DOCTOR'S ADVICE - What is the best Pill to take?

Q. Hello, Doc. Which is the best contraceptive Pill for me to take so I don't get pregnant? And how do I take it?

A. That's a pretty good question because there are many young women in your situation. They think that they'd like to go on the Pill, but they don't really know much about it. So let me explain.

The contraceptive Pill contains two hormones called an oestrogen and a progestin. The effect of them is to stop you ovulating, that is, releasing an ovum or 'egg' each month. So the Pill gives you a regular cycle in which you have a short, light, pain-free menstrual loss every four weeks.

If you take it exactly as prescribed, you will not get pregnant, but it is important that you do not miss any! Forgetting to take a tablet can easily lead to pregnancy.

Most Pills come in packs of 21. You take one every day, preferably around the same time. So the pack lasts you for three weeks. At the end of those three weeks, you have a break for seven days.

During that break, you will have your menses. It is stopping the Pill at the end of the pack that causes you to bleed. A good thing about the Pill is that the monthly blood loss is much easier to cope with than a 'natural' period.

Please note that in Jamaica, there are some brands of Pill that contain more than 21 Pills. Also, there are brands that give you dummy tablets to take during the break. That is because some women find that system easier to remember.

Now, you ask about how to take the Pill. You should simply begin by taking the first one on the first day of your menses. After that, it is a straight question of three weeks on and one week off.

Next, you enquire about choosing the best Pill. This is complicated. In my opinion, a patient simply cannot have the vast knowledge required in order to choose her own brand of Pill - unless she herself is a nurse or a doctor or a medical scientist. In general, what happens is that the doctor suggests a brand of Pill to the woman, and she usually accepts.

However, I do think that you should lay dowm certain stipulations to the doctor before he puts you on the Pill. These are that he gives you a brand that

• 1. Has a low content of oestrogen;
• 2. Does not contain the group of progestins that carry a higher risk of thrombosis.

Finally, I suggest that you pay no mind to any advertising that 'touts' various brands of Pill. It is better to take the advice of a doctor, a nurse, or a midwife.