What
are Birth Control Pills?
The
Pill is the most popular type of birth control. There are many different brands
of The Pill and they come in packs of 21 or 28 pills. One pill is taken every
day. The first 21 pills have a combination of synthetic estrogen and progesterone
hormones. The Pill stops ovulation, preventing the ovaries from releasing eggs.
The Pill also thickens cervical mucus, making it harder for sperm to enter the
uterus. The hormones in the Pill prevent fertilization. The last 7 pills of a
28-day pack have no hormones and are called spacer pills. The Pill is
92-99.7%
effective as birth control. It does not protect against reproductive tract infections,
including HIV/AIDS.
Use • Cautions • Side Effects • Drug Interactions • Danger
Signs
Missed Pills • Missed
Periods • Future Fertility
Advantages • Disadvantages • Further
References • PDF Version
Use
When started
within 6 days of the start of a period or within 6 days after an abortion, The
Pill is effective immediately. If the Pill is started at other times, it will
be effective after one month. To lower the risk of pregnancy and sexually transmitted
infections, condoms can be used while taking The Pill.
Starting The
Pill:
There are
several ways to begin taking The Pill. One common way is to start on the first
day of your period or the first day after an abortion. Some women prefer to start
on the first Sunday after they begin their period or the first Sunday after an
abortion.
Continuing:
Take one pill every day until you finish
an entire pack. Try to link taking The Pill with a regular activity that you do
at the same time every day, like eating a meal or brushing your teeth. If you
have a 28-day pack, start a new pack immediately after you finish the old one.
If you have a 21-day pack, take one pill every day for 21 days, no pills for 7
days, then start the new pack immediately.
Cautions
Some
women may not be able to take The Pill because of the risk of serious health problems.
Women who are over 35 and smoke or who have any of the following conditions should
not take The Pill:
- History
of heart attack or stroke
- Blood
clots
- Unexplained vaginal
bleeding
- Known or suspected
cancer
- Known or suspected
pregnancy
- Liver disease
Women
who are under 35 and smoke, have migraines, gallbladder disease, hypertension,
diabetes, epilepsy, sickle cell disease, elective surgery, a history of blood
clots, liver or heart disease may not be able to take The Pill. Your clinician
or doctor can decide.
Women
who use The Pill have a higher risk of heart attack and stroke. The effects of
The Pill on breast cancer are still unknown. The Pill lowers a woman's chance
of developing ovarian cancer, endometrial cancer, and pelvic inflammatory disease.
As
the body adjusts to hormonal changes created by The Pill, women often experience
some minor side effects, including:
- Irregular
bleeding or spotting
- Nausea
- Breast
tenderness
- Weight gain and/or
water retention
- Spotty darkening
of the skin
- Mood changes
Side
effects usually disappear after 2-3 cycles. If your side effects are bothersome
after 2-3 cycles or if heavy bleeding occurs, continue taking your pills and call
the clinic for an appointment to talk about your prescription.
Drug
Interactions
The
effectiveness of the Pill is lowered when taken with certain medications, including
antibiotics, anti-seizure, tuberculosis, and migraine medications. If you are
taking any medications, tell your clinician. When taking medications that may
interfere with BC, consider adding a backup method of birth control, like condoms
and spermicide. As with all drugs, it is useful to inform all your medical providers
if you are using hormonal birth control.
Women
who experience any of the following symptoms while taking The Pill should call
the clinic immediately:
- Abdominal
pains (severe)
- Chest
pain or shortness of breath
- Headaches
(severe)
- Eye
problems, such as blurred vision
- Severe
leg or arm pain or numbness
Missed
Pills: Late Start
The
most common way women get pregnant while using The Pill is starting late.
- 1 day late starting
the next package: Take 2 pills as
soon as you remember and one pill each day after. Use a backup form of birth control
for two weeks.
- 2
days late starting the next package: Take 2 pills per day for 2 days, then continue as usual. Use a backup form of
birth control for two weeks.
- 3
or more days late starting the next package: Call the clinic for instructions.
Missed
Pills: During the Cycle
- 1
pill missed: Take it as soon as you
remember and take your next pill at your usual time. This may mean taking two
pills in one day.
- 2
pills missed in a row in the first two weeks: Take two pills on the day you remember and two pills the next day. Finish the
rest of the pack as usual. Use a backup form of birth control for one week.
- 2
pills missed in a row in the third week: Keep taking one pill every day until Sunday. On Sunday, set aside the rest of
the pack, including the spacers, and start taking a new pack of pills. Use a backup
form of birth control for one week.
- 3
or more pills missed in a row anytime: Keep taking one pill every day until Sunday. On Sunday, set aside the rest of
the pack and start taking a new pack of pills. Use a backup form of birth control
for two weeks.
Missing
any of the last 7 pills of a 28-day package will not raise your risk of pregnancy.
Skip the pills you missed, but be sure you start your next pack on time.
Missing
a period does not always mean that you are pregnant. If you do miss a period,
think about how likely a pregnancy is. Also consider the risks related to continuing
birth control pills. Pregnancy is more likely:
- in
the first few months of Pill use
- if
you missed taking any Pills
- if
you are taking another medication (especially antibiotics)
- if
you have been sick (vomiting and/or diarrhea)
If
you forgot one or more pills and do not have a period that month, we recommend
that you have a sensitive pregnancy test done at a clinic.
If
you miss two periods in a row, it could either be normal or a sign of pregnancy.
Pregnancy tests are recommended right away. If you become pregnant while on The
Pill, there is probably no risk of birth defects.
Future
Fertility
Women
who want to become pregnant may stop using The Pill at any time. Fertility may
return immediately or after a few months.
- Periods
may be lighter or more regular.
- Easy
to use.
- Does not harm future
fertility.
- Does not interrupt
sex play.
- May protect against
uterine and ovarian cancers.
- May
reduce acne.
- Can be used
for Emergency Contraception.
Disadvantages
- Does
not protect against sexually transmitted infections,
including HIV/AIDS.
- Must
be taken every day.
- Less
effective when taken with some drugs.
- Raised
risk of heart attack and stroke.
- Requires
a prescription.
Emergency Contraception (The "Morning After" Pill - "Plan B" - "EC")
You can prevent pregnancy after sexual intercourse by taking Emergency Contraception pills (Plan B). Plan B works by giving the body a short burst of synthetic hormones that disrupt the hormone patterns needed for a pregnancy to start. Some types of regular birth control pills will work. Emergency Contraception is most effective 24-48 hours after unprotected intercourse but it can work for several days.
To find a clinic, doctor or pharmacy close to you, call the nationwide Emergency Contraception Hotline at 1-800-584-9911, 24 hours a day in English or Spanish (also at 1-888-NOT-2-LATE and ec.princeton.edu).
If you already have birth control pills in your possession, ask the hotline how to use them as emergency contraception. Or call our clinics at 800-572-4223 and ask how to use the birth control pills you already have to prevent pregnancy after sex.
In Washington State you can get Plan B directly from your pharmacy without first getting a prescription from a doctor. Call ahead to make sure they have it in stock and a trained person available to give it to you.
Women's health activists are working to make Plan B available over-the-counter nationwide so that one day soon you could purchase it at your neighborhood drug store.
Some people are buying Plan B in advance (it costs around $35-50) so they will have it on hand if they need.
March 3, 2008
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