Oral Contraceptives: “The Pill”

General Information

Oral contraceptive pills work primarily by stopping the release of an egg.  When used correctly, the birth control pill is 99% effective in preventing pregnancy and is 100% reversible.  Birth control pills may also help a woman by decreasing her risk for endometrial cancer, ovarian cancer, benign breast masses, and pelvic inflammatory disease; decreasing menstrual cramps and menstrual blood loss, and regulating periods.  The pill does not protect against HIV or other sexually transmitted infections.  It may be slightly less effective if your body weight is over 198 pounds.  Antibiotics, anticonvulsants, and St. John's Wort decrease the pill’s effectiveness.

Using the pill

• Use a back-up birth control method for the first month of pill use.
• Take one pill a day, at the same time each day, until you finish the 28-day pack. 
• Begin a new pack immediately. Skip no day between packages.
• Periods tend to be short and scanty on pills and you may see no fresh blood at all.  A spot of blood, or a brown smudge on your pad, tampon, or your underwear can be considered a period.
• Spotting between periods may occur, especially during the first 3 months of pill use.
• If you do not have your period when expected while taking birth control pills, consult your clinician.
• Many women experience nausea the first month they take the pills.  This tends to go away in the next month or so.  If it continues, switching to the lowest estrogen pill may be very helpful.  See your clinician for a new prescription.

Starting the pill

Sunday Start:

• Begin taking your pills the first Sunday after your period starts. 
• If your period starts on Sunday then start your pills that same day.
• Use a back-up birth control method for the first month.

“Quick” Start:

• Take your first pill at your clinician’s office after ruling out pregnancy.
• Your next period will be delayed until the completion of your pill pack.

First Period Day Start:

• Begin taking your pills during the first 24 hours of your period.

Following a first trimester abortion or miscarriage:

• Begin taking your pills within 5 days following a complete miscarriage/abortion. 
• Use a back-up birth control method as directed by your clinitian.

Following a full-term pregnancy and delivery:

• If you are breastfeeding:
• Discuss with your clinician alternative methods to regular, estrogen-containing pills, such as the minipill and non-hormonal methods.
• Do not use estrogen-containing pills for at least 6 weeks.
• If you are not breastfeeding:
• Discuss with your clinician an appropriate pill start date . 
• Use a back-up birth control method for 1 week.

Forgetting Pills

If you are less than 12 hours late taking a pill:

• Take the pill as soon as you remember. You do not need to use a back-up method of birth control.

If you are more than 12 hours late taking a pill:

• Take the missed pill as soon as you remember, continue with pill package
• Use a back-up method until you start a new pack of pills. 
• Know that break through bleeding may occur.

 If you miss two or more pills:

• Take two pills at once or Plan B emergency contraception.
• Remove and discard any additional forgotten pills.  Thus, the next pill you take is the one you would have normally taken had you not forgotten the other pills.
• Use a back-up method of birth control until you start a new pack of pills. 
• Know that break through bleeding may occur & you may have nausea.
• Follow-up with your clinician.

If you are forgetting to take your pills regularly:

• Call the Mabel Wadsworth Center to discuss other birth control options

If you had diarrhea or vomiting:

• Start using a back-up method on your first day of diarrhea or vomiting and use until your next period. 

Missing Periods

• It is not unusual to miss a period, even when you are taking your pills as instructed. If this is the case, you can take a pregnancy test if it makes you feel more comfortable, but it is unlikely that you are pregnant.
• If you miss a period and have forgotten one or more pills, take a pregnancy test. Also, check in with your provider if you are concerned about test results
• If you have missed two periods in a row, check in with your provider to help determine if you are pregnant or if there are other reasons for not having your period. 

Discontinuing The Pill

• To discontinue the pill, finish your pack and do not start a new one. 
• If you do not want to be pregnant please call your clinician before discontinuing to discuss other birth control options. 
• If you want to becom pregnant, use a non-hormonal birth control (condoms and spermicide) until you have had 3 normal periods.  Your periods may be irregular after discontinuing the pill while your body adjusts. 

Side Effects

Some common minor side effects of the pills include: 

Nausea                                                             Weight gain                                         Vaginal infections

Spotting between periods                             Decreased menstrual flow                 Headaches

High blood pressure                                      Breast tenderness

Depression/mood swings/irritability

If you notice any pronounced mood changes, depression, irritability, or change in sex-drive, see your clinician.  Switching pill brand may help with these symptoms. 

Danger Signs

Call Mabel Wadsworth Center if you experience any of the following ACHES:

Abdominal pain (severe)

Chest pain or shortness of breath

Headaches (severe)

Eye problems, such as blurred vision or loss of vision

Severe pain, weakness or numbness in arms, legs or face

Smoking increases the potential for serious risks linked to hormonal birth control. If you are over 35 and smoke, you will not be able to obtain birth control pills from most providers, including Mabel Wadsworth Womens Health Center

Always inform any medical provider that you are taking oral contraceptives. 

Call Mabel Wadsworth Women's Health Center if you have questions about your pills.        

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