Birth Control Pill

What is the birth control pill?

The birth control pill is an oral contraceptive that releases a daily dose of hormones (estrogen and progesterone) into a woman’s body. There are several types of birth control pills available with varying levels of estrogen and progestin, called combination pills. Other kinds of birth control pills, called mini-pills, contain only progestin.

A combination oral contraceptive pill stops a woman’s ovaries from releasing an egg (ovulation). The pill also thickens the cervical mucus, making it more difficult for sperm to travel to the uterus and fallopian tubes. Mini-pills work mainly by thickening cervical mucus; they do not prevent ovulation.

A doctor’s prescription is required for birth control pills, which generally cost between $15-$50 for a one-month supply.

Like other hormonal birth control methods – such as the shot, patch, or ring – the pill does not protect against sexually transmitted diseases (STDs).

How to use birth control pills

Birth control pills must be taken daily, ideally at the same time each day. Progestin-only pills must be taken at exactly the same time every day. It may be helpful to associate taking the pill with another daily routine, such as brushing your teeth.

What to do if a combination birth control pill is missed:

  • Take the pill as soon as possible you remember.
  • If a full day has passed without a pill, take two pills the next day.
  • If two or more pills are missed, read the instructions that came with the pill pack or contact a health care provider for detailed information on what to do.

What to do if a progestin-only birth control pill is taken more than three hours late

  • Take the pill as soon as possible, even if it means taking two pills that day.
  • Use an alternate form of birth control for the following 48 hours (such as a condom or abstinence).
  • Consider using emergency contraception such as the morning after pill (Plan B, Next Choice) if you have had sex in the last three to five days before missing the progestin-only pill.

Women who have missed multiple doses of the birth control pill should use an alternate form of birth control until starting a new pack of birth control pills.

Who should not use the birth control pill

Women should not take the combination birth control pill if they have hypertension, liver disease, or diabetes with complications. If a woman has a history of breast cancer, stroke, blood clots, or migraine headaches with aura, she should not take the combination pill.

Women who are older than age 35 should not use the combination birth control pill if they are smokers, have diabetes or high cholesterol, or take medication to manage high blood pressure.

The progestin-only pill is often considered safe for women with medical conditions. However, it’s important to talk with a health care provider for individualized information regarding this decision. 

Birth control pill effectiveness

When taken exactly as directed, only three women out of 1,000 become pregnant annually. Among all women who take birth control pills, eight out of 100 women become pregnant annually, usually due to one or more missed pills.

Many “low-dose” estrogen pills are available. They are equally effective at preventing pregnancy as other pills.

Certain oral medications prescribed for HIV and seizure disorders may make the pill less effective. The antibiotic rifampin and the supplement St. John’s wort can also interfere with the effectiveness of the pill.

Vomiting or diarrhea may also reduce the effectiveness of the birth control pill because the body does not have adequate time to absorb the birth control hormones.

Women who use oral contraception must remember to take their pill at the same time each day, or the pill loses its effectiveness.

Benefits of birth control pills

The combination birth control pill may be a good option for women who prefer a contraceptive method that does not interfere with sexual intercourse.

Some women elect to take combination birth control pills that reduce the number of periods they have each year. Some brands, such as Seasonique or Seasonale, cause women to have only four periods per year. Another brand called Lybrel eliminates periods altogether. Not having a period while on combined birth control pills is safe and does not increase a woman’s risk for gynecologic cancer.

Combination birth control pills offer some relief of symptoms to women who have endometriosis or ovarian cysts. The pill can also help regulate heavy, painful, or irregular menstrual periods.

In some cases, birth control pills may be prescribed to treat other conditions, such as pre-menstrual syndrome (PMS) and symptoms of peri-menopause and menopause.

Progestin-only birth control pills may be a good option for women who want many of the same benefits of the combination pill, but who cannot take estrogen.

Side effects of birth control

When taking the birth control pill, some side effects may occur. Most frequently, women notice changes in their menstrual cycles, including skipped periods or slight spotting between periods.

During the first few months of use, some women may experience headaches, breast tenderness, and nausea. A woman’s interest in sexual activity may change while on the pill. Please contact your physician to discuss any side effects you may be experiences while using birth control pills.