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There are two different types of birth control
pills; combination estrogen/progesterone and progestin-only pills
(also called the mini-pill). The most common is the combination
pill. Progestin-only pills are often used for breastfeeding mothers,
women with increased blood pressure, and women who have conditions
that prohibit the use of estrogen.
Combination birth control pills contain estrogen
and progesterone, similar to hormones that the body makes naturally.
Taken on a daily basis, the birth control pill prevents ovulation.
This means that an egg will not be released by the ovary; thereby
preventing pregnancy. Birth control pills also thicken cervical
mucus which makes it difficult for sperm to penetrate the cervix.
Lastly, birth control pills keep the lining inside the uterus
very thin, which has the added benefit of making the menstrual
cycle lighter and less painful.
When taken correctly, combination birth control
pills are about 99% effective in preventing pregnancy. Progestin-only
pills are about 80-85% effective.
It is important to understand that while birth
control pills are very effective in the prevention of pregnancy,
they do not protect against sexually transmitted diseases, including
HIV.
The most common side effects of taking the pill
are: nausea, breast tenderness, headache, irregular bleeding,
and missed periods. Usually these side effects will resolve in
the first 1-3 cycles of use. Taking the pill at the same time
each day and avoiding missed pills will lessen these side effects.
The side effects, especially irregular bleeding,
will usually worsen if you change to a different pill within the
first 1-3 months of use. Weight gain in excess of 4-5 pounds is
NOT associated with the birth control pill.
In rare cases, the pill can cause cardiovascular
problems such as blood clots, increased blood pressure, heart
attack, and stroke. The pill can also cause problems with the
liver or gall bladder. Call your doctor immediately if you experience
any of the following symptoms:
- sudden abdominal pain unexplained chest pain or shortness
of breath
- severe headache
- blurred vision
- severe leg pain (calf or thigh area)
- weakness in one side of the body
The first pill should be taken on the Sunday
following the start of your period. For example, if your period
starts on Wednesday, you should begin your first pill on Sunday.
If your period starts on Saturday, you should begin the pill the
next day (Sunday). If your period begins on a Sunday, you should
begin the pill that day. Do not wait until the following Sunday!
You will take one pill per day for 3 weeks,
then you will have one week of inactive pills. This will be the
week that your period will start.
You should begin your first pill on that schedule,
even if your period has not ended. It is important that you use
an alternate method of birth control for the first full pack of
pills (4 weeks) in order to prevent pregnancy while your body
is adjusting to the pill. You can discontinue the alternate form
of birth control once you begin your second pack of pills.
In order for birth controls pills to work properly,
they need to be taken consistently and correctly. Thus, you should
take your pill around the same time each day and try not to forget
pills. This will decrease the likelihood of missed pills, break-through
bleeding, and other side effects.
If you forget to take one pill, you should take
it as soon as you remember. This means that you may have to take
two pills in one day or at the same time. This may cause mild
nausea or break-through bleeding. These symptoms usually resolve
without treatment. You should still be protected from pregnancy
if only one pill was missed or taken late.
If 2 pills are missed, you should take 2 pills
for 2 days in order to 'catch up'. The contraceptive effect of
your pills can be altered by missing 2 or more pills, so an alternate
form of birth control should be used for one cycle following the
missed pills. You may experience nausea from taking 2 pills per
day, but it should resolve once you get back to your regular pill
schedule. Additionally, you may have irregular spotting or bleeding.
This will usually resolve when you consistently begin taking the
pill again.
If 3 or more pills are missed, a new medication
cycle must be initiated. Discontinue your current pack of pills
and initiate an alternate form of birth control. You can begin
a new pack of pills the Sunday after your next period begins.
You should continue to use the alternate form of birth control
throughout the next pill pack (4 weeks). You may experience irregular
bleeding or spotting for the next 1-3 cycles.
If you have taken your birth control pills correctly,
without missing any pills, it is unlikely that you are pregnant.
Birth control pills can keep the lining inside your uterus so
thin that at the end of the cycle, there may be little or no bleeding.
This is not a health risk. Matter of fact, it is usually a welcome
benefit of taking birth control pills. You can take a home pregnancy
test if you are concerned about pregnancy.
If you are breastfeeding, you can begin the
first pill right away. You should use an alternate method of birth
control for 7 days.
If you are not breastfeeding, start the pill the first day of
your next period. In this case, an alternate form of birth control
is not needed.
You should take one pill each day through the
entire pill pack, and then begin a new pill pack right away. You
will not have any placebo pills or days off with this pill.
For maximum effectiveness, it is important that
progestin-only pills be taken at the same time each day.
If you are more than 3 hours late in taking
your pill, take the pill as soon as you remember and use an alternate
method of birth control for 48 hours.
If you miss 2 or more pills, you should take
2 pills for 2 days to catch up and initiate an alternate form
of birth control for 48 hours after the missed pills.
Due to the low medication dosage and lack of
estrogen, the bleeding pattern with this pill is completely unpredictable.
You may have irregular bleeding or spotting, regular periods,
or no bleeding at all. Any of these patterns are normal while
taking this pill.
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