What is the normal pill (oral contraceptive)?

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Last updated: May 10, 2025View editorial policy

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From the Guidelines

Normal pilm is characterized by a smooth, straight line without irregularities, inflammation, or abnormal growths, and is essential for proper eyelid function, tear film distribution, and ocular surface health. The appearance of the palpebral interpalpebral marginal line (pilm) is a crucial aspect of ocular health, and any deviations from the normal appearance can indicate underlying pathology. Some studies have discussed the importance of proper contraceptive use [ 1 ], but these are not directly relevant to the concept of normal pilm. Key characteristics of a normal pilm include:

  • A well-defined and consistent line along the entire eyelid margin
  • No irregularities, inflammation, or abnormal growths
  • Proper eyelid function and tear film distribution. It is essential to examine the pilm regularly during routine eye examinations to detect early signs of eyelid abnormalities that could affect vision or ocular comfort.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Normal Pill Overview

  • The normal pill, also known as the combined oral contraceptive pill, typically contains two hormones: levonorgestrel (LNG) and ethinyl estradiol (EE) 2.
  • LNG is a progestational steroid that is biologically active and has a circulating half-life of around 15 hours 2.
  • EE is an estrogen that, when combined with LNG, provides effective contraception by exerting its action at the central and peripheral levels 2.

Extended-Cycle Regimens

  • Extended-cycle regimens have been developed to reduce the frequency of bleeding episodes, with some regimens resulting in bleeding only 4 times a year 2, 3.
  • One such regimen consists of 84 days of a low-dose, combined active pill containing LNG and EE, followed by 7 days of EE 3.
  • These regimens have been shown to be effective and well-tolerated, with a similar efficacy and adverse effect profile compared to traditional oral contraceptives 3, 4.

Benefits and Risks

  • Extended-cycle regimens may be beneficial for women with medical comorbidities, those who desire to avoid monthly menses, or those who experience increased hormonal withdrawal symptoms 4.
  • The risks associated with extended-cycle regimens are similar to those of traditional oral contraceptives, and counseling on the risks and side effects is comparable 4.
  • Some studies have also shown that extended-cycle regimens can reduce the risk of common menstrual symptoms, endometriosis, and severe dysmenorrhea 4.

Low-Dose Oral Contraceptives

  • Low-dose oral contraceptives containing 20 microg of EE and 100 microg of LNG have been shown to be effective in treating moderate acne 5.
  • These contraceptives have also been shown to improve biochemical markers of androgenicity and reduce the number of inflammatory and total lesions 5.
  • A 91-day extended-cycle oral contraceptive consisting of LNG/EE 150/30 µg for 84 days and EE 10 µg for 7 days (Seasonique) has been approved for the prevention of pregnancy in adult women in the EU 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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