Birth Control Pills
*adapted from https://www.plannedparenthood.org
What is the birth control pill?
Birth control pills are a kind of medicine with hormones (estrogen and/or progesterone). Birth control pills come in a pack, and you take 1 pill every day. The pill is safe, affordable, and effective if you always take your pill on time. Besides preventing pregnancy, the pill has lots of other health benefits, too.
How do birth control pills prevent pregnancy?
The birth control pill works by stopping sperm from joining with an egg. When sperm joins with an egg it’s called fertilization.
The hormones in the pill safely stop ovulation. No ovulation means there’s no egg for sperm to fertilize, so pregnancy can’t happen.
The pill’s hormones also thicken the mucus on the cervix. This thicker cervical mucus blocks sperm so it can’t swim to an egg — kind of like a sticky security guard.
How do I make the pill work best for me?
Forgetting pills, losing the pack, not refilling your prescription on time — these are the main reasons why people might get pregnant when they use the pill. It’s good to plan ahead and think about the best way for you to use the pill correctly. Here are some ways to help you remember to take your pills every day:
- Use the Planned Parenthood birth control reminder app or set an alarm on your phone.
- Keep your pill pack next to something you use every day (like your toothbrush or phone charger).
- Keep your pills in your bag so they’re always with you.
Want to be really sure you don’t accidentally get pregnant? You can also use a condom every time you have penis-in-vagina sex. That way you’ll be protected from sexually transmitted diseases (STDs) too.
Does the pill protect against STDs?
Nope. The pill is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections like chlamydia, gonorrhea, syphilis or HIV.
Luckily, using condoms every time you have sex really lowers your chances of getting or spreading STDs. Condoms also protect against pregnancy — so using condoms + birth control pills together gives protection from STDs AND very effective pregnancy-preventing power.
What are the different types of birth control pills?
There are 2 types of birth control pills (combination pills and progestin-only pills), and many different brands.
Combination Pills (COCs):
Combination pills have 2 hormones: estrogen and progestin. Combination pills are the most common type of birth control pill.
As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take your combination pill at the exact same time every day. But taking it at the same time is a good idea because it helps keep you in the habit of remembering your pill.
Progestin-Only Pills (aka POPs or Mini Pills):
Progestin-only pills have 1 kind of hormone (progestin) — these pills don’t have any estrogen. You must take a progestin-only pill within the same 3 hours every day to be protected from pregnancy.
How do I use the different types of birth control pills?
Combination Pills (COCs):
As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take your combination pill at the exact same time every day. But taking it at the same time is a good idea because it helps keep you in the habit of remembering your pill. You can also use an alarm, calendar reminder, or the Planned Parenthood birth control app to help you remember. Most combination pills come in 28-day or 21-day packs.
If you have 28-day packs:
Take 1 pill every day for 28 days (four weeks) in a row, and then start a new pack on day 29. The last pills in 28-day packs of combination pills do not have hormones in them. These pills are called “reminder” or “placebo” pills — they help remind you to take your pill every day and start your next pack on time. How many days you take hormone-free reminder pills depends on the brand of pill. Most pill packs have hormone-free pills for 7 days, but sometimes there are less. The reminder pills may contain iron or other supplements. You get your period during the week you take these reminder pills. You’ll still be protected from pregnancy even if you don’t take the reminder pills — just remember to start your next pack on time.
If you have 21-day packs:
Take 1 pill every day for 21 days (3 weeks) in a row. Then don’t take any pills for seven days (week 4). You’ll get your period during the fourth week while you aren’t taking any pills. It’s important to take every pill in a 21-day pack because there are no reminder (hormone-free) pills. The hormone pills will prevent pregnancy even if you have sex during the week when you don’t take any pills. Start your next pack after not taking your pills for 7 days — you may want to use an alarm or reminder to help you stay on track.
If you have 91-day packs:
Some combination pills have 12 weeks (3 months) of hormone pills in a row, followed by up to 1 week of hormone-free reminder pills. This is so you’ll only have your period once every 3 months. The hormones will prevent pregnancy even if you have sex during the reminder pill week. You can also use other pill brands to skip your period by skipping the reminder pills.
Progestin-Only Pills (aka POPs or Mini Pills):
You must take progestin-only pills within the same 3 hours every day to be protected from pregnancy. For example, if you take your progestin-only pill at 12:00 p.m., taking it after 3:00 p.m. the next day puts you at risk for pregnancy. Alarms, reminders, or birth control apps can help you take your pill on time.
Progestin-only pills come in 28-day (4 week) packs. Take 1 pill every day for 28 days (4 weeks) in a row, then start a new pack the day after you finish the old pack (day 29). All 28 pills have hormones, so you must take every pill in a progestin-only pack to be protected from pregnancy — there is no hormone-free week. You may get your period during the fourth week. You could also have bleeding on and off throughout the month (spotting), or get no period at all.
There’s also a newer type of progestin-only pill called Slynd that’s a little different than other POPs. Slynd packs have 24 “active” hormone pills and 4 hormone-free “reminder” (placebo) pills. You don’t have to take the hormone-free pills, but make sure you remember to start your next pack on time. And you don’t need to take Slynd within the same 3 hours every day — as long as you take one pill every day, you’ll be protected from pregnancy.
How do I use the pill to stop my period?
Skipping your period with the combination pill is safe and super easy. Basically you just take a pill with hormones every day and skip your hormone-free “reminder” pills. You can do this two ways:
- You can use a brand of pills that has 3 months of hormone pills in a row, so you only get your period 4 times a year.
- You can skip the hormone-free reminder pills in your pack and jump right to the next pack. You can do this every month, or just whenever you want to skip your period.
You may have some bleeding or spotting when you use the pill to skip your period — that’s totally normal. If you skip your hormone-free week every month, the spotting should go away after about 6 months. If you find you continue to have spotting, you may want to just go about 3 months between pill packs without having a period.
There’s nothing dangerous or harmful about using the pill to skip your period. And it comes in really handy if you want a special occasion (like a vacation or a hot date) to be period-free.
You can only skip your period with combination pills. If you’re using a progestin-only pill (POP or Mini Pill), take every pill in your pill pack. But many people who use POPs don’t get periods anyway.
When can I start taking birth control pills?
You can start taking birth control pills as soon as you get them — any day of the week, and anytime during your menstrual cycle. But when you’ll be protected from pregnancy depends on when you start and the kind of pill you’re using. You may need to use a backup birth control method (like condoms) for up to the first 7 days.
Combination Pills (COCs):
You can start the combination pill at any time.
- If you start taking combination pills within 5 days after your period starts, you’ll be protected from pregnancy right away. For example, if you get your period Monday morning, you can start the pill anytime until Saturday morning and be protected from pregnancy right away.
- If you do a “Sunday start” (the first Sunday after onset of your period) you will get your period during the week instead of a weekend.
- If you start combination pills any other time, you need to take the pill for 7 days before you’re protected from pregnancy. Use another method of birth control — like a condom— if you have penis-in-vagina sex during the first week on the pill.
Progestin-Only Pills (POPs or Mini Pills):
You can start progestin-only pills at any time. You’ll be protected from pregnancy after 48 hours (2 days) on the pill. If you have penis-in-vagina sex during those first 2 days, use another method of birth control, like a condom.
You must take progestin-only pills at the same time every day. If you take it more than 3 hours past your usual time, use a backup method of birth control for the next 48 hours (2 days).
Starting the pill after taking emergency contraception:
If you took a levonorgestrel emergency contraception pill (like Plan B or other over-the-counter brands), you can start taking the pill right away.
If you recently took the ella emergency contraception pill, don’t start taking your birth control pills until it’s been 6 days or more since you had unprotected sex.
If you start using the birth control pill after taking any emergency contraception pill — like Plan B or ella — use a backup birth control method (like condoms) for 7 days.
What do I do if I want to get pregnant?
If you decide you want to get pregnant, just stop taking the pill. No matter what kind of birth control pill you’re on, it’s possible to get pregnant right after you stop taking it. It can take a few months for your period to go back to the cycle you had before you started taking the pill, but you can still get pregnant during that time.
What birth control side effects should I expect while taking the pill?
The hormones in birth control pills may cause side effects in some people. But this doesn’t happen to everyone — many people use the pill with no problems.
After starting the pill, some people may have:
- Sore breasts
- Changes in your periods (early, late, or stopping altogether while on the pill)
- Spotting (bleeding between periods or brown discharge)
The good news is that these side effects usually go away in 2-3 months. So if you just started the pill and you have side effects that bother you, try to stick it out and give your body a chance to adjust to the hormones.
Birth control shouldn’t make you feel sick or uncomfortable. If you still don’t like the way the pill makes you feel after a few months, talk with your doctor.
And remember: if you stop taking the pill and don’t use another birth control method, you’ll be at risk for pregnancy right away.
Will the birth control pill have any negative effects on growth?
No, the birth control pill will not affect or hinder growth if you have already started your period. By the time you have your first period, you are already at 95% of your final height. A girl grows about 2 inches in the 2 years after her first menstrual period.
Are there good birth control pill side effects?
Side effects aren’t always a bad thing — many people use the pill because some of the side effects can be really helpful. For example, the hormones in the pill can help with painful, heavy, or irregular periods. The pill may ease cramps and PreMenstrual Syndrome (PMS), and it will usually make your period lighter and more regular. You can even use the combination pill to safely skip your period.
The changes in your periods while on the pill can sometimes make people worry about being pregnant. But the chance of pregnancy is very low as long as you’re taking your pill every day. If you’re worried, you can always take a pregnancy test to be sure.
Some types of birth control pills can also help prevent acne, iron deficiency (anemia), bone thinning, cysts in your breasts and ovaries, and uterine and ovarian cancers.
Will the birth control pill make acne better?
Birth control pills usually improve acne. For moderate to severe acne, which over-the-counter and prescription medications haven’t cured, birth control pills may be prescribed. The hormones in the birth control pill can help stop acne from forming. It doesn’t usually matter which type of birth control pills you taks, since most of them can be used to treat acne. However, be patient as iit may take several months to see a difference with her acne.
What if I have PCOS? How do birth control pills help?
If you have PCOS, you’re probably already aware that PCOS can cause irregular menstrual cycles, excess hair growth, and acne. One of the treatments prescribed for PCOS are birth control pills (oral contraceptives), because the hormones (estrogen and progestin) in the pill regulate menstrual cycles. Birth control pills allow the endometrial lining to be shed every four weeks so your menstrual period will be regular. Because birth control pills cause women to menstruate regularly and shed the endometrial lining on time, they reduce the risk of endometrial cancer. Birth control pills also improve acne and lessen excess hair growth, which is another reason they are used to treat PCOS.
What if I have endometriosis? How do birth control pills help?
Hormonal treatment such as birth control pills either taken in cycles or continuously are felt to relieve symptoms associated with endometriosis in 8 out of 10 patients. The Pill does not cure endometriosis, but when prescribed continuously, it will stop your period along with the pain that is often associated with it and lessen the chance of the endometriosis growing.
What other medical benefits does the pill have?
Because there is less menstrual bleeding with the use of birth control pills, you are less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills also decrease the chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.
What are the side effects of stopping the birth control pill?
Any time there’s a change in your hormones — like when you go on or off hormonal birth control such as the pill — there’s a chance of temporary side effects. But they usually go away after a few months.
When you go off the pill, your body will eventually return to the way it was before you went on it.
So if the pill made your periods lighter, your periods will probably get heavier once you stop using it. It can also take a few months for your period to go back to the cycle you had before you started taking the pill. And if the pill helped clear up your skin, your acne may come back after you go off the pill. But everyone’s body is different, and our bodies also change over time. For example: you’re less likely to have acne after puberty so if you started taking the pill in your teens but go off it in your 20s, you may have naturally grown out of your acne by then.
Another important thing to note: you can get pregnant right away once you stop taking the pill (even if your periods aren’t regular). So if you’re going off the pill but you don’t want to get pregnant, make sure to use another birth control method.
There’s no way to know exactly how your body will react to going off the pill, but any negative side effects that you may have will go away within a few months as your body gets used to being off the hormones.
Is the birth control pill safe?
There’s a good chance the pill will be totally safe for you — most people can take it with no problems. The pill has been around for more than 50 years, and millions of people have used it safely. Birth control pill side effects aren’t dangerous (though there are some possible risks with taking the pill, like with any medicine).
Can I take the birth control pill?
Like all medicines, the pill isn’t for everyone.
Smoking and birth control pills don’t always mix.
- If you smoke 15 cigarettes a day or more, don’t use the combination pill (COCs) or any other kind of birth control that has the hormone estrogen.
- If you smoke fewer than 15 cigarettes a day or vape nicotine at all, talk with your doctor about whether the combination pill is safe for you.
Smoking while taking birth control with estrogen (like combination pills, the patch, or the ring), makes you more likely to have problems like a stroke or heart attack.
You can take progestin-only pills (POPs or mini pills) if you’re a smoker.You can also safely use any other method without estrogen — like the birth control shot, the birth control implant, and IUDs.
Also avoid using combination pills if you’ve had:
- Blood clots, an inherited blood-clotting disorder, or vein inflammation
- Heart attack, stroke, angina, or other serious heart problems
- Migraine headaches with aura (seeing flashing, zigzag lines)
- We will ask if there is any family history of blood-clotting disorders or early (prior to age 50) heart disease in your family.
- Breast Cancer
Avoid using progestin-only pills if you’ve had:
- Certain forms of lupus
- Breast Cancer
What are the risks of birth control pills?
Even though birth control pills are very safe, using the combination pill can slightly increase your risk of health problems. Complications are rare, but they can be serious. These include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death. For the most part, progestin-only pills (aka POPs or mini pills) don’t have these risks.
Does the birth control pill cause blood clots?
There is a very slight risk of developing blood clots in the legs, but much less than the risk during pregnancy. Among adolescent females who do not take the Pill, 1-10 in 100,000 will develop blood clots each year. Among women who take combined oral contraceptive pills, the risk increases 3-5 fold or to 5-50 per 100,000 per year. For women who are pregnant, the risk of developing blood clots is twice as high as Pill users and 4-10 fold compared to nonusers.
Is there any way to lower the risk of getting blood clots while taking the Pill?
Make sure you let your doctor know if any blood relatives have had blood clots, especially when they were young (in their 20s, 30s, or 40s). There are other factors that can contribute to the likelihood of whether a teen or adult woman develops blood clots such as a diagnosis of Factor V Leiden, trauma, or surgery, being overweight and smoking.
If you smoke, we encourage you to quit. If you are planning a flight or long car ride (especially if 6-8 hours or longer), get up and walk around and drink lots of fluids to lessen the risk of blood clots. If you are having surgery (and will be immobilized and on bed rest for a period of time), ask your health care provider about whether you should go off the Pill 3-4 weeks before the surgery.
It’s important to remember that the chance of having any of these problems while taking birth control pills is really, really low for most people. In fact, pregnancy is more likely to cause serious health problems than the pill.
What warning signs should I know about?
Most people on the pill won’t have any problems at all. But just in case, it’s good to know what the signs of a serious issue are.
See a doctor right away if you have:
- Abdominal or stomach pain (severe)
- Chest pain (severe), cough, shortness of breath
- Headache (severe), dizziness, weakness, or numbness
- Eye problems (vision loss or blurring), speech problems
- Severe leg pain (calf or thigh)
What happens if I miss a birth control pill?
If you miss a pill, go to this link (https://www.plannedparenthood.org/online-tools/missed-birth-control-pill) to find out what you will need to do. You’ll need to know the brand name of the pill you’re on in order to use this tool. You can find the name on your pill pack or by calling your doctor or the drugstore where you got it.
If you can’t find out the name of your pill, use a condom anytime you have vaginal sex until you can talk with your doctor. If you’ve already had sex in the last 5 days since making a pill mistake, you may want to use emergency contraception.