Birth Control Pills

Benefits of Oral Contraceptives

Regular menstrual cycles, less cramping, reduced menstrual flow, improvement of acne, less anemia, decreased incidence of ovarian cysts, decreased incidence of ectopic pregnancy, significant protection from ovarian and endometrial cancers, decreased incidence of pelvic inflammatory disease, and decreased incidence of non-cancerous breast problems.

Nuisance Side Effects

• Nausea is a common side effect that can be minimized by taking your pill with food and having a snack 4-6 hours after taking your pill. For some, it is best to take the pill before bed, and nausea will occur while you are sleeping.
• Breakthrough bleeding occurs when you have bleeding while taking your “active” pills. If this continues to occur after 2-3 cycles, and you have been taking your pills correctly, you will need an appointment to discuss changing your pill.
• Breast changes such as enlargement or tenderness can occur. If this lasts longer than 2-3 cycles, the pill will need to be changed.
• Weight gain is not expected but can occur for some patients. If you gain or lose 10lbs or more, you need to schedule an appointment and discuss changing the pill.
• Mood issues such as feeling tired, minor headaches, feeling “blah,” irritable, or teary can be minimized by taking Vitamin B6 (50-150mg) daily. You need to do this for at least 2 months to know if it will help.
• Depression may occur. If depression starts or worsens, call for an appointment to discuss other options of birth control.

These side effects tend to improve or disappear after 2-3 cycles of use. If they do not go away, keep track of when in your pill pack the side effects are happening and discuss this with your provider.

Signs and Symptoms of Serious Side Effects

Severe abdominal pain, severe chest pain, shortness of breath, severe headache, eye problems (loss of vision, flashing lights, etc.), or severe pain in the calf or thigh. If you experience any of these symptoms, do not take any more pills and contact your provider or emergency department immediately for evaluation.

Starting Your Pills

Take your pills at the same time each day. There are 3 ways to start taking your pills:

1. Take the first pill of the pack on the first day of your period.
2. Take the first pill of the pack today, and you will need to use condoms for 7 days.
3. Take the first pill of the pack on the first Sunday after you start bleeding or on Sunday if that is the first day of bleeding, and you will need to use condoms for 7 days.

Extending Cycling

This refers to skipping periods, which is possible with monophasic pills. To do this, you will need to discuss it with your provider. It involves skipping the placebo pills in the pack and starting a new pack instead. This method is not appropriate for everyone.

If You Need to Take Antibiotics For Any Reason

Antibiotics can cause birth control pills to lose their effectiveness. While taking antibiotics and for at least 7 days after you finish antibiotics, you should use condoms or abstain from sexual activity.

If You Miss a Pill

• If you miss 1 pill: take the pill as soon as you realize you missed it; take the next pill at the regular time, and use condoms for 7 days.
• If you missed 2 pills: on the day you realize you missed 2 days, take the 2 pills you missed at the same time. Then take 2 pills the next day, and then return to the normal 1 pill per day at the usual time the next day. Use condoms for 7 days.
• If you miss 3 or more pills: contact your healthcare provider.

After 3 months of using the pill, it is important to see your provider for weight and blood pressure checks. After this appointment, your pills will be filled until your annual exam is due. You should have an annual exam yearly, and the pills can be refilled at those appointments.

Birth control pills do not protect from sexually transmitted infections (STIs). Only condoms can protect you from STIs.

Precautions and Contraindications

Oral birth control pills are contraindicated in women with a history of blood clots, stroke, coronary artery disease, or ischemic heart disease, kidney failure, liver cancer, acute stages of hepatitis, or personal history of breast cancer.

Women who are 35 years old and smoke, have migraine headaches with aura (vision changes prior to a headache), high blood pressure, high cholesterol, diabetes, sickle cell disease, active gallbladder disease or jaundice, over 50 years old, breastfeeding, or immobilization are at an increased risk of serious complications, and oral birth control pills may not be a good option.

If you have a history of any of these health issues, please make sure your provider is aware and that the risks vs. benefits have been reviewed.