The Pill

“The Pill” is a small pill that comes packaged for each month. Some people call it “oral contraception.” You take it once a day, at the same time every day. There are many different kinds of pills available, and new options are available often. Most work by releasing hormones that keep your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place.

Types of pills:

Combination. Combination pills use estrogen and progestin to prevent ovulation. A monthly combination pill pack contains 3 weeks of hormone-based pills and a week of placebos. The placebos will bring on your period each month.

Progestin-only. These have no estrogen in them and are often recommended if you are sensitive to combination pills. They are also recommended if you are having side effects from a combination pill. They release a small amount of progestin everyday of the month and do not give you a period during a set week.

Quick facts:

  • The pill has been around for 50 years. They are easy to swallow and can have positive side effects.
  • Effectiveness: the pill is really effective when taken perfectly, but most women do not take it perfectly.
    • Perfect use: greater than

      99%

    • Typical use:

      91%

  • Side effects: the most common are sore breasts, nausea, spotting, and decreased sex drive
  • Effort: high. You need to take a pill at the same time every single day.

The Pill

Quick facts:

“The Pill” is a small pill that comes packaged for each month. Some people call it “oral contraception.” You take it once a day, at the same time every day. There are many different kinds of pills available, and new options are available often. Most work by releasing hormones that keep your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place.

Types of pills:

Combination. Combination pills use estrogen and progestin to prevent ovulation. A monthly combination pill pack contains 3 weeks of hormone-based pills and a week of placebos. The placebos will bring on your period each month.

Progestin-only. These have no estrogen in them and are often recommended if you are sensitive to combination pills. They are also recommended if you are having side effects from a combination pill. They release a small amount of progestin everyday of the month and do not give you a period during a set week.

  • The pill has been around for 50 years. They are easy to swallow and can have positive side effects.
  • Effectiveness: the pill is really effective when taken perfectly, but most women do not take it perfectly.
    • Perfect use: greater than

      99%

    • Typical use:

      91%

  • Side effects: the most common are sore breasts, nausea, spotting, and decreased sex drive
  • Effort: high. You need to take a pill at the same time every single day.

The pill takes discipline. You need to remember to take your pill at the same time every day. If you do not take it at the same time every day then it will not work as well.

You want predictable periods. If you like getting your period every month, with no spotting, then the pill may be a good choice.

You can skip your period. The pill allows you to skip your period altogether, which is totally safe.

Smokers over 35 years old, be careful. For women over 35 years old, smoking while using the pill increases the risk of certain side effects.

You want to stop using birth control and get pregnant quickly. You will be able to get pregnant a few days after stopping the pill. If you are not ready for a baby, use another method if you stop using the pill.

If you can swallow an aspirin, you can take the pill. But the important thing: you have to remember to take it every day, at the same time, no matter what.

Some pills come in 21-day packs. Others come in 28-day packs. Some give you a regular period every month. Others let you have your period once every three months. And some let you skip your period for an entire year. There are many different pills available and it can be a bit confusing. Your doctor or clinic can help you figure out which pill is right for you.

Tips and tricks

Try taking your pill at the same time you always do something else in your daily routine – like brushing your teeth.

If you do not want a pregnancy and forget your pill, make sure to use a condom or another barrier method. Keep emergency contraception available, just in case you forget your pill and have sex without a condom.

Everyone is different. What you experience may not be the same thing as another woman.

The Positive: there are actually lots of things about birth control that are good for your body as well as your sex life.

  • The pill is easy to use – just swallow it with water
  • You do not need to interrupt sex to use it
  • Might give you lighter periods
  • Gives you control over when you have your period
  • Some pills clear up acne
  • Can reduce menstrual cramps and PMS
  • Some pills offer protection against some health problems: like endometrial and ovarian cancer; iron deficiency anemia; ovarian cysts; and pelvic inflammatory disease

The Negative: Everyone worries about negative side effects, but for many women, they are not a problem. And if you do experience side effects, they will probably go away. Remember, you are introducing hormones into your body, so it can take a few months to adjust. Give it time.

Things that will probably go away after two or three months:

  • Spotting
  • Sore breasts
  • Nausea and vomiting

Things that may last longer:

  • A change in your sex drive

 

If you still feel uncomfortable after 3 months, switch methods and stay protected.

* For a very small number of women there are risks of serious side effects.

We are here to help you. If it still does not feel right, we have ideas for other methods. Just remember: If you change methods, make sure you use another method while you switch.

Should I be worried about spotting?

  • Spotting can happen with a bunch of different methods. You do not lose that much blood with spotting, even though it might seem like it.
  • Still not working? You may have more luck on a pill with a slightly higher dose of estrogen, or one that provides estrogen during a different part of your cycle.
  • Try a different method: IUD

Will the pill give me cancer?

  • The pill does not give you cancer. In some very rare cases women may get a blood clot. The risk of getting a blood clot while taking the pill is lower than the risk of getting a clot while pregnant. Some women have medical problems that mean they should not use the pill.
  • If you are healthy, birth control pills are actually very safe. They can help you with some problems now (like anemia from heavy periods) as well as later in life (they may protect you against some kinds of cancer).

What if I have problems remembering to take the pill?

  • Try setting a daily reminder on your mobile device.
  • Still not working? If you use a reminder system and you are still having trouble remembering, you might want to consider a method that you do not have to think about quite so often.
    • You only have to remember to change the patch once a week.
    • You only have to worry about the ring each month.
    • There are even options you can forget about for years: take a look at the 2 types of IUD and the implant.
  • Try a different method: implant; IUD; patch; ring

Is it normal to getacne?

Why does the pill make me nauseous?

  • Try this: if you want to stay on your current type of pill, try taking it at night. You can also think about getting a pill with less estrogen.
  • Still not working? You might want to try another hormonal method that is not taken by mouth, such as the implant, an IUD, the patch, the ring, or the shot.
  • Try a different method: implant; IUD; patch; ring; shot

Why am I bleeding between periods?

  • If you just started the pill in the last few months, try to power through – this problem will most likely fix itself. Make sure you are taking your pills at the same time each day and not skipping pills and then taking two at once. Skipping pills or taking two at once can increase chances of spotting.
  • Still not working? If you have been on the pill for a few months, are taking it correctly, and still spotting, then consider a new method. You should also get checked for STIs and pregnancy, just to be sure those are not the reason for the bleeding.
  • Try a different method: patch; ring; shot

What if I travel to a different time zone? Do I have to adjust when I take my pill

  • You need to figure out what time it is in your home time zone and take it at that time. For example, if you live in Washington, DC, and you travel to Spain, which is 6 hours ahead, you should take your pill 6 hours later in the day than you normally would. So if you take your pill at 9am in DC, you should take it at 3pm in Spain.
  • If you remember your pill by setting an alarm on your phone, make sure to adjust it as needed when you are on the road.
  • If it is easier, you can change your schedule, as long as you do not go more than 24 hours without a pill. So if you live in DC and you go to Spain and want to stay on a 9am schedule, it is totally fine to take your next pill at 9am Spanish time (18 hours after your last East Coast pill).
  • If you are traveling long enough that you will be starting a new pack of pills while you are gone, do not forget to pack them in your bag.
  • Still not working? If you travel a lot and like using a hormonal method, you may want to consider switching to the ring or even the patch so you will not have to worry so much about keeping track of time zones. If you want to completely forget about time zone calculations, check out the implant or an IUD.
  • Try a different method: implant; IUD; patch; ring

I missed a pill, or I took my pill late. What do I do?

  • Take your next pill as soon as you remember, and use a back-up method for 7 days afterward. If it was a placebo pill during the 4th week, throw out the placebo for that day and get back on schedule the next day.
  • If you have had sex since you got off schedule and that is within the last five days, you might want to take emergency contraception just in case.

I missed my pill yesterday. Is it safe to take two pills on the same day?

  • If you missed a pill then sometimes it is recommended to take two pills in one day. Taking the two pills at least 10 hours apart should not be a problem. Taking them closer together could make you a little nauseous, and you do not want to throw up after taking the pills.
  • If you want to take regular birth control pills as emergency contraception, you might take 2-4 at once.
  • If it has been more than 24 hours since your last pill, use a second form of birth control, like a condom or internal condom anytime you have sex for the next 7 days.

What if I want to start taking my pill at a different time each day?

  • That is fine. The easiest way to do that is to start your next pack of pills at the time you prefer. You will not need backup that way.
  • If you cannot wait for the next pack, just make sure you do not wait more than 24 hours between pills.

Is the pill bad for the environment?

  • Any form of birth control is better than no birth control when it comes to the environment.
  • Some of the hormones from the pill will enter the environment through a woman’s urine. But it is smaller than other sources of estrogen in the environment.
  • Estrogen from industrial and manufacturing processes, fertilizers and pesticides, and the drugs given to animals all enter the environment in larger amounts than the estrogen in a woman’s urine from the pill.
  • If you do not want to add hormones to the environment or your body, there are options for you. Natural latex condoms and the copper IUD are both good options. Whatever you decide, pick a method and keep using it.
  • Still not working? If would like to use a very effective method without any hormones, try the ParaGard IUD.
  • Try a different method: IUD

Does the pill prevent pregnancy if I am taking antibiotics?

  • Rifampin is the only antibiotic that has been shown to lessen the effectiveness of the pill. It is usually used to treat tuberculosis.
  • If you need to take rifampin, talk with your provider about what form of birth control is best.

What if I threw up after taking my pill?

  • If you throw up within two hours of taking your pill, treat it as a missed pill. Take the next pill in your pack right away.
  • Use a second method of birth control, like condoms, for the next seven days to be on the safe side.

What if I had diarrhea after taking my pill?

  • Having diarrheasometimeswill probably not affect how well your pill works.
  • Severe diarrhea (several times in one day) might affect how well your pill works.
  • You should use a second method of birth control (like a condom) if you have severe diarrhea. You should use the back-up method every time you have sex while sick, and for the 7 days after you recover.
  • Still not working? Forgetting to take a pill, throwing up right after one, or having severe diarrhea are why the pill has a 9% failure rate. If that it is too risky for you, use a back-up method. Another option is to switch to a birth control that requires less effort.
  • Try a different method: condom; implant; IUD; ring

Is it safe to take the pill for years without a break?

  • If you want to get pregnant then you should stop taking the pill.
  • If you experience spotting, taking a break sometimes may help manage it. If you want to take a break, stop using the pill for 3-7 days. Use a second method of birth control, like a condom, every time you have sex during the break and for the first seven days after you start taking the pill again.
  • Research about birth control pills over the years indicates that using the pill for years does not affect your ability to get pregnant once you stop taking the pill.
  • Still not working? If you smoke or have a medical condition that makes the pill risky for you, consider trying a progestin-only method instead.
  • Try a different method: implant; IUD; shot