1

Chapter 1

The Problem

Introduction
Hormones are powerful. Just a small fluctuation in your
hormone levels can have profound effects, from changing your
metabolism to dictating if you want to get down and dirty or curl
up into a ball and sob for days. So its no surprise that
introducing synthetic hormones into your body which is what you
do when you take hormonal birth control like the pill, affects
you on a number of levels.
In todays time, most women will use birth control pills at
some time in their lives. But many women dont know that birth
control pills also can be used to treat a variety of female
problems

just

like

regulating

menstrual

cycle

that

can

give

surprising health benefits, such as fertility improvement.

Birth

control

pills

are

made

of

synthetic

(laboratory

derived) versions of the two ovarian hormones: progesterone and

estradiol. Also, birth control pills can contain synthetic forms
of both hormones and progesterone (progestin) only. Progestinonly pills are best for women who should not or do not want to
take estrogen, but are not used as much because they have a
higher rate of causing unpredictable vaginal bleeding for at

least the first year.( 1996 - 2015 ASRM, American Society for
Reproductive Medicine)
To understand how birth control pills affect periods, it is
helpful to understand how the normal menstrual cycle works. A
menstrual period takes place when the uterus (womb) sheds its
lining; this process is controlled by the hormones made by the
ovary (estrogen and progesterone). A menstrual cycle begins with
the first day of the period, lasts for about one month and is
divided into two halves by ovulation (the release of an egg from
the ovary). During the first half of the cycle, only estrogen is
made. Under the influence of estrogen, the uterine lining grows
to prepare for a potential pregnancy. During the second half of
the

cycle,

after

ovulation,

progesterone

is

also

made.

Progesterone stops the lining from growing and prepares it for

implantation

of

progesterone

and

an

embryo.

estrogen

If

levels

pregnancy
fall,

does

which

not

occur,

triggers

the

shedding of the uterine lining and the next period begins.

So, how does a pill help in regulating menstrual cycle?
Well, this is what happens, most combination birth control pills
contain three weeks of active pills (those that contain hormones)
and one week of inactive placebo pills (those that do not contain
hormones). The bleeding of the period occurs when the hormones
are no longer taken during the week that the sugar or placebo
pills are taken. A woman can increase the length of time between

periods

by

companies

taking

make

active

pill

packs

pills
that

for

more

contain

up

weeks.
to

Some

drug

months

of

continuous active pills. Women on these pills only have four

periods a year, which can be convenient during such times as
final

exams,

aspect,

it

sports

can

activities,

also

treat

or

social

irregular

events.

menstrual

In

other

cycle.

Birth

control pills can be used to make irregular or unpredictable

periods occur on a monthly basis. Women who have menstrual cycles
longer than 35 days might not be making progesterone, which
prevents the uterine lining from growing too much. Excess growth
of the uterine lining can cause heavy bleeding or increase the
risk for developing abnormal patterns of growth in the uterine
lining, including cancer. The most common reason for irregular
and

infrequent

Because

periods

birth

is

control

Polycystic
pill

Ovary

contains

Syndrome

(PCOS).

progesterone-like

medication, it can help regulate the menstrual cycle and protect

the lining of the uterus against pre-cancer or cancer.
The purpose of the study was to investigate women in San
Pablo regarding their knowledge about menstrual-cycle regulatingpills. As part of the health team, the researchers felt the need
to explore the knowledge level of women in San Pablo on the use
of pills in regulating the menstrual cycle and thus, improve the
fertility rate of women in San Pablo

Statement of the problem

This study looked into the pills in regulating menstrual
cycle that will eventually help improve fertility of women in San
Pablo, Zamboanga del Sur.
Specifically, it sought to answer the following questions:
1.

What

is

the

respondents

profile

as

to

age

and

educational level?
2. What is the respondents level of knowledge about the use
of pills in regulating menstrual cycle?
3. Is there a significant difference in the respondents
knowledge score in the use of pills in regulating menstrual cycle
when grouped according to profile?
a. Age
b. Educational Level

Significance of the Study

The findings of this research will be beneficial to the
following:
Menstruating woman. Through this study, menstruating woman
who have regular or irregular menstrual cycle may be able to know
the uses of pills and not merely in controlling birth.
Health team members. The findings of this study may provide
basis for proper dissemination of information in their program on
the benefits of pills in womans body.

Community People. The findings of this study may provide

data for community people to learn about the different uses and
about its benefits if strictly followed.
Future Researchers. The results of this study may provide
basis for future researches on the different factors that may
affect

ones

knowledge

and

adherence

on

the

uses

of

pills

especially in regulating menstrual cycle that will help improve

fertility on women.

Definition of Terms
The following terms are operationally defined for better
understanding:
Pills. A type of pill/tablet with estrogen content used in
regulating menstrual cycle.
Estrogen.
responsible

Is
for

female reproductive

the

primary female sex

development
system

and

and

hormone and

regulation

secondary

sex

of

is
the

characteristic

system. It also refers to any substance, natural or synthetic,

that mimics the effects of the natural hormone.
Age. This refers to respondents number of years at the
present calendar year from birth. In this study the age belongs
in the range of 15-25 years old, 26-35 years old.

Educational Level. This refers to the educational attainment

of the respondents. In the study, it is measured as to basic
education and tertiary education.
Fertility. This refers to the ability to conceive children
or young.
Knowledge Score. In this study, refers to the sum of correct
responses

to

the

nine

items

in

the

questionnaire

regarding

knowledge about menstrual-cycle regulating-pills. The values vary

from 0 (very low level) to 9 (very high level)
Menstrual cycle. This refers to the monthly ovulation of
women.
Basic education. This refers to the education attain by the
respondents mostly belongs to the primary and secondary level.
Tertiary education. This refers to the education attain by
the respondents that belongs to the college level.

Conceptual Framework

Level of Knowledge

Menstrual Cycle
Regulating-pill

Demographic Profile

Age

Educational
level

Chapter 2

REVIEW OF RELATED LITERATURE

Presented in this chapter are the related literature and
studies used in the research study.

Related Literature
Irregular or abnormal ovulation accounts for 30% to 40% of
all cases of infertility. Having irregular periods, no periods,
or abnormal bleeding often indicates that you aren't ovulating, a
condition known clinically as anovulation. Although anovulation
can usually be treated with fertility drugs, it is important to
be

evaluated

for

other

conditions

that

could

interfere

with ovulation, such as thyroid conditions or abnormalities of

the adrenal or pituitary glands. Once your doctor has ruled out
other medical conditions, he or she may prescribe fertility drugs
to

stimulate

your

ovulation.

The

drug

contained

in

both Clomid and Serophene (clomiphene) is often a first choice

because it's effective and has been prescribed to women for
decades. Unlike many infertility drugs, it also has the advantage
of being taken orally instead of by injection. It is used to
induce ovulation and to correct irregular ovulation by increasing
egg production by the ovaries. (WebMD Medical Reference by Nivin
Todd, MD)
A common ovulation problem that affects about 5% to 10% of
women

in

their

reproductive

years

is polycystic

ovary

syndrome (PCOS). PCOS is a hormonal imbalance that can cause the

ovaries

not

treatments

to

work.

available

to

PCOS

can't

treat

the

be

cured,

symptoms

of

but

there

PCOS

and

are
the

infertility

associated

with

this

condition.

By

stimulating

ovulation, especially in women trying to conceive, and treating

insulin

resistance,

regular

ovulation

and

periods

often

are

restored. That is why other physicians suggest the use of pills to

help

menstrual

cycle

regulation

and

aid

fertility.

(NHS.uk:

"Treating Irregular Periods.")

Menstruation is the time of month when the womb (uterus)
sheds its lining and vaginal bleeding occurs. This is known as a
menstrual period. Periods vary widely from woman to woman. Some
periods are punctual, some are unpredictable. On average, a woman
gets her period every 21 to 35 days. A period usually lasts about
three to five days. Irregular periods may require treatment. One
of the treatments is the

Hormone therapy (HT); an

irregular

menstrual cycle is often due to a lack or imbalance of certain

hormones in the body. Birth control pills (oral contraceptives)
often

containing

the

hormones estrogen and

progesterone

are

commonly prescribed to help control irregular periods. A hormone

medication called progestin can also help trigger periods in
women who do not get them. (Womenshealth.gov: "Menstruation and
the menstrual cycle fact sheet)
If your daughter has recently started taking birth control
pills or is thinking about taking them, you probably have some
questions and worries of your own. Adolescent girls and young
women are frequently prescribed birth control pills (also called
oral contraceptive pills, hormonal pills, or simply the Pill)
for irregular menstrual periods, menstrual cramps, acne, PMS,
endometriosis,

and

hormone

replacement

therapy.

For

example,

girls diagnosed with Polycystic Ovary Syndrome (PCOS) a hormone

imbalance which causes irregular menstrual periods, acne, and
excess hair growth, are prescribed birth control pills to lower
their hormone levels (to the normal range) and regulate menstrual

10

periods.

Girls

with

acne

that

is

not

responding

to

simple

measures are often prescribed birth control pills. Does the birth
control pill have health benefits? Yes. The Pill has lots of
health

benefits

periods,

for

teens,

decreased

such

menstrual

as:

Regulation

cramps,

of

menstrual

treatment

for

acne,

treatment for polycystic ovary syndrome (PCOS), lowered risk of

anemia and lowered risk for some cancers. Is there any trouble
getting pregnant after using the birth control pill? There is no
change in fertility with using the birth control pill. Regular
periods and ovulation usually start up again right away. However,
girls who were very irregular before starting the pill may be
irregular after they stop the pill. Girls who have PCOS or lose
weight on the pill are particularly likely to be irregular, not
because of the Pill, but because of their medical condition. If
your daughter was using the Pill for birth control, she should
use another birth control method right away if she doesnt want
to get pregnant. She should talk to her health care provider
before

she

actually

stops

taking

the

birth

control

pill.

(youngwomenshealth.org/parents/birth-control-pills-parent)
If you experience irregular periods you will know just how
frustrating and inconvenient they can be. You can never predict
when

they'll

come

and

you

may

suffer

from

more

abdominal

cramping. Irregular periods are extremely common. In fact 90% of

females

will

menopause.

experience

The

term

irregular

irregular

bleeding

periods

before

can

they

mean

reach

something

different to everybody because women's cycles are not all the

same.

By

definition, irregular

periods

are

characterized

as

infrequent or too frequent periods, missed periods, and a change

in

blood

flow.

Due

to

the

inconvenience

and

distress

that irregular periods can cause, women often seek a ways to help
regulate them. Treating them with birth control is an obvious
choice. If you want to use birth control as a way of controlling

11

your periods, then you must consider the various hormonal birth
control methods. Some have a large impact on your menstrual
cycle, while others have less. When choosing one, consider the
symptoms

you

are

experiencing

and

the

irregularity

of

your

menstrual cycle. Birth Control Pill is a pill that combines

estrogen and progesterone and is taken for 21 days. During the
seven

day

pill

break,

menstruation

will

occur.

The

pill

manipulates your natural hormones (meaning you don't ovulate) so

that any bleeding that occurs in the pill break is withdrawal
bleeding induced by the withdrawal of synthetic hormones in
those seven days. Using the pill can make it much easier to
predict when menstruation will occur.
Most methods of hormonal birth control will can manipulate
your

monthly

period

and

make

your

cycle

more

regular.

When

beginning any of these, it may take a few months for the body to
adjust

and

for

the

cycle

to

regulate.

Using

hormonal

birth

control is not an option if you are trying to get pregnant but

have irregular periods. You should talk to your doctor about ways
to improve the chances of conception without hormonal influences.
(www.irregular-periods/articles.com)
Menstruation is the time of month when the womb (uterus)
sheds its lining and vaginal bleeding occurs. This is known as a
menstrual period.Periods varies widely from woman to woman. Some
periods are punctual, some are unpredictable. On average, a woman
gets her period every 24 to 38 days. A period usually lasts about
two to eight days. Irregular periods may require treatment. Do
Irregular Periods Need Treatment? Treatment of irregular periods
depends on the cause and your desire to have children in the
future. Irregular periods can be caused by many different things.
Changes

in

your

body's

level

of

the

hormones estrogen

and progesterone can disrupt the normal pattern of your period.

12

That's

why

young

approaching
common

girls

going

menopause commonly

causes

of

an intrauterine

through

have

irregular

puberty

irregular

periods

and

women

periods.

Other

include:

device (IUD),Changing birth

Having

control

pills or

using certain medications, Excessive exercise, Polycystic ovary

disease

(PCOS),

thyroid or

Pregnancy or breastfeeding,

hyperthyroidism.

less

Stress,

common

Overactive

cause

is

severe

scarring (adhesions) of the lining of the uterus, a condition

known as Asherman syndrome. How Are Irregular Periods Treated?
Usually, no treatment is needed for irregular periods caused by
puberty and menopause unless they are excessive or bothersome. It
is also normal for your period to stop when you are pregnant.
Treatments for irregular periods due to other causes may include:
Correcting or treating underlying disease, Changing your
type of birth control, Lifestyle changes, including weight
loss, Hormone therapy and Surgery. Example: Hormone therapy
(HT). An irregular menstrual cycle is often due to a lack or
imbalance of certain hormones in the body. Birth control
pills

(oral contraceptives)

often

containing

the

hormones estrogen and progesterone are commonly prescribed

to

help

control

irregular

periods.

hormone

medication

called progestin can also help trigger periods in women who

do not get them.
Other

hormone

irregular

treatments
periods

may
who

be

prescribed

are

having

to

women

with

difficulty getting

pregnant.
Other

medications,

provide

such

relief

from

as hormonal
irregular

birth

control,

periods.

may

However,

it

also
is

important to understand that medications and surgery have a

high risk of side effects. In fact, some of these side
effects

can

overshadow

any

potential

benefit.

So,

in

13

considering this third level of approach, it is always best

to speak with a healthcare practitioner before attempting
any treatment.
The

three

approaches

to

treating

irregular

periods

are

not

mutually exclusive. More and more women are discovering that

a combination of lifestyle changes plus hormone-regulating
herbal supplements is the overall best and most effective
way

to

regulate

their

periods.

(http://www.34-menopause-

symptoms.com/irregular-periods-treatments.htm)

14

Chapter 3

RESEARCH METHODOLOGY

The chapter presents the description of the research design,

research

setting,

validation

of

research

instrument,

respondents,
data

research

gathering

instruments,

procedures

and

statistical treatment.

Research Design
The descriptive research design was used in this research
study. Descriptive method of research is a fact finding study
with

adequate

describes

what

and

accurate

actually

interpretations

exist

such

as

of

current

findings.

It

conditions,

practices, situations or phenomena.

Since the present study or investigation is concerned with
the level of knowledge on the pills in regulating menstrual cycle
to improve fertility of a woman, the researchers considered it as
an appropriate research design.

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Research Setting
This

study

was

conducted

in

different

barangays

in

San

Pablo, Zamboanga del Sur a coastal municipality of Zamboanga del

Sur, located southeastern part of the province. It is a 4th class
municipality, with a population that more or less totals to about
23,450. It is about 149.9 km in area and it is not readily
easily accessible by all means of transportation because of the
type of road present.
Specifically,

this

study

is

conducted

by

the

midwifery

students of Sibugay Technical Institute, Incorporated headed by

its College Dean Maam Eloisa Donar Abdulla.

Research Respondents
The respondents of the study were the 30 women from
different types of age range and educational attainment. The said
respondents were chosen through convenient.
Convenient sampling is a type of non-probability sampling
where

the

respondents

are

chosen

at

the

convenience

of

the

researchers. In the study, the respondents are residents of San

Pablo Zamboanga del Sur and also, some are with the convenience
of being a client in the health care facility were in some of the
respondents are assigned to.

Research Instrument

16

To gather the necessary data and information, a researchermade questionnaire was used. Contained in the questionnaire were
statements that would determine the level of knowledge on pills
in regulating menstrual cycle to improve fertility of a woman.
The questionnaire is composed of two parts. Part I identified the
respondents profile as to age and educational level. Part II
determined the respondents level of knowledge in the use of
pills in regulating menstrual cycle to improve fertility of a
woman.
To evaluate the knowledge score in the use of pills in
regulating menstrual cycle to improve fertility of a woman, the
scale below was used:

Knowledge in the use of pills on regulating menstrual cycle to

improve fertility of a woman
Interpretation in
Interval

Scores

Terms of Level of

0.00 1.49

0 1

1.50 3.49

2 3

Low

3.50 5.49

4 5

Fair

5.50 7.49

6 7

High

7.50 9.00

8 9

Knowledge
Very Low

Very High

17

Validation of Instrument
The instrument that was utilized by the researchers was
presented to the adviser for appraisal as to its aptness to the
study. The questionnaire was prepared and was validated by the
researchers through a pre-testing to 20 women. After the pretesting, suggestions and recommendations from the respondents and
adviser was included in modifying the items of the questionnaire.

Data Gathering Procedure

Prior to the actual process of data gathering required in
the study, a letter seeking permission to carry out the inquiry
was obtained from the Mayor of San Pablo Zamboanga del Sur, Hon.
Velman Mantos. On the same regard, the researchers also asked the
permission from the Baranggay Captain of different Baranggays, to
conduct

study

utilizing

their

residents.

And

lastly,

the

Municipal Health Officer, Dr. Hermiraldo Catubig Jr. A cover

letter was attached on the questionnaire explaining the nature
and purpose of the study to the respondents.
After approval was obtained, the researchers then proceeded
to personally distribute the questionnaires to the respondents in
the different baranggays and clients in the health care facility.

18

Statistical Technique Used

The following statistical tools were applied in the study:
Frequency and Percentage. These tools were used to determine
the number of respondents giving a particular response to a given
question in proportion to the total number of respondents in the
survey.
Weighted Mean. This tool was used to determine the knowledge
score

on

the

use

of

pills

in

regulating

menstrual

cycle

to

level

of

improve fertility of a woman.

T-test.
knowledge

of

This
the

tool

was

used

respondents

to

was

determine
significant

the
when

grouped

according to age and educational level.

Levenes Test. This tool was used to assume that variances
of the populations from which different samples are drawn are
equal.