل للتغيير إليه."

Other forms of contraception

If you're fed up with the trial and error game of searching for a pill that suits you, Cooper recommends looking at hormonal options in non-tablet form, for example, the حلقة مهبلية و ال لاصقة منع الحمل. "A lot of women aren't aware of things such as the ring and the patch, but they're the same hormones as you're getting in an oral pill," she explains.

"يتم امتصاص الحلقة عبر المهبل، وهذا يمنحك مستويات منخفضة ومستدامة من الهرمونات، مما يمكن أن يكون مفيدًا جدًا للنساء اللواتي يعانين من أعراض مرتبطة بمستويات عالية من الإستروجين. وبالمثل، يتم امتصاص اللصقة عبر الجلد وتمنحك جرعة مستمرة. مع ذلك، تحصلين على جرعة أعلى قليلاً من الإستروجين، لذا يمكن أن يكون ذلك جيدًا للنساء اللواتي يعانين من آثار جانبية سلبية مثل حب الشباب أو تقلبات المزاج."