About Low-Dose Birth Control Pills and Emergency Contraceptive Pills
Low-dose birth control pills are widely used not only for contraception but also for treating menstrual pain, PMS, acne, and irregular periods. When taken appropriately, they have a contraceptive efficacy of over 99% and can significantly improve one's quality of life (QOL).
Emergency contraceptive pills are used when contraception fails or after sexual assault, and they can help prevent pregnancy if taken within 72 to 120 hours after intercourse.
Available for prescription at our clinic (Internal Medicine)
Low-dose birth control pills and emergency contraceptive pills are medications that can be prescribed by an internal medicine doctor. At our clinic, we safely prescribe these medications after a medical interview, blood pressure measurement, and necessary blood tests. Please feel free to consult us for anything from regular prescriptions to emergency situations.
What are Low-Dose Birth Control Pills (OC/LEP)?
Low-dose birth control pills are a combination of estrogen and progestin. They prevent pregnancy by suppressing ovulation and also improve menstruation-related symptoms.
Differences between OC and LEP
| Category | Main Purpose | Insurance Coverage |
|---|---|---|
| OC (Oral Contraceptive) | Contraception | Self-pay |
| LEP (Low-Dose Estrogen-Progestin) | Treatment of dysmenorrhea and endometriosis | Insurance-covered |
* Even with the same drug components, insurance coverage varies depending on whether the purpose is "contraception" or "treatment."
Effects of Low-Dose Birth Control Pills
| Effect | Details |
|---|---|
| Contraception | Over 99% effective if taken without missing doses |
| Reduction of menstrual pain | First-line treatment for dysmenorrhea, significantly improves severe menstrual pain |
| Reduction of menstrual bleeding | Effective for menorrhagia, prevents iron deficiency anemia |
| Stabilization of menstrual cycle | Cycle regulates to 28 days, making premenstrual symptoms predictable |
| Improvement of PMS/PMDD | Reduces premenstrual irritability, swelling, and breast tenderness |
| Improvement of acne | Suppresses androgen effects, reduces sebum secretion |
| Endometriosis/Uterine fibroids | Prevention of progression, symptom relief |
| Prevention of ovarian/endometrial cancer | Reduces incidence risk by approximately 50% with long-term use |
Types of Common Low-Dose Birth Control Pills
| Category | Representative Products | Characteristics |
|---|---|---|
| Second generation, monophasic | Lunabel Combined Tablets, Friwell Combined Tablets | LEP (insurance-covered), for dysmenorrhea |
| Third generation, triphasic | Marvelon, Favowell | For contraception (self-pay), also effective for acne |
| Fourth generation | YAZ Combined Tablets, Yaz Flex | LEP (insurance-covered), less swelling and weight gain |
| Ultra low-dose | Yaz Flex (continuous use) | Can reduce the number of menstrual periods, for endometriosis |
Recommended for people who:
- Desire contraception
- Suffer from severe menstrual pain and cannot do without pain relievers
- Have heavy menstrual bleeding and are prone to anemia
- Have an unstable menstrual cycle, making planning difficult
- Experience PMS/PMDD that interferes with daily life
- Have acne that worsens before menstruation
- Have been diagnosed with endometriosis or uterine fibroids
- Wish to temporarily shift their menstrual period (for travel, exams, weddings, etc.)
Precautions and Contraindications for Low-Dose Birth Control Pills
For safe use
While low-dose birth control pills are highly effective, they slightly increase the risk of venous thromboembolism (economy class syndrome). It is important to carefully assess the indications.
Absolute Contraindications (Cannot be taken)
- Smokers aged 35 or older who smoke 15 or more cigarettes a day
- History of thrombosis (deep vein thrombosis, pulmonary embolism)
- History of breast cancer or endometrial cancer
- Migraines with aura
- Severe high blood pressure/hyperlipidemia
- Diabetics with complications
- Severe liver dysfunction
- Pregnancy/lactation
- Within 4 weeks before or after surgery
Relative Contraindications (Administer with caution)
- Aged 40 or older
- Obesity (BMI 30 or higher)
- High blood pressure (mild)
- Family history of venous thrombosis
- Prolonged immobility (e.g., long-term hospitalization)
Main Side Effects
| Side Effect | Characteristics/Management |
|---|---|
| Irregular bleeding | Common in the first 1-3 months, gradually improves |
| Nausea/headache | Common at the start of use, usually improves within 2-3 cycles |
| Breast tenderness/pain | Due to hormonal action, usually mild |
| Swelling/weight fluctuation | Less common with fourth-generation pills |
| Mood changes | Rare, consider changing type if severe |
| Venous thromboembolism | 3-9 cases per 100,000 women per year (rare but serious) |
Watch for signs of thrombosis
If you suddenly experience any of the following symptoms, stop taking the pill and seek emergency medical attention: pain or swelling in one calf, severe chest pain, shortness of breath, severe headache, vision abnormalities, difficulty speaking, or paralysis on one side.
About Emergency Contraceptive Pills
This medication is used as a "last resort" when contraception has failed. Since its effectiveness is higher the sooner it's taken, please consult us as quickly as possible.
Types of Emergency Contraceptive Pills
| Drug | Effective Time | Contraceptive Efficacy | Characteristics |
|---|---|---|---|
| Levonorgestrel (LNG) | Within 72 hours | Within 24 hours: 95% 25-48 hours: 85% 49-72 hours: 58% |
Most common in Japan |
| Ulipristal (ella-one) | Within 120 hours | ~85% (slower decline over time) | Not approved for use (personal import not recommended) |
Key Points for Emergency Contraceptive Pills
- The sooner it's taken, the more effective it is
- Take 1 tablet within 72 hours (3 days)
- If menstruation does not occur within 3 weeks after taking, take a pregnancy test
- If vomiting occurs within 2 hours of taking, re-dosing is necessary
- Contraception such as condoms is required for subsequent sexual intercourse (no ongoing contraceptive effect)
- Side effects: nausea, headache, fatigue, irregular bleeding (usually mild and resolves within a few days)
- Not covered by insurance (self-pay treatment)
Contact us immediately in an emergency
Time is of the essence. Our clinic offers daily consultations from 9 AM to 9 PM, with same-day walk-ins accepted, allowing us to respond quickly in emergencies. In cases of sexual assault, we also provide support for consulting the police and sexual assault support centers.
Our Clinic's Examination and Prescription Process
Initial Examination (Low-Dose Birth Control Pills)
- Fill out medical questionnaire (medical history, family history, smoking status, preferences)
- Blood pressure, weight, and BMI measurement
- Blood tests as needed (for thrombosis risk, liver function, lipids, thyroid)
- Doctor's explanation and prescription
- Typically starts with 1 pack (1 month's supply)
Continued Prescription
- Re-examination every 3-6 months (side effect and blood pressure check)
- Blood tests approximately once a year
- Up to 6 months' supply can be prescribed once stable
Estimated Costs
| Type | Cost |
|---|---|
| LEP (Dysmenorrhea, insurance-covered) | Approx. 2,000-3,000 yen/month with 30% co-pay |
| OC (Contraception, self-pay) | 2,500-3,500 yen/month (varies by type) |
| Emergency contraceptive pill (LNG, self-pay) | 10,000-15,000 yen |
| Initial consultation fee/test fee | Separate |
Common Misconceptions
"Taking birth control pills makes it harder to get pregnant in the future" is false
Even when taking low-dose birth control pills, ovulation resumes quickly after stopping. It does not affect future fertility. In fact, by suppressing the progression of endometriosis, it even has the effect of preserving fertility.
"Taking birth control pills makes you gain weight" is largely a misconception
While there were reports of weight gain with first- and second-generation pills, fourth-generation pills (e.g., Yaz) have little to no reported effect. For those concerned about swelling, choosing a fourth-generation pill can address this.
Features of Our Clinic (Pill Prescription)
- Safe prescription through medical interview, blood pressure, and blood tests by an internal medicine doctor
- Selection of the optimal pill from multiple options, from second to fourth generation
- Also handles LEP (insurance-covered), so dysmenorrhea is covered by insurance
- Same-day prescription of emergency contraceptive pills available (daily from 9 AM to 9 PM)
- Also handles menstrual period shifting (for travel, exams, weddings)
- Thorough consultation for concerns about side effects or thrombosis risk
- Walk-ins accepted without appointment / Open daily from 9 AM to 9 PM / 1-minute walk from Jujo Station
Birth control pills are a "tool for women to choose their body and life"
They are medications that improve quality of life across a wide range of issues, not just contraception, but also menstrual discomfort, acne, PMS, and anemia prevention. Let's work together to find the right way for you to use them, armed with correct knowledge.
