Birth Control Pills

WHAT YOU SHOULD KNOW:

• Birth control pills (BCPs), also called oral contraceptives or the pill, help you prevent pregnancy. They help you and your partner plan how many children you want and when to have them. They are made of the female hormones, estrogen and progesterone, which control body functions. These hormones work by preventing ovulation. Ovulation is the time each month when the ovaries make and release an egg cell. Before pregnancy can occur, an egg needs to be fertilized by sperm. They may also keep a fertilized egg from sticking to the lining of the uterus (womb) and growing into a baby. Before taking BCPs, your caregiver may ask you about diseases or illnesses you have had in the past. He will check your risk for blood clots, heart conditions, or stroke (problem with blood vessels of your brain).
  
  
• There are different types of BCPs available, including monophasic, multiphasic, progesterone-only, low-dose, and extended cycle BCPs. You need to work with your caregiver to choose which kind is best for you. Birth control pills are usually arranged in packs with 21 or 28 pills. These packs tell you which pills to take on certain days. If you miss a pill, you may need to use another birth control method, like barrier methods of contraception. When BCPs are used correctly, the chances of getting pregnant are very low.

INSTRUCTIONS:

Medicines:

• Keep a written list of what medicines you take and when and why you take them. Tell your caregiver if you are taking other medicines before starting BCPs or bring the pill bottles with you. Some medicines may decrease the effectiveness of birth control pills in preventing pregnancy. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without talking to caregivers first. Your caregiver can find out if these medicines affect BCPs or other medicines that you are taking. You should use other methods of contraception, like barrier methods, when your medicines affect BCPs. Ask your caregiver for more information about barrier methods of contraception.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking medicines until you discuss it with your caregiver.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Types of birth control pills:

The different types of BCPs include monophasic, multiphasic, progesterone-only, low-dose, and extended cycle BCPs. They have different amounts of estrogen and progesterone, side effects, risks, and schedules for taking them.

• Monophasic birth control pills: These pills have the same amount of estrogen and progesterone in each active pill. They may help prevent sudden changes in your mood or feelings caused by changing hormone levels.
  
  
• Multiphasic birth control pills: The level of hormones in these pills change like those in your body through the month. Each pill has different amounts of estrogen and progesterone depending on the day they will be taken. This helps you get the right amount of hormones and helps prevent any unwanted side effects.
  
  
• Progesterone-only birth control pills: These BCPs only contain progesterone, which prevents ovulation and thickens cervical mucus to block sperm. Progesterone also prevents a fertilized egg from attaching to the endometrium and letting a baby grow in the uterus. They may give you less nausea, breast pain, weight gain, and changes in mood than other BCPs.
  
  
• Low-dose birth control pills: These BCPs have lower amounts of the estrogen and progesterone which may help avoid unwanted side effects. They are available in monophasic and multiphasic forms, and may help prevent blood clots and putting on weight.
  
  
• Extended cycle birth control pills: These pills are taken every day for three months at a time to stop ovulation. You may also have less frequent periods, or you may miss periods completely. You may have some bleeding during the first 3 to 4 months of use. Do not worry, this should go away after some time. These pills may also be used to treat conditions of your uterus, such as endometriosis.

When to take your birth control pills:

• If your pills are packaged in a 21-day pack, take one pill from the pack every day. After you finish the 21-day pack, do not take any BCPs for the next seven days. You will have your period during the seven days off the pill. Start a new pack on day eight.
  
  
• If your pills are packaged in a 28-pack, take one pill from the pack every day. The last seven pills in the 28-day pack are usually a different color than the rest of the pills. You may start a new pack after finishing the old one.
  
  
• If you are taking extended cycle birth control pills, take one pill each day for 12 weeks and take care not to miss a pill.
  
  
• Pick a time of the day that is easy for you to take BCPs. Taking them at the same time every day may help prevent bleeding. If you want to change the time you take BCPs, finish a pack of pills and try a different time for the next pack.

Advantages of using birth control pills:

Birth control pills may help decrease bleeding and pain during your monthly period. They may also help prevent cancer of the uterus and ovaries.

Disadvantages of using birth control pills:

• You may have sudden changes in your mood or feelings when taking BCPs. You may have nausea (upset stomach) and decreased appetite for sex. You may have an increased appetite and gain weight very fast. You may also have bleeding in between periods, less frequent periods, vaginal dryness, and breast pain.
  
  
• Using some types of birth control can place you at a higher risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening. Talk to your caregiver if you have any questions or concerns.

When you should start taking your birth control pills:

You may start taking your pills at any of the following times:

• The first day of your monthly period: You will be protected right away. You may not need to use another birth control method during the first seven days of your period.
  
  
• The first sunday after your monthly period begins: Start taking your BCPs the first sunday after your monthly period begins. You may take them even if you still have your period.
  
  
• The fifth day of your monthly period: Use another birth control method for the first 7 days after taking the pill. Ask your caregiver about other birth control methods.

If you forget to take your pills:

• If you miss one pill, take it as soon as you remember. Continue taking the remaining pills at your usual time.
  
  
• If you miss two pills in a row, take one as soon as you remember. Continue taking the remaining pills at your usual time.
  
  
• If you miss three BCPs in a row, call your caregiver. You may have to stop that pack of pills, wait for your period, and start a new pack.
  
  
• Do not take two BCPs in one day.
  
  
• Use barrier methods of contraception for two weeks if you cannot remember how many pills you may have missed. You may get pregnant if you have sex and not taken two or more BCPs in a row. You may want to consider using another method of birth control if you find that you forget to take your BCPs often.

If you want to get pregnant:

If you are planning to have a baby, ask your caregiver when you may stop taking your BCPs. It may take some time for you to start ovulating again. Ask your caregiver for more information about getting pregnant after taking BCPs.

When to start taking birth control pills after having a baby:

Your caregiver may let you start taking progesterone-only pills after giving birth. For those breast feeding, some BCPs may only be started from six weeks to six months after giving birth. For those not breast feeding, BCPs may be started three weeks after giving birth. Ask your caregiver for more information about taking BCPs after giving birth.

CONTACT A CAREGIVER IF:

• You feel a lump in your breast.
  
  
• You have forgotten to take BCPs for at least a day.
  
  
• You have mood changes, such as depression, since starting BCPs.
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• You missed a period and have questions or concerns about getting pregnant.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You have questions or concerns about how to take your BCPs.

SEEK CARE IMMEDIATELY IF:

• You have very bad headaches or blurring of vision.
  
  
• You have very bad pain in your abdomen (stomach).
  
  
• You have very bad pain, numbness, or swelling in your arms or legs.
  
  
• You still have bleeding even after four months of taking BCPs correctly.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  
  
• Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Learn more about Birth Control Pills (Aftercare Instructions)