Health: A Better Pill to Swallow?; Want to Find the Right Oral Contraceptive for Your Body? Here Are the Questions to Ask.(Features)

Article excerpt

Byline: Words: Lynne Michelle

There are 24 types of combined pill, but visit your GP and chances are you'll only be offered Microgynon - which also happens to be the cheapest brand. So is your doc fobbing you off with a one-size-fits-all approach to save money? `Microgynon wouldn't be prescribed if it wasn't a good pill,' says Toni Belfield from the Family Planning Association. `It has a good safety record and a low side effects profile. Doctors start women off with a three-month supply then look at alternatives if they have ongoing side effects. Being on the pill shouldn't be a trade-off between protection and well-being - you should feel the same as you would normally.'

The science bit

The pill is made up of two hormones, progestogen and oestrogen, which stop ovulation. All brands use the same form of synthetic oestrogen and contain 20, 30 or 35mg per pill. The type of progestogen depends on whether the brand is, like Microgynon, `second generation' or `third generation' (eg Femodene). Third generation pills were developed in the 80s using a different kind of progestogen which reduced certain side effects associated with older pills. Researchers later discovered they slightly increase the risk of blood clots so most doctors prefer to try women on the older type of pill first.

Breakthrough bleeding, vaginal dryness, lack of libido,

depression

Your pill may have too little oestrogen and too much progestogen to suit you.

Switch to an oestrogen-dominant brand like Brevinor, Mercilon, Logynon or Marvelon. `The same approach is used with hormone replacement therapy, which increases a woman's oestrogen levels,' explains GP Dr Deepak Kansagra. `If that didn't work, we'd try a brand with a different type of progestogen, switching, for example, from a second to a third generation pill, providing there were no risk factors, such as a history of blood clots.'

Nausea, headaches,

dizziness, mood swings, vaginal discharge

A pill with too high an oestrogen ratio.

Swapping to a progestogen-dominant brand like Loestrin or Eugynon may help. `Alternatively, trying a brand with a different kind of progestogen may be beneficial, although there is no simple answer - what works for one woman will have no effect on another,' says Toni Belfield.

Breast

tenderness

Women who are intolerant to oestrogen are likely to suffer from permanently tender and/or enlarged breasts when they go on the combined pill.

Having bigger breasts is something most women will happily live with, but soreness is another matter. `If swapping to a lower oestrogen brand doesn't help, women will be advised to swap to the progestogen-only pill, commonly known as the mini-pill,' says Sheila Hancock from Marie Stopes. …