Question

How pill or oral administration work as a contraceptive? Explain their working process

Answer 1

in short

In principle, all contraceptive pills work in the same way. They contain hormones which thicken the mucus at the entrance to the womb so sperm can’t enter, change the lining of the womb so eggs can’t implant and they stop ovulation. Different pills contains different hormones but the working mechanism is the same, with the exception that some minipills do not stop ovulation.

Minpills are pills which do not contain any oestrogen. They have to be taken within a smaller time frame and unlike combined pills, they are taken every day without a break (whereas combined pills are taken for three weeks per cycle).

Depending on the hormones your pill contains it can have additional benefits such as improving your skin. If appropriate, your doctor will approve a pill which suits your needs. However, you may have to try several pills before you find the pill which works best for you. How long does it take for the pill to work? How quickly you are protected from pregnancy depends on when you start taking the pill. If you take the first pill as advised on the first day of your period, you won’t need to use any additional contraception. However, if you begin taking the contraceptive pill at a later stage during your menstrual cycle you need to use a condom or other barrier method for at least seven days. in detail The pill was the first drug to be created and prescribed for healthy people. Oral contraceptives became available in 1961 and within a decade were so ubiquitous as to gain the pet name of “the pill”. Fast-forward to the present: 100 million women will take a form of the pill today, right after brushing their teeth or before they go to bed. In fact, 80% of women will use oral contraceptives at some point during their lives. Many women now start taking the pill during their teens and continue taking it, every day, for several decades. The pill has become such a normalised, commonplace part of women’s daily routine that it’s easy to forget that the pill is actually a powerful medication. But all of us, at some point, will want to know: “How does the pill work?”
The pill is made up of a synthetic estrogen and synthetic progesterone (known as progestin). These synthetic hormones are not the same as the hormones produced by the female body. The pill actually stops the production of those endogenous hormones via the brain. It suppresses the creation and fluctuation of hormones that make up the menstrual cycle and replaces that cycle with an artificial, flat stream of synthetic hormones. The body stops producing its own hormones and the pill acts as hormone replacement.


This process switches off the ovaries, preventing ovulation (the release of the egg from the ovary). The pill also prevents the production of fertile cervical fluid (essential for sperm to reach the egg). Plus, the lining of the uterus does not grow thicker (this uterine lining is what would usually, in an unmedicated cycle, become your period). This is the three-fold action by which the pill prevents pregnancy. Although women are only able to get pregnant on six days per menstrual cycle, the pill is taken every day to ensure infertility.
The usual language used for describing how the pill works is too often a mix of half-truths, platitudes, and a simple fudging of the facts. Understanding how the female body works when not on the pill can help us understand how the pill works. However, the female body and reproductive health have long been after-thoughts in science, as in our society. As a result, the pill has become both a product and a proponent of a sexist set-up, creating a gap in knowledge that gets filled with a host of medical myths.
For example, you may have heard that the pill “regulates” periods. The pill doesn’t manage the menstrual cycle, it replaces it, and therefore the pill does not “regulate” the menstrual cycle. When women take the pill, they do not experience a cycle or periods. When they take a break from the pill once a month or take the placebo/sugar pills and bleed, this is not menstruation. The bleed experienced on the pill is a “withdrawal bleed” (your body is withdrawing from the synthetic hormones) and very different from a physiological period.

Early pill researchers decided to create the break week (or the few days of placebo pills) to allow women to experience a bleed each month. At the time, it was considered a good sales tactic to design the pill packs this way; they thought women would be concerned by not bleeding month-in-month-out and, as such, would be reluctant to take the pill. Today you’ll often hear that there is no medical reason to have “periods” on the pill. What is meant is that there’s no medical reason to have “withdrawal bleeds” on the pill, and that’s precisely because the bleeds on the pill are not real periods. Withdrawal bleeds are an inessential design feature of the pill, but actual menstruation is different. There are many good medical reasons to have a period – in fact, the American Committee of Obstetricians and Gynecologists (ACOG) recommends women view their periods as “the fifth vital sign” of health.
Part of the mythology that surrounds the pill is the idea that menstruation is unnatural. This developed from the “paleofantasy” of one doctor. He assumed that, because paleolithic women did not experience many periods in a lifetime (presuming they were pregnant often, breastfeeding, and then, of course, dying very young) in comparison to modern-day women, it is therefore more “natural” for women today to not have a menstrual cycle. It is more natural, he reasons, for them to be on hormonal birth control. So, the theory is that the pill takes women back to our presumed “natural” state of constant pregnancy and breastfeeding (no ovulation, no periods).

But it’s just a theory, without evidence, as we cannot know what occurred pre-science, or pre-society for that matter. Anyway, the pill does not actually mimic pregnancy; what happens to the body on the pill is more like a chemically induced menopause. The pregnancy hormones are estradiol, estriol and progesterone, which give many benefits. The pill contains ethinylestradiol and a synthetic progestin (like levonorgestrel or drospirenone, for example, as there are many kinds), which do not give the same benefits, and actually have many of the opposite effects.
Rather than questioning if a biological function is “natural”, it makes more sense to investigate whether it is important for good health. It’s interesting to note that there are few functions of the male body we consider obsolete, unnecessary, or unnatural. I’ve yet to hear a doctor make the argument that men might actually ejaculate too much, and as such should avoid ejaculation (preferably with ejaculation-preventive drugs), unless it’s for the purpose of conceiving a child.
The connection between the menstrual cycle and women’s health is not theory, but scientific fact. The menstrual cycle and ovulation, specifically female biology, allows women to get pregnant and give birth, but that’s not its only reason for being. Menstruation and ovulation are two connected parts of the same biological system. That we ask “do women need periods?” rather than “do women need to ovulate?” reveals that theorising around the necessity of menstruation is always wrapped up in the culture of period shaming and taboo.

Long-term, ovulation is connected to good bone, heart, and breast health. Short term, ovulation is connected to energy levels, libido, mood, creativity, partner choice, and more than 150 other essential biological functions, from memory to sense of smell to nutrient absorption. While we usually ask, “What are the side-effects of taking the pill?”, we could ask: “What are the benefits of having a menstrual cycle?” Ovulation and the hormones produced via ovulation, their levels and fluctuations, are intricately connected to the workings of the immune, metabolic, and endocrine system.
This information can help build our understanding of why the pill has so many adverse effects, with just a sampling of recent research revealing that it alters the structure of the brain, triggers Crohn’s disease, and increases the risk of depression.

The pill has to disrupt the endocrine system in order to stop the production of endogenous hormones. The hypothalamus, the pituitary gland – the brain’s control centre for hormones – is what the pill overrides to prevent pregnancy. When we hear the term “endocrine disruptor”it’s normally in relation to other environmental toxins. In the last year nail polish, fire-retardant sofas, receipts, pesticides and household cleaners have all made the headlines for having endocrine disruptive properties and, therefore, carcinogenic and disease-causing consequences. The pill is an endocrine disruptor by design.
During the early days of research for my book on the pill, I interviewed a GP. I asked him why women are so rarely told how the pill works at the time that this discussion would be most relevant: in the doctor’s office before getting the prescription. I often think of his response, which was: “‘Why wouldn’t you be satisfied with just knowing it stops you producing eggs so you don’t get pregnant?” I knew why I wasn’t satisfied, because that wasn’t all that the pill did for me – it also caused debilitating physical and psychological side-effects. It hadn’t occurred to this GP that some women experience side-effects on the pill and want to know why and how this happens; or that some want to know more about a medication they’re putting in their (healthy) body every day; or that some think any behaviour expected of only women, and never men, is always worthy of our attention.