Assoc Prof Devendra Kanagalingam, Senior Consultant from The Department of Obstetrics & Gynaecology at Singapore General Hospital explains why Combined Oral Contraceptives (COCs), is a common birth control option for women.
Exploring birth control options for women in their 20s
While age is one consideration, individual preferences and other factors such as the presence of medical conditions influence the choice of contraception for a woman. No matter what the woman's age, a comprehensive discussion with a family doctor or a gynaecologist will help identify the best choice of contraception for her.
The 20s: peak of fertility
A woman’s fertility peaks in her mid-20s and effective contraception at this age is essential as many women often favour pursuing career or personal goals over starting a family. The combined oral contraceptive (COC) – better known as the Pill – is a clear favourite.
Benefits of combined oral contraceptives (COCs)
COCs are easily reversible and women often start ovulating within two months of going off the pill. Also, modern versions contain only a fraction of the hormone dose contained in the original pill and have fewer side effects.
COCs contain a mix of oestrogen and progesterone and act by preventing ovulation. They are typically taken for 21 days in a month followed by a seven-day break – a pill-free interval – during which a menstrual period will occur.
Non-contraceptive benefits include lighter, less painful periods and a reduced incidence of oily skin and acne. Taking two or more packets consecutively without allowing for the usual pill-free interval will delay the menstrual period, which is useful when having a period is inconvenient.
The combined use of a barrier method such as a condom and COCs is known as the “Double Dutch”. This provides additional effectiveness as a contraceptive and reduces the risk of contracting a sexually transmitted infection such as HIV.
Much is often said of the risk of cancer. While it’s true that there is an increase in breast cancer incidence following five years of pill use, this increase is small and amounts to one additional case of breast cancer per year in 1,000 women who have been on the pill. This risk diminishes quickly to normal once oral contraception is discontinued.