Obstetric & Gynaecology Malaysia


What are combined hormonal birth control methods?

Birth control pills, the birth control patch, and the vaginal birth control ring are combined hormonal birth control methods. They contain two hormonesestrogen and progestin.

How do combined hormonal methods prevent pregnancy?

Combined hormonal birth control methods release estrogen and progestin into the whole body. These hormones prevent pregnancy mainly by stopping ovulation (the release of an egg from one of the ovaries). The mucus in the cervix thickens, making it hard for sperm to enter the uterus. The lining of the uterus also thin.

How effective are combined hormonal birth control methods?

With typical use—meaning that the method may not always be used consistently or correctly—9 women out of 100 (90%) will become pregnant during the first year of using these methods.

What are the benefits of combined hormonal methods?

Combined hormonal methods have several benefits in addition to protecting against pregnancy:

  • They may make your period more regular, lighter, and shorter.
  • They help reduce menstrual cramps.
  • They decrease the risk of cancer of the uterus, ovary, and colon.
  • They may improve acne and reduce unwanted hair growth.
  • They can be used to treat fibroids and endometriosis that cause heavy bleeding and menstrual pain
  • Used continuously, they can reduce the frequency of migraines associated with menstruation (although they should not be used if you have migraines with aura).

What are possible risks of combined hormonal methods?

Combined hormonal methods are safe for most women, but they are associated with a small increased risk of deep vein thrombosis (DVT), heart attack, and stroke. The risk is higher in some women, including women older than 35 years who smoke more than 15 cigarettes a day or women who have multiple risk factors for cardiovascular disease, such as high cholesterol, high blood pressure, and diabetes; a history of stroke, heart attack, or DVT; or a history of migraine headaches with aura.

You should not use combined hormonal methods during the first 3 weeks after delivery because the risk of DVT is higher in the weeks after childbirth. You are also not advised to have sex during this period due to risk of trauma. If you have additional risk factors for DVT, you should wait to use combined hormonal methods until after the first 6 weeks following delivery.

Can I use combined hormonal birth control methods while I am breastfeeding?

If you are breastfeeding, estrogen may affect your milk supply. It is recommended that you use progestin only pill eg Cerazette(RM 30 a pack) for first 6 months post partum. The progestin-only pill comes in packs of 28 pills. It is important to take the progestin-only pill at the exact same time each day for maximum effectiveness. Do not skip pills for any reason—even if you bleed between periods.


What are the different types of combined hormonal pills and how are they taken?

  • 21-day pills-Take one pill at the same time each day for 21 days. Start the pill on the first day of menses. Wait 7 days before starting a new pack. During the week you are not taking the pill, you will have your period.

      • Low dose estrogen 25mcg eg Mercilon(RM25), Loette, Minipill (RM15).
      • Normal dose estrogen 30mcg eg Yasmin, Liza, Diane, Cybelle, Microgynon(RM 25), Marvelon, Rigevidon(RM8), Oralcon.

  • 28-day pills-Take one pill at the same time each day for 28 days. Depending on the brand, the first 24 pills contain estrogen and progestin. The remaining pills may has no hormones; or inactive pills (containing no hormones or supplements). During the days you are taking the hormone-free pills, you will have your period. Eg. Yaz, Lizelle

Evra patch weekly patch (1 box with 3 patches-RM 80)-avoid first pass metabolism in the liver.

Nuva Ring 3 weekly vaginal ring-women need to insert & removed it themselves, not a popular option among conservative Malaysian women.

How can I get hormonal pills? You can get it from most Pharmacy in Malaysia without prescription.

What if I forget to take a pill?

If a pill is missed by more than 12 hours, you should take a pill as soon as possible and use a backup method of contraception (such as condoms) for the next 7 days. If vomiting or severe diarrhea occurs within 3 hours after taking a pill, it may not be absorbed completely by your body. Keep taking your pills, but use a backup method until 7 days after your vomiting or diarrhea stops.

What are possible side effects of using the hormonal birth control pill?

Possible side effects include the following:

  • Headache, nausea, breast tenderness-estrogen
  • Breakthrough bleeding- temporary effect as the body adjusts to hormone changes & resolved in 3 months.
  • Weight gain (in progestin only pill due to water retention and increased appetite)
  • Depression, skin changes( rarely in progestin only pill due to prolonged use)

What is emergency contraception?

Emergency contraception (EC) reduces the include forgetting to take several birth control pills in a row, having a condom break or slip off, or not using a birth control method during sex. Maximun use is twice in a month. To reduce the chance of pregnancy after unprotected sexual intercourse 85%.

What are the different types of emergency contraception?

There are two types of EC: 

1) the copper intrauterine device (IUD) and 

2) EC pills. There are three types of EC pills: 1) ulipristal RM 35, 2) progestin-only pills RM 8 (Prostinor 2), and 3) combined EC pills. Some EC pills can be bought over the counter without a prescription. Only an obstetrician–gynecologist can insert the IUD.

What is the birth control injection?

The birth control injection is an injection of the hormone depot medroxyprogesterone acetate. It provides protection against pregnancy for 3 months. This need prescription (RM 50)

What is the intrauterine device?

The IUD is a small, T-shaped, plastic device that is inserted into and left inside the uterus. There are two types:

  • Hormonal IUD (Mirena) (RM995)-the hormone progestin into the uterus, approved for 5 years of use.
  • Copper IUD (RM380) releases copper into the uterus. It is approved for up to 5 years of use.

LPPKN (NGO for family planning) https://www.lppkn.gov.my

LPPKN at PPUM (Every Wednesday afternoon)
Bilik 10 dan 11, Tingkat 4, Kompleks Kesihatan Wanita Dan Kanak-kanak, Pusat Perubatan Universiti Malaya, 59100 Kuala Lumpur,

Klinik Subfertiliti Ibu Pejabat LPPKN (IVF Kasih)
Tingkat 6, Bangunan LPPKN Jalan Raja Laut Kuala Lumpur

03-26137555 ext : 3610/ 3612/ 3613