Birth control pills are a method of preventing pregnancy that uses hormones taken in the form of daily pills.
(last reviewed February 9, 2008)
How do birth control pills work?
The man-made female hormones in the pills change a woman's natural hormone levels and prevent her ovaries from releasing an egg each month. The hormones also help prevent pregnancy in 2 other ways. They cause a thickening of the mucus on the cervix and they change the lining of the uterus. The thickened mucus on the cervix makes it hard for sperm to enter the uterus. The change in the lining of the uterus helps prevent a fertilized egg from attaching to the uterus.
(last reviewed February 8, 2008)
What are "combination" birth control pills?
Combination or combined birth control pills are the most common form of birth control pills. They contain man-made forms of 2 hormones: estrogen and progesterone. There is also a progesterone-only pill (the mini-pill), but it is not as effective and causes a lot of blood spotting between menstrual periods.
(last reviewed February 8, 2008)
How do I take the birth control pills?
The combined pills usually come in a package of 28 pills. They are also available in 21-pill or 91-pill packs. For more information on the 91 day packs, click here. You and your doctor will decide which type of pills are best for you. Your doctor will probably advise you to start taking the pills on the Sunday after your period has started or on the first day of your next period, depending on your preference.
It is worthwhile to follow the following instructions:
Try to take your pill at the same time every day. This will help you remember to take the pills. It will also help keep hormone levels steady.
Use a backup method of birth control (such as condoms and spermicide) until you have been taking the pills for 2 weeks.
Use condoms, even though you are taking birth control pills, for protection against sexually transmitted disease unless you have a long-term, single-partner relationship.
If you have bleeding between periods for several cycles you may need a different pill. Call your healthcare provider for an appointment.
Any time you are seen for medical reasons, be sure to mention that you are taking birth control pills. This is particularly important if you are admitted to the hospital or having surgery.
21-day pill pack
If you are using the 21-pill pack, take 1 pill every day for 3 weeks. Stop taking the pills for 7 days and then start a new pack. Your period comes during the week that you are not taking pills.
28-day pill pack
If you are using the 28-day package, take 1 pill every day for 4 weeks and then start a new package the next day. The last 7 pills are inactive and contain no medicine for birth control. They just keep you in the habit of taking a pill every day. Your period comes during the week that you are taking the last 7 pills.
What if I forget to take the birth control pill?
It is important not to forget to take the pill because your risk of pregnancy increases when you miss any pills. Follow these instructions if you do forget a pill.<br /><br /><strong>If you forget 1 pill</strong>, take it as soon as you remember, even if it is the next day. Take the next pill on time.<br /><br /><strong>If you miss 2 or more doses in a row</strong>, see the information sheet that comes in the medicine package or ask your doctor provider what to do. Use an additional method of birth control, such as condoms or spermicide, until your next period starts.<br /><br />(last reviewed February 8, 2008)
When can I start taking birth control pills after having a baby?
If you are breast-feeding your baby, do not use birth control pills unless your doctor says it is OK. Remember that breast-feeding is not sure protection against pregnancy, so use another form of birth control before you start taking birth control pills again.
If you are not breast-feeding your baby, you may be able to start taking birth control pills 1 to 2 weeks after the birth or when you begin menstruating again. Use condoms or spermicides until you start the pills. Be sure to check with your doctor before you start taking birth control pills again.
(last reviewed February 8, 2008)
What are the benefits of taking birth control pills?
The benefits of birth control pills are:
Birth control pills are 92 to over 99% effective in preventing pregnancy.
You do not have to interrupt lovemaking to use a birth control device or spermicide.
Periods become regular and usually lighter. Menstrual cramps may be less severe.
Long-term use lowers the risk of cancer of the ovary.
Birth control pills may reduce symptoms of premenstrual syndrome (PMS).
(last reviewed February 8, 2008)
Will it be more difficult to get pregnant when I stop taking the birth control pill?
No. You should be able to get pregnant just as easily as if you were never on the birth control pill.<br /><br />(last reviewed February 8, 2008)
Is it safe to use birth control pills if I am a smoker?
You should not smoke. Smoking increases the risk of serious side effects, such as heart attack, stroke, and blood clots. This is especially true if you are over 35 years old and smoke 15 or more cigarettes a day. If you are not 35 years old it is generally safe to take the birth control pill. You should speak with your doctor before you start the pills.
(last reviewed February 8, 2008)
Can I take other medications when I am on the birth control pills?
Some medicines can affect the way birth control pills work in your body. Birth control pills may not keep protecting you against pregnancy if you are taking certain antibiotics or medicines for seizures or fungal infections. Tell your doctor about all medicines or natural remedies you are taking. You may need to use an additional form of birth control while you are taking these medicines.
(last reviewed February 8, 2008)
Do birth control pills help prevent sexually transmitted infections?
No. You must always use condoms and take proper precautions to help prevent sexually transmitted infections even when you are on birth control pills.
(last reviewed February 8, 2008)
Are there any disadvantages of the birth control pill?
One disadvantage of birth control pills is that you must remember to take a pill every day. The pills usually have no side effects, but sometimes they cause side effects such as:
irregular menstrual bleeding or spotting for the first few months after you start birth control pills
yellowing of the skin or whites of the eyes (jaundice).
(last reviewed February 8, 2008)
Is there anyone who should not take birth control pills?
Some women with chronic diseases or other problems should not use birth control pills. For example, women who have had blood clots, certain cancers, heart attack. or stroke should not use the pills. Your doctor will discuss your medical history with you.
(last reviewed February 8, 2008)
When should I call my doctor if I am taking birth control pills??
Call your doctor right away if you have:
sharp chest pain or sudden shortness of breath or are coughing up blood
sudden severe headache or vomiting, dizziness or fainting, or problems with vision or speech
sudden partial or complete loss of vision
yellowing of the skin or whites of the eyes (jaundice), especially with fever, tiredness, loss of appetite, dark urine, or light-colored bowel movements
unexplained pain, weakness, or numbness in the calf of one of your legs
severe pain, swelling, or tenderness in the abdomen.
Call your doctor during office hours if you have:
problems with your menstrual periods, such as bleeding between periods, prolonged periods, or missed periods, or you think you are pregnant
more headaches than you used to have
severe mood changes
vaginal discharge with itching.
(last reviewed February 8, 2008)
What are some examples of "combination" birth control pills?
Since these are the most common types of birth control pills, there are numerous types. The following is a list of many of them, but it is almost impossible to give a complete list of the pills available around the world.
The first important difference among the different pills is in which form of synthetic (man-made) hormone the pills have.
The following are the different types of estrogens that are used in the birth control pills:
Ethinyl Estradiol (used in almost every birth control pill)
Mestranol (very rarely used)
The following are the different types of progestins that are used in the combination birth control pills:
Norgestimate
Norethindrone
Desogestrel
Levonorgestrel
Norgestrel
The second important difference among combination birth control pills is in the dose of estrogen contained in the pill. The doses are usually in the following increments:
20 micrograms (mcg)
35 mcg
50 mcg
The third important difference among combination birth control pills is in change of dosing that may occur week to week during each month. For example, there are three ways the combination birth control pills can be designed:
Monophasic - this is the most common. This means that the amounts of medicine in each pill is exactly the same during the three weeks between periods. The fourth week of pills usually has no medicine in the pill, thus you will usually have your period this week.
Biphasic - The dose of progesterone changes once during the three weeks between periods. This type of dosing is rarely, if ever used.
Triphasic - The dose of the progesterone changes for each of the three weeks between periods. This is done in an attempt to approximate the natural changes that occur in the levels of progesterone during a natural menstrual cycle. This is a very popular type of pill.
Extended (continuous) dosing - see our section on continuous dose contreceptives for more information. These pills are designed to have fewer periods or no periods at all. The fourth week of the pack also has medicine in each pill.
(last reviewed February 11, 2008)
How do I choose which birth control pill is right for me?
It is important to discuss with your doctor all of the specific details of your own medical histiory when choosing a birth control pill. In general, some pills have been shown to be effective against acne, some have been shown to be effective against some PMS symptoms. Lower dose pills may have less side effects, and higher dose pills may have less breakthrough bleeding. there are many variables that may influence your decision, and this is something you and your doctor should discuss. Remember that ALL of the birth control pills are effective against pregnancy, as long as you take them as instructed.
