Learning About Birth Control Pills
Although women are grateful for this relatively simple and reliable form of contraception, most of them readily admit that they don't know much about how oral contraceptives actually work.
So Many Choices
Most birth control pills contain two hormones, estrogen and progestin.
The same kind of estrogen is in all low dose pills. The exact dose of estrogen may have an impact on the kind of side effects you experience.
Some women should not take pills with estrogen. Women who are breastfeeding, have a history of blood clots, or have
Different brands of the pill may contain one of many types of progestins. Different varieties of progestin can have different side effects on different individuals.
Monophasic vs. Triphasic
Within the family of estrogen-containing pills, there are two main types: monophasic and triphasic. As the names suggest, monophasic pills provide the same level of hormones throughout the pill cycle. Triphasic pills also induce a steady state of hormones, but at three different levels during the cycle. The two types are equally effective for pregnancy prevention.
"Work with your doctor to figure out which one might be right for you," suggests Holly Hughes, RN, a staff nurse at the Brigham Ob-Gyn Group in Boston. "Just because someone else had a great experience with a certain kind of pill doesn't mean you will."
Fewer Side Effects Today
There are fewer side effects now than there used to be because oral contraceptives today contain a much lower level of estrogen. Lower hormone levels usually mean fewer side effects, but side effects do still occur.
Negative Side Effects
The most common complaint is about breakthrough bleeding. If you are new to the pill or have recently switched types, you should give your body three months to adjust.
Some women believe that they will gain weight when taking the pill, but a study reported that the pill has no major effect on weight.
Other possible side effects include headaches, nausea, breast tenderness, and bloating. If the negative side effects last for more than three months, talk to your doctor and consider changing brands.
Your Period on the Pill
Your pills may come in packages of 21, 28, or 91.If there are 21 pills, take one pill at the same time each day for 21 days. After seven days of not taking a pill, start a new pack. You will have your pediod during the break. If your pack has 28 pills, take one pill at the same time each day for 28 days. The last seven pills do not contain hormones. When you are taking these pills, you will have your period. Some pills come in packages of 91 pills (also called continuous dosing or extended use). The first 84 pills contain hormones, but the last seven do not. You will have your period during the seven days with no hormones.
Oops, I Skipped a Day…
Taking a week off after three weeks of active hormones is part of a normal pill cycle, but skipping days in the middle of the three weeks is not a good idea.
When you take oral contraceptives, the hormone thins out the lining of the uterus making it unable to host egg implantation, and the mucus in the cervix thickens, making it tough for sperm to swim through. These benefits go away if you miss a day, increasing your risk for pregnancy.
If you do miss a pill, take it that day as soon as you remember. Or double up (take two pills) if you do not remember until the next day. You should use another method of contraception if you forget to take two or more pills. Call your doctor or nurse and ask for advise. Complete directions for what to do are also included under the patient package-insert instructions that come with your birth control pills.
Talk to Your Doctor
You cannot get birth control pills without a prescription, so you have to see a doctor at some point. Be open with your doctor so that you can make the best decision possible about birth control. Women with certain conditions should not take oral contraceptive. Talk to your doctor about any medicines you take, as well as any over-the-counter or herbal medicines.
If you experience problems and side effects, speak up. There may be something out there that's better for you.
American Congress of Obstetricians and Gynecologists
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient_education/bp021.cfm. Accessed June 20, 2010.
American College of Obstetricians and Gynecologists. Prophylactic oophorectomy. Practice Bulletin. No 7. September 1999.
11/19/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Gallo MF, Nanda K, Grimes DA, Lopez LM, Schulz K. 20 µg versus >20 µg estrogen combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2008;CD003989.
11/19/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Gallo MF, Nanda K, Grimes DA, Schulz K, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database Syst Rev. 2008;CD003987.
4/9/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Beral V, Hermon C, Kay C, Hannaford P, Darby S, Reeves G. Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. BMJ. 1999;318:96-100.
Hannaford PC, Iversen L, Macfarlane TV, Elliott AM, Angus V, Lee AJ. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study. BMJ. 2010 Mar 11;340:c927.
Last reviewed June 2010 by
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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