• Dr Peter Chew

Contraceptive pills

I have been taking contraceptive pills (Diane 35) for the treatment of pimples. How does the pill work? Will it affect my fertility in future?

A. Diane 35 is an oral contraceptive pill containing a female hormone (oestrogen) and another hormone(anti-androgen) which works against the male hormones (androgen). Androgens are produced by men as well as women. They stimulate the growth of the skin glands that produce oil (sebum). If the body produces too much androgen, excessive sebum will form. This will eventually block up the hair follicles, resulting in acne spots which can get infected or inflamed.

The anti-androgen in Diane 35 will reduce the levels of male hormones produced by the ovary as well as counteract the effects of androgens on the skin. The treatment of acne using this drug is very effective.

With regards to whether the drug will affect your future fertility, the answer remains unclear. Previous studies have shown that oral contraceptive pills do not cause infertility. Most women will experience normal cycles within one to three months after stopping the pills and many will conceive within six months to a year with well-timed intercourse.

But a recent study of more than 2,200 women attending antenatal clinics in England in 2017 has suggested otherwise. The hormones in the pills could upset the reproductive system for months or even years after women stop taking them.

The study has found that former pill users took twice as long to conceive than those who had used condoms. The longer they had been on the pill, the longer it took to conceive. The risks appear to be even greater among women who are over 35, or obese, or suffer from irregular periods. Over-35s who had taken the pill took two-and-a-half times as long to conceive as those in the same age group who had used condoms.

The researchers believe that in some women, the hormones may stop the ovaries from releasing the eggs normally and may take some time to wear off.

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