Contraceptive pills in Nigeria: Birth control pills in Nigeria

Contraceptive pills in Nigeria. This article will address important topics like:

(Oral) Contraceptive pills in Nigeria

Birth control pills in Nigeria and

The brand names of contraceptive pills in Nigeria

There are two types of birth control pills in Nigeria. They are the combined oral contraceptive pills commonly known as ” the pills” which contain progesterone and oestrogen and the progestin only pills commonly called “minipills” which contain only progesterone.

Combined Oral Contraceptive Pills- “the pills”

The composition
They are oral contraceptive pills (OCPs) that contain both oestrogen and progesterone. The estrogen is commonly 30-35 microgram of ethinyl oestradiol or mestranol, while the progesterone is usually 0.5-1.0mg of norethindrone or ethynodiol diacetate.

How does “the pills ” work? Mode of action of the oral contraceptive pills

The combined effect of oestrogen and progesterone suppresses the release of ovulation hormones. No ovarian follicles are therefore developed. Pills may suppress or abort the maturation of your eggs. The progesterone component of the pills causes the thickening of your cervical mucus thereby preventing the upward passage of spermatozoa to a released egg.

Commonly used brand names of contraceptive pills in Nigeria

The names of birth control pills available in Nigeria include:

Microgynon, Logynon, Yasmin, Lo-Fermenal, Nordette, Marvelon, Ovanon, Normovla etc

The above are the common brand names of the combined pills.

Commonly used preparations contraceptive pills in Nigeria

A common monthly oral contraceptive preparations is taken for 20 or 21 days starting from the first day of your menstrual flow. In order to ensure greater compliance, some preparations contain 28 tablets. This is the so called daily pills as it ensures that you develop a daily pill intake culture. Day 22-28 tablets have no contraceptive value as they contain iron and/or vitamins only. The biphasic and triphasic formulations differ from the standard pills; they contain varying quantities of estrogens as they are designed to mimic the increasing estrogen levels of a normal menstrual cycle.

Women that cannot use the combined contraceptive pills in Nigeria

Just like other medications, birth control pills are not meant for every woman but contraception and family planning is a right of every girl, lady or woman. If your system does not “agree” with the pills, I advise you use other forms of contraception available in Nigeria that is best suited for you like the IUD, Implanon, Jadelle, etc

Women with the medical conditions highlighted below should avoid the pills or consult a doctor before using them.

Heavy smokers

Previous history of stroke

Hypertension

Chronic liver disease

Depression

Diabetes milletus

Breast mass

Sickle cell disease

Migraine

Varicose veins

Gall bladder disease

Abnormal vaginal bleeding

Previous history of jaundice

Obesity

Suspected pregnancy

Advantages of oral contraceptive pills in the Nigerian woman

The pills have both contraceptive and non-contraceptive benefits. The benefits are highlighted below:

a) Menstrual

Regular menstrual cycle

Lighter menstrual loss

Painless menstruation (pills are useful in treating painful menstruation called dysmenorrhea)

Eliminates mid-cycle ovulation pain

Useful in treating endometriosis

b) Reduced risk of cancer

Reduces chances of developing ovarian cancer by 50%. This protection extends of to 20years of cessation of use.

50% reduction in endometrial cancer

25% reduction in developing breast masses.

The risk of death from colorectal cancer is reduced in both current and past users of oral contraceptive pills.

c) sexual benefits

Makes sex spontaneous.

Diminished risk or fear of unwanted pregnancy leads to enhanced satisfaction.

d) others

Reduced risk of pelvic inflammatory disease.

Reduced risk of anemia…don’t forget the COCP contains iron supplements

Combined pills are used in the treatment of acne, hirsutism and polycystic ovarian syndrome.

Reduced risk of ectopic pregnancy.

Complications and other disadvantages of the ordinary pills in Nigerian women

a) Major

Dose related increased risk of venous thromboembolic conditions like deep venous thrombosis, pulmonary embolism (I have seen this happen), stroke, myocardial infarction, and bleeding into the brain. Risks of these complications are higher in obese women, those over 35 years, in heavy smokers, diabetics, hypertensives, and high level of cholesterol.

Nigerian women on long term use of combined oral contraceptive ( especially high doses) have increased risk of breast, cervical and liver cancers. Usually, they are prone to developing gall bladder diseases like inflammation and gall stone formation.

b) Minor

Nausea vomiting, break through bleeding, weight gain, scanty or missed periods, headaches, mood changes, breast tenderness, headaches, depression, leg cramps, loss of libido, vagina discharge etc.

c) Others

The pills have to be taken everyday, some women have difficulty remembering.

You must have a new packet each time.

Does not protect against sexually transmitted infection including HIV/AIDs.

Estrogen causes enlargement of fibroids.

Instructions on the use oral contraceptive pills in Nigeria

Your doctor will take a full medical history that includes known risk factors, check your blood pressure, weight and pulse rate. He/she will counsel you properly and ensure you use the lowest effective dose of the pills. In any case, preparations should contain less than 50 micrograms of oestrogen. The doctor will provide for you specific information on side effects with adequate emphasis on major effects that would warrant immediate medical consultation.

You should take the tablets preferably at the same time daily; taking two the next day may make up for a missed day.

For the 28-day pack, take one daily and start on another pack on the completion of a pack. For the 21-day pack, wait seven days after the completion of a pack and then commence on another pack. You should continue taking your pills despite common side effects e.g. nausea, vomiting and vagina spotting.

A bout of vomiting within one hour after taking a pill calls for taking another pill within 24 hours, you should keep on taking the pill but can also use a condom or spermicide or avoid sexual intercourse until you have taken a pill each day for seven days in a row after your diarrhoea or vomiting has stopped.

Lactating women

Because combined oral contraceptive pills may diminish breast milk production, they are not recommended for breastfeeding women. Alternatively, breast feeding women are may be given the progestin only pills (minipills), which has no effect on lactation.

Drug- drug reaction

Note that certain drugs, when taken with oral contraceptives affect its efficacy. These include the anticonvulsants, rifampicin, and other antibiotics like ampicillin. These drug interfere with estrogen metabolism and may cause contraceptive failure.

Return to fertility following use of “the pills”

By 12 months or less, you will be able to get pregnant if you wish to. This is unlikely for women on other available oral contraceptive pills in Nigeria.

Effectiveness of the oral contraceptive pills in Nigeria

When taken constantly and religiously as per instructions, the pills has a theoretical effectiveness of 100%. However, in the first 12 months of use about 6-8 per 100 women will get pregnant.

READ ALSO: COST OF POSTINOR 1 & 2 IN NIGERIA

Acceptability and extent of use of birth control pills in Nigeria

The OCPs are the most widely used contraceptives worldwide. Over 50 million women are on oral contraceptive. In developing countries like Nigeria, pills use are still very low with less than 20% of contraceptive acceptors.

We are are still very much in love with the natural family planning methods.

Progestin Only Oral contraceptives (minipills)

These are daily oral hormonal contraceptives that contain only small quantity of progesterone ( 75 micrograms of norgestrel or 30 micrograms of levonorgestrel).

Commonly used preparations consist of either 28 or 35 day packs.

In virtually other parameters, the progestin only pills are either similar to the combined pills with the notable exception that the minipills have the specific advantage over oestrogen related side effects e.g. heart attacks or stroke.

Furthermore, are reduced risks of progestin related side effects, such as acne and weight gain, than with the combined oral contraceptive in Nigeria. It is good for breastfeeding mothers.

The minipill is taken daily with no breaks. It is slightly less effective than the combined OC, but rather more effective when used for emergency contraception.

The non- contraceptive benefits of the minipill are the same as for the combined pills with the exception that it has no effect on rheumatoid arthritis and ectopic pregnancies.

There is also a slightly increased incidence of simple follicular cysts in women on the minipill compared to women on the combined birth control pill or those using no contraception at all.

Some brand names of minipills in Nigeria

Brand names of progestin only pills include Camila, Errin, Heather, Jolivette, Nora- BE

Please note that common questions like best contraceptive pills in Nigeria can best be answered if the the question was contraceptive pills best suited for me. Contraceptive pills and effectiveness are individualized! It is not a “one cap fits all”.

Resources:

Clinical Gynaecology by Professor Eugene Okpere

Textbook of Obstetrics and Gynaecology by Dr Akin Agboola

Medicinenet.com