The Oral Contraceptive Pill Versus The Injectable Contraceptive: Which Method is Better?

The use of chemical contraceptives has their own conveniences. Unfortunately, some unlikable side-effects can also be seen with their use. Oral contraceptive pills and injectable contraceptives are two popular chemical contraceptives. Both have their own handiness and untoward reactions but which method is better?

The oral contraceptive pill

Estrogen and progestin are the active elements of an oral contraceptive pill. While estrogen alone can cause the thromboembolism - a clotting of blood inside the blood vessel that may lead to stroke or heart attack, progestin alone may result to spotting or bleeding. Hence to minimize the untoward effect, estrogen is always used in combination with progestin.

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Progestin on the other hand can be recognized alone. As its natural form - progesterone, it can only be effective in injection form. With the half-life of five minutes, progesterone is metabolized quickly making it useless if taken orally. However as a synthesized progestin as lynesterol ( Exluton, Daphne) for example, researchers had found their way in making them orally active.

The injectable contraceptive

Also known as depot contraceptive, the injectable form has medroxyprogesterone acetate as the active component. Medroxyprogesterone ( Depotrust, Lyndavel ) is a progestin only contraceptive. Combination of estrogen and progestin has also been considered for the long-acting effect, so far medroxyprogesterone is the only one proven as the safest active constituent for the injectable types.

Comparison between the pill and the injectable form

• Convenience

Oral contraceptive pills are to be taken daily with the same time as much as possible. Contraceptive injectable are to be administered every three months.

• Adverse reactions

The most untoward side-effects for both methods are gastric upsets, vomiting and skin rashes. Injectable contraceptives can cause bleeding or spotting during the first shot but will eventually cease the following session.

• Lactation

Progesterone has no negative effect on milk. Logically, injectable types are safe for breast feeding mothers. Progestin only oral contraceptive such as lynesterol ( Exluton, Daphne) is also harmless for lactation.

• Thromboembolism and cardiovascular disease

Estrogen may be responsible for thromboembolism that so little amount of this active constituent is used in combination with a progestin. Progestin may also aggregate thromboembolism and thus heart diseases. However the injection form has lesser risk for thromboembolic and cardiovascular disease than combined oral contraceptives.

• Cancer

Natural estrogen can be carcinogenic upon prolonged use. With this basis, the use of estrogen containing pill is contraindicated for those women with a family history of breast or genital cancer.

Summing it all up

An injectable contraceptive may have a better advantage than oral contraceptive pills. It has no effect on milk and has minimal risk for thromboembolic and cardiovascular disease. It is not known to cause cancer unlike estrogen containing pills. Considering convenience, as long as the woman has no problem with a needle, an injectable contraceptive is likely to be more favourable than an oral contraceptive pill. While injectable contraceptive shots are to be administered only for every three months, an oral contraceptive must be remembered to be taken daily and the chances of missing one tablet has greater risk for pregnancy.

A disadvantage of an injectable contraceptive though, is the common side effect of the progesterone - the break through bleeding or spotting. It can also cause weight gain and acne. With this, oral contraceptives may have the advantage. Progesterone may have the characteristics of the male hormone, testosterone which is responsible for weight gain and acne, but since the progestin used in most combination pills has been improved over the years, there are progestins that lack the male hormone activity as the Drospirenone ( Yasmin, Yaz).

Final words

So, which method is better? The choice will always depend on the woman’s conditions and wants. One thing is certain. The use of these chemical contraceptives has no effect on a woman’s fertility. These do not increase fetal abnormalities when a woman wants to have a baby later. But, as a reminder there are contraindications and precautions regarding the use of these contraceptives. A medical advice from a registered physician is still required.

Reference:

Pharmacognosy 9th Edition

Wilson and Gisvold Textbook of Inorganic Medicinal and Pharmaceutical Chemistry 9th edition

PPDr Philippine Pharmaceutical Directory Review 5th edition