Contraceptive pills, or birth control pills, prevent pregnancy by releasing hormones; the process can take place in different ways, depending on the type of pill. Combined birth control pills block ovulation, thicken cervical mucus to prevent sperm from passing through the cervix, and thin the uterine lining (endometrium) to prevent implantation of the egg. The minipill thickens the cervical mucus and thins the endometrium; it can also prevent ovulation. While oral hormonal contraception is commonly referred to as "the pill", there are actually several different types of contraceptive pills. If you have never taken the pill before and want to be sure you are taking it correctly (which is essential for maximum effectiveness), find out about the different options and talk to your doctor.
Steps
Part 1 of 4: Choosing the Pill Type
Step 1. Discuss the different alternatives with your doctor
There are many contraceptive pills that are safe, effective and easy to find, and some are even inexpensive, which makes them an attractive option; however, the choice of the right type of pill also depends a lot on personal needs, on the current state of health as well as on any previous pathologies, so it is important to discuss this with your doctor.
- There are two main types of contraceptive pills: combined (or estrogen-progestagen) birth control pills contain estrogen and progestin hormones; the minipill (or progestin pill) contains only progestin hormones.
- Combination pills come in two types: monophasic pills all contain the same amount of estrogen and progestogen; multiphasic ones vary the amount of hormones depending on the phase of the cycle.
- Combination pills also include so-called "low dose" pills: they contain less than 20 micrograms of ethinyl estradiol, while conventional ones contain up to 50 micrograms. They can be a good choice for women who are very sensitive to hormones, especially estrogen; however, they can also cause problems such as bleeding between periods.
Step 2. Consider your health
Combination pills are prescribed very frequently, but they are not always appropriate. You and your doctor will make the final decision. If you recognize yourself in any of the following conditions, your doctor may recommend that you not use this type of pill:
- You are breastfeeding
- You are over 35 and you smoke
- You suffer from high blood pressure
- You have a previous history of pulmonary embolism or deep vein thrombosis or have an inherited condition that increases the risk of blood clots
- You have a previous history of breast cancer
- You have heart disease or have had a stroke
- You suffer from diabetes-related medical complications
- You have liver or kidney disease
- You have unexplained uterine or vaginal bleeding
- You suffered from thrombosis
- You have lupus
- You suffer from migraine with aura
- You need to undergo major surgery which will prevent you from moving for a long period of time
- Take hypericum (or St. John's wort), anticonvulsants or antituberculosis drugs
- Your doctor may advise you not to use the minipill if you have breast cancer, unexplained vaginal or uterine bleeding, or are taking anticonvulsant or anti-tuberculosis medications.
Step 3. Consider the benefits of the combination pill
It offers a number of benefits that make it an attractive choice for many women; however, it also carries some risks. Pros and cons should be considered when choosing the type of pill. The advantages are as follows:
-
It has a very high contraceptive efficacy if used correctly (99%)
Only 8 out of 100 women become pregnant during the first year of use due to incorrect use
- Reduces menstrual cramps
- It can prevent pelvic inflammatory disease
- Reduces the risk of ovarian and endometrial cancer
- It can reduce the frequency and intensity of menstruation
- Improve acne
- It can help improve bone mineral density
- Reduces androgen production caused by polycystic ovary syndrome (PCOS)
- Protects against ectopic pregnancy
- Reduces the risk of iron deficiency anemia (iron deficiency) caused by too heavy a menstrual flow
- Prevents breast and ovarian cysts
Step 4. Consider the risks of the combined pill
While it offers many benefits, it also carries risks that you should discuss with your doctor. Most side effects are very rare, but they can be serious. Many of these risks increase if you have certain health problems or if you smoke. The disadvantages include:
- No protection against sexually transmitted diseases, including HIV (you have to use condoms to protect yourself)
- Increased risk of heart attack and stroke
- Increased risk of clot formation
- Increased risk of hypertension (high blood pressure)
- Increased risk of developing liver cancer, gallstones or jaundice
- Increased sensitivity of the breast
- Nausea or vomiting
- Weight gain
- Headache
- Depression
- Irregular bleeding
Step 5. Consider the benefits of the minipill
It offers fewer benefits than the estrogen-progestogen one; however, it also tends to have fewer side effects. Consult with your doctor to determine if it is a good choice for you. The advantages are as follows:
- It could also be taken if you have certain health problems, such as blood clots, high blood pressure, migraines or heart disease
- It can be taken during breastfeeding
- Reduces menstrual cramps
- It can make menstruation lighter
- It can help prevent pelvic inflammatory disease
Step 6. Consider the risks of the minipill
Although they are less than those of the combined pill, it is still possible to experience rare but serious side effects. Talk to your doctor to see if the benefits outweigh the risks. The disadvantages include:
- No protection against sexually transmitted diseases, including HIV (you have to use condoms to protect yourself)
- It is potentially less effective than combination pills
- You must use an alternative method of contraception if you do not take it within three hours of the usual time of use
- Intermenstrual bleeding (more commonly caused by the minipill than by the combination pills)
- Increased sensitivity of the breast
- Nausea and vomit
- Increased risk of ovarian cysts
- Slightly higher risk of ectopic pregnancy than with combination pills
- Possible worsening of acne
- Weight gain
- Depression
- Abnormal hair growth
- Headache
Step 7. Think about your menstruation preferences
If you are healthy enough to take birth control pills, you have several options. If you choose a combo, as many women do, you can decide to reduce the frequency of your menstrual cycles if you wish.
- Continuous pills, also called "extended cycle" pills, can reduce the frequency of menstruation to as little as four cycles per year or, in some cases, stop them altogether.
- Conventional pills do not reduce the number of menstrual cycles. You will still have your period every month.
Step 8. Be aware that some medications can interfere with the pill
Your doctor can help you determine if you are taking any medications or supplements that inhibit the effectiveness of hormonal contraceptives. Some well-known examples are:
- Several antibiotics, including penicillin and tetracycline
- Some medications for seizures
- Some drugs used to treat HIV
- Anti-tuberculosis drugs
- Hypericum (or St. John's wort)
Step 9. Tell your doctor about any medications or supplements you are taking
Some medications interfere with the effectiveness of birth control pills, and many others can cause negative interactions and side effects. Be sure to tell your doctor if you take any of the following:
- Thyroid medications
- Benzodiazepines
- Prednisone
- Tricyclic antidepressants
- Beta blockers
- Anticoagulants
- Insulin
Part 2 of 4: Starting the Pill Cycle
Step 1. Follow your doctor's directions
You should always follow the directions given by your doctor. Different pills have different rules: some must be started at a particular time, others must be taken on specific days. Read the instructions and follow the next steps.
If you don't take the pill as directed, it may not be effective and you could get pregnant
Step 2. Don't smoke
Smoking makes the pill extremely dangerous to health: together, they greatly increase the risk of thrombosis, which can easily kill you. Women over the age of 35 who smoke should not use any type of combined birth control pill.
If you smoke, quit; even the occasional cigarette can be dangerous. If you don't smoke, don't start
Step 3. Start taking the pill
Depending on the type you have been prescribed, you may need to start taking it at a certain time. Ask your doctor when you should start. Generally speaking, the options are as follows:
- You can start the combination pills on the first day of your cycle
- You can also start taking them on the first Sunday after your period starts
- If you have just given birth vaginally, you need to wait three weeks before you can take them
- You should wait at least six weeks after giving birth if you are at risk for thrombosis or are breastfeeding
- You can start taking them right away if you have had an abortion or have had a miscarriage
- Always start a new pack on the same day of the week you started the first one
- You can start taking the minipill at any time. If you plan to have vaginal intercourse within 48 hours after the first intake, use another method of contraception as well.
- You must take the minipill at the same time each day. Choose a time of day when you know you will remember to take it, such as when you get up or before you go to bed.
- You can start taking the minipill right away if you have had an abortion or have had a miscarriage.
Step 4. Know that it is still possible to get pregnant in some cases
If you start taking the pill on the first day of your period, it will be effective right away. If you start taking it on a different day, there is a chance you could get pregnant if you have unprotected sex.
- Therefore, it is advisable to use other contraceptive methods as well throughout the first pill cycle.
- If you start taking it at a time other than the first day of your period, it may take a full month for the pill to become fully effective.
- If you don't start within 5 days of starting your period, you should use an alternative method of contraception for a full month or full pill cycle.
Part 3 of 4: Take the Pill
Step 1. Take the pill at the same time each day
You can take it in the morning or in the evening, but most women find it easier to remember it in the evening, because the nightly bedtime routine isn't as varied as the morning one. If you don't take it at the same time every day, you won't be adequately protected; in addition, you may experience side effects such as abnormal bleeding (spotting).
- If you take the minipill, it is essential that you take it within three hours of your usual time each day. If not, you need to use an additional contraceptive for the next 48 hours. For example, if you usually take it at 8pm, but you only remembered it at midnight, you still need to take it but also use another contraceptive, such as condoms, for the next two days.
- If you're a bit forgetful, you can try setting an alarm on your phone or putting the box next to your toothbrush.
- There are even apps that remind you to take the pill, such as "myPill Reminder" and "Pill Alert".
- Take it about half an hour after eating to avoid nausea.
Step 2. Be aware of what kind of pill you are using
Some combination pills are divided into several 'phases', meaning the level of hormones they contain changes over the course of the cycle. If you are taking a non-monophasic pill, there may be specific additional instructions on what to do if you miss one.
- The monophasic pills all have the same dosage of estrogen and progestin. If you forget one, take it as soon as you remember and take the next day at the usual time.
- Biphasics change the dosage of estrogen and progestogen once a month.
- Triphasics change the hormone dosage every seven days for the first three weeks.
- Quadruphasics change the dosage of hormones four times.
Step 3. Take the combination pills according to your chosen regimen
They can be conventional or continuous administration (or "extended cycle"). Depending on the type you have chosen, you may need to take different pills at different times. Check the instructions.
- Pills that have 21-day cycles should be taken one a day, at the same time, for 21 days. This is followed by a seven-day break in which no pills are taken; menstruation usually occurs during this period. After seven days, a new pack is started.
- Those with 28-day cycles should be taken once a day, at the same time, for 28 days. Some of these pills do not contain hormones or contain only estrogen. You will have your period for 4-7 days.
- Those with three-month cycles should be taken one a day, at the same time, for 84 days. Then, for seven days, take a pill that does not contain hormones or contains only estrogen at the same time each day. You only have your period during these seven days, so once every three months.
- Those with an annual cycle must be taken one a day, at the same time, throughout the year. Menstrual cycles will drop dramatically or may even stop altogether.
Step 4. Let your body adjust to the hormones
Keep in mind that during the first month, while your body is still adjusting to hormones, you may experience symptoms associated with pregnancy (swollen breasts, sensitive nipples, spotting, nausea). Some pill types can even stop your period altogether, so make sure you and your doctor know which pill you are taking so you know what to look out for.
If you are concerned that you are pregnant, you can use a home pregnancy test. The test results are reliable even if you are taking hormonal contraceptives
Step 5. Watch out for blood loss
If you are taking a pill that is supposed to decrease menstrual cycles, be aware of any spotting (irregular bleeding between periods). Even pills that allow you to have regular periods can sometimes cause you to leak. This is absolutely normal: it takes a while for the body to adjust to the new regime. They usually disappear within three months, but can persist for up to six months.
- Spotting is most commonly caused by low-dose combination pills.
- You are even more likely to have these leaks if you miss a day or if you don't take the pill at the same time each day.
Step 6. Make sure you refuel on time
Request a new prescription well in advance to avoid running out of pills. You should do this when you only have one pack left (the number of packs required by the recipe depends on the type of prescription).
Step 7. Try another type of contraceptive if the first one doesn't work for you
Don't be afraid to try different brands or other methods. Talk to your doctor about changing brands if you are overly affected by PMS symptoms or the side effects of a particular pill. also remember that there are other methods of contraception, many of which are easier to manage.
- Other types of hormonal contraceptives include the combined estrogen and progestin patches and the vaginal ring.
- Other highly effective and long-lasting methods are intrauterine coils (IUDs), subcutaneous implants and injections.
Step 8. Watch for negative drug reactions
Stop taking if you have jaundice, abdominal pain, chest pain, leg pain, severe headache or eye problems. Be especially careful if you smoke, although it would be better to quit smoking altogether if you take contraceptive pills: combining the two significantly increases health risks, such as blood clots.
Step 9. Learn in which situations you need to see a doctor
Taking contraceptive pills carries some risks. If any of the following occur, contact your doctor as soon as possible:
- Bad headache
- Change or loss of vision
- Aura (see flashes of light and sparkling lines)
- Numbness
- Severe pain in the chest
- Respiratory problems
- Hemoptysis (coughing up blood)
- Dizziness or fainting
- Severe pain in the calf or thigh
- Yellowing of the skin or eyes (jaundice)
Part 4 of 4: Know what to do if you forget a pill
Step 1. Try never to forget to take the pill and make up for it if it happens
If you forget one, take it as soon as you remember and take the next one as usual. Some combination pills, especially multiphasic ones, may have additional instructions to follow.
- If you only remember the pill the next day, you should normally take two on the same day.
- If you forget for two consecutive days, take two pills the day you remember and two more the next day.
- If you forget a pill, you should use a back-up method of contraception (such as condoms) until you finish the pack.
- If you miss one during the first week of your period, you may need to use emergency contraception (morning-after pill) to prevent pregnancy.
- If you are taking the minipill, it is extremely important that you take it at the same time every day. You can risk getting pregnant even for a few hours late.
Step 2. See your doctor
If you've forgotten a pill and aren't sure what to do or want to know if you need to consider emergency contraception, contact your doctor. Explain exactly what happened (how many pills you forgot, for how many days, etc.).
How you manage a missed intake varies depending on the type of pill you are taking, so contacting your doctor is always a good idea
Step 3. Consider alternative options when you are sick
Use another method of contraception if you are vomiting or diarrhea, as the pill may not have been in the digestive system long enough to be absorbed and may therefore be ineffective.
- If you vomit or have an episode of diarrhea within four hours of taking it, it will likely be ineffective. Use another contraceptive, as if you forgot to take it.
- If you have an eating disorder and have a habit of vomiting or use laxatives, an oral contraceptive is unlikely to be effective; you should use a different birth control method. Consult your doctor or psychologist for help.
Advice
- Always tell any doctor or healthcare professional you are receiving treatment from that you are taking birth control pills or that you have taken the morning-after pill, including those you would never think of, such as the dentist.
- Don't be afraid to take the pill. It carries far less risk than pregnancy.
- Weight gain is usually the thing that worries women the most when it comes to taking the pill. However, studies have shown that you gain weight of just over a pound in the first year and then lose that pound again. So, in general, weight gain shouldn't be a problem for most women; however, some are more sensitive than others to progesterone, which increases appetite.
