Birth Control Pill Instructions – Combined Oral Contraceptives
What is “the Pill?”
The birth control pill, also known as “the pill,” is a medicine that can prevent pregnancy, make periods lighter and less painful, and make periods come regularly. A birth control pill has two hormones: estrogen and progestin. Taking the pill everyday prevents your ovaries from releasing an egg every month. Progestin only contraceptives are another type of birth control pill.
How Effective is the Pill in Preventing Pregnancy?
With typical use, about 8 women out of 100 who take the pill may become pregnant in 1 year. This means it is about 92% effective in preventing pregnancy. If you take the pill exactly as directed (correct and consistent use), less than 1 out of 100 may become pregnant in 1 year. The pill may be slightly less effective for women who are very overweight. Talk with your health care provider if you are concerned about how well the pill may work for you.
Certain medicines and supplements may make the pill less effective. It is imperative to use backup birth control (such as condoms with spermicide) if on any of these medications:
- The antibiotic rifampin — other antibiotics do not make the pill less effective
- The antifungal griseofulvin — other antifungals do not make the pill less effective
- Certain HIV medicines
- Certain anti-seizure medicines
- St. John’s wort
Vomiting and diarrhea may also keep the pill from working. Use a backup method of birth control (such as condoms) for the durations of the illness and 1 full week of active pills after symptoms resolve.
Always keep in mind that the pill does not protect against sexually transmitted infections. Use a latex or female condom to reduce the risk of infection.
How Do I Start the Pill?
Your doctor or nurse will suggest 1 of the following methods to begin taking the pill:
- Start your first pack of pills on the first day of your menstrual period. Use a backup method of birth control (such as condoms) until you have completed the first pill pack.
- Start your first pack of pills on the Sunday after you start your menstrual periods. You should use a backup method of birth control (condoms) until you have completed the first pill pack.
- Start your pills today. If you start your pills today you should use a backup method of birth control (condoms) during the first pill pack.
How Do I take the Pill Correctly?
Take 1 pill at the same time each day until you finish all of the pills in the pack. When you finish the last pill, start a new package of pills the next day. Try to associate taking your pills with something you do at the same time of the day, like brushing your teeth, eating a meal or going to bed. For example, keep your pills next to your toothbrush.
- Take the pills in the correct order
- Take the pills at the same time each day
- If you have nausea with your pill, try taking the pill with food, after eating or at bedtime
- Your menstrual period will usually come during the last 7 days of each pill pack, once your body adjusts to the pills
- Start a new pill pack the day after you finish the last pill in your old pack
- Never miss a day of taking your pill
- Check your pack each time you take the pill to make sure you took yesterday’s pill
What Should I Do if I Miss a Pill?
Be careful not to miss any pill, but if you do:
- Take the pill as soon as you remember it.
- Take your next pill at the correct time.
- If you realize when taking your pill that you skipped one, take the pill you skipped and the new one together. It’s OK to take 2 pills at once. Use backup method (condoms) for one week.
- If you forget to take a pill for 2 days in a row, take 2 pills each day for the next 2 days, and then go back to 1 pill each day. Use backup method (condoms) for one week.
- If you forget 3 or more pills in a row, start a new package of pills. Use a backup method (such as condoms for one week.
- If you have sex when you have not been taking your pill correctly, or if the backup method fails (for example, the condom breaks), you should use emergency contraception to prevent pregnancy. If you do not already have emergency contraception at home, you can visit a drug store to buy ECP (emergency contraception, sometimes called the morning-after pill).
What Side Effects Will I Have?
Minor side effects usually will go away within 3 months after starting birth control pills. These may include:
- Nausea; try taking the pill with meals or at bedtime to alleviate this symptom
- Spotting or break through bleeding is very common during the first three months. Use backup contraception when spotting or bleeding occurs
- Breast tenderness, headaches, bloating and mood changes ore also possible side effects, which usually resolve after the first three months
Serious side effects are very rare, but they may occur. The most serious is the formation of blood clots in the legs, which occurs in 1 out of 10,000 pill users. Increased blood pressure is another potential complication. Your blood pressure needs to be check during your third month on the pill and then yearly, thereafter. Notify us immediately if you have:
- Severe headaches that do not go away
- Blurred vision
- Chest pain
- Shortness of breath
- Slurred speech
- Pain or swelling in one or both legs
- Tingling or weakness on one side of the body
Do’s and Don’ts
- Do know the name of your pill
- Do keep track of any side effects
- Do keep a backup method of birth control available at all time (in case you drop or lose a pill)
- Do call during office hours whenever you have questions
- Do not run out of pills. Call to schedule a return appointment with your doctor when you have 2 packs of pills left on your prescription. Plan ahead so you do not run out of pills. Refills will not be authorized by the on call doctor.
- Do not stop taking the pill because you are confused or having side effects; call us first as we may be able to suggest a solution.
- Do not forget your appointments. You must be up to date on your blood pressure checks, pap smears and annual exams to continue receiving your pill refills.