Why is the contraceptive pill containing progestin good for breastfeeding women?

The article was consulted professionally by Bsck II Pham Thi Xuan Minh – Obstetrics and Gynecology Department, Share99 Hai Phong International Health Hub.

The recommendations when using contraceptive pills for women who are breastfeeding are mainly related to the process of milk production. So, why is the progestin-only contraceptive pill believed to be a safe method of contraception during breastfeeding?

Usually, there are 3 main end-to-end contraceptives for women, including:

• Combined Oral Contraceptives (COCs);
• The contraceptive pill contains progestin alone (a synthetic form of progesterone);
• Emergency contraceptive pill.

In particular, the contraceptive pill contains only Progestin called Progestin-Only contraceptive Pill (abbreviated POPs), also known as "mini-pill". As the name is, this drug has only one component, progestin, because it does not contain estrogen, so the side effects will also be less.

Similar to other end of end of life tablets, progestin-only contraceptives also have 3 mechanisms of action:

• First: The effects of progestin cause the ovaries to stop releasing eggs each cycle;
• Second: In case ovulation has occurred, the mini-pill produces several changes that make the uterus no longer favorable for the embryo to nest;
• Finally: POPs make the mucus between the uterus and vagina dense to interfere with the path of sperm to egg contact.

The oral contraceptive pill only Progestin is believed to be suitable for women during breastfeeding because progestin does not affect lactination nor the composition of milk. Meanwhile, estrogen in other end-to-end contraceptives reduces the quality and quantity of milk.

Although it is possible to take the drug immediately after birth, the World Health Organization WHO recommends that women take POPs after 6 weeks of post-production. At this stage, the process of milk production in the mother has been fully established, so taking a low-dose mini-pill will not have much impact on the lactation period, as well as the general nutritional status of the newborn.

However, progestin-only contraceptives are less effective than coordinated ende secretion tablets, with a failure rate of about 8% in the first year of use. Therefore during contraception while breastfeeding with POPs, also known as Mini-pills, women should keep in mind important notes are:

• Take the drug at the same time every day;
• Do not take the drug 3 hours later than the fixed time;
• Take the medicine immediately if forgetting for 3 hours or more;
• Do not take 2 or more at the same time on the next day;
• Use preventive contraception within 48 hours when forgetting the drug;
• Apply other contraceptives (such as condoms) during the first month of taking POPs.

It is necessary to meet the above strict compliance conditions, the effectiveness of contraceptives containing only progestin will maximize.

In principle, the mother should not apply hormone-containing contraceptives if she wants to contraceptive during breastfeeding, except for the same hormone progesterone. Instead, some safer options may be considered:

• Hormone-free contraception: Method of asym neuroning (LAM), placing the contraceptive ring, intra-uterus instrument or using a condom;
• Hormone contraceptives: Include DMPA contraceptives or Implanon contraceptive implants,however sometimes side effects may be encountered;
• Permanent contraception: Suitable for women over 35 years of age, sterilization is possible by vasectation or sterilization in the husband depending on the aspiration.

In addition, coordinated contraceptives (COCs) provide a high contraceptive effect but are not recommended during breastfeeding because they contain estrogen. According to who, breastfeeding women should only use COCs when the baby is 6 months or older and have the ability to receive a variety of foods in addition to breast milk.

In summary, the estrogen composition in the contraceptive pill secreted through milk will reduce the amount of milk and can affect babies, especially those born without months who need adequate nutrition. Therefore, the contraceptive pill contains only progestin is an appropriate option for mothers and does not harm the baby as well as the entire process of breastfeeding. Women should think about contraceptives during safe breastfeeding from the first time they have sex after giving birth to ensure no unsymed pregnancy.