Island Sexual Health Society Be informed, not surprised!

Birth control pills

2006 May 11

Birth control pills are also known as:

* The Pill
* Oral contraceptive pill (OCP)
* Oral contraceptives (OC)

“Make an appointment”:/about/appointments/ to get birth control pills, or for help choosing the best birth control for you.

h3. The Pill in detail

* “How it works”:#overview
* “Benefits and side-effects”:#pro-con
* “How to get birth control pills”:#get-pills
* “Using birth control pills”:#using
** “starting the pill”:#starting
** “when to use a back up”:#backup
** “danger signs for pill users”:#danger
** “missed pill guidelines”:#missed-pills

h3(#overview). How the birth control pill works

Birth control pills are a dose of hormones (estrogen and progestin) that a female takes once a day to prevent pregnancy. The birth control pill is about *99% effective* at preventing pregnancy when used perfectly. It is one of the most popular and effective methods of birth control.

The birth control pill works primarily by preventing the ovaries from releasing an egg each month (ovulation). It also thickens the cervical mucus, which acts as a barrier and helps to immobilize sperm. And lastly, it thins out the lining of the uterus (endometrium), which makes it difficult for a fertilized egg to implant itself into the wall of the uterus.

The pill does not protect against “sexually transmitted infections”:/infections/.

h3(#pro-con). Birth control pill side-effects and advantages

h4. Possible side-effects are usually minor

For most women, the pill is safe, effective and convenient. Some women may experience minor side effects such as midcycle bleeding, bloating or moodiness when starting the pill. These side-effects should disappear within the first 3 months.

If you have persistent side-effects, your doctor may recommend trying a different brand of pills to reduce them.

There are some rare but serious risks associated with hormonal contraception (blood clots, stroke, etc). The risks of using birth control pills are *smaller* than the health risks associated with pregnancy. See the “danger signs”:#danger below.

However, there are some women who may not be able to use the pill because of their health history (for example, women who have migraines with auras need to use “other methods”:/birthcontrol/ instead).

h4. Advantages of birth control pills

* regulates periods
* reliable (99% effective when taken correctly)
* convenient
* reduces risk of ovarian cysts, benign breast disease, endometriosis, ectopic pregnancy, ovarian and endometrial cancer

h3(#get-pills). How to get birth control pills

“Make an appointment”:/about/appointments/ at any of our clinics to see a doctor about getting a prescription for birth control pills.

Once our doctor has determined you can safely take the pill and has recommended a good brand for you to try, you can buy your pills right here at our clinic! We will teach you everything you need to know about the pill and answer any questions you have.

h3(#using). Using birth control pills properly

* It is important to take your pill at the same time everyday, for it to be most effective.
* Be sure to start your new pack immediately after finishing your last, without missing a day, even if you still have bleeding. You will always start your new package on the same day of the week.

If you are new to the pill, the doctor will probably start you on a 28 day package which means you will be taking a pill everyday for 4 weeks.

The last week of your package contains placebo pills which are inactive (they contain no hormones). This placebo week is when you will get your period. You are still protected from pregnancy even during this placebo week provided you have taken your pills correctly during the cycle.

A period or bleed outside this week is not uncommon. If midcycle bleeding persists, speak to a physician.

h3(#starting). Starting the birth control pill

If you take your first pill on the first day of your period, you are protected right away against pregnancy.

You may also do a “quick start” method which means you start your pills as soon as they are prescribed, regardless of where you are in your cycle. With this quick start method, you should use a back-up method of birth control, such as “condoms”:/birthcontrol/condom/, for at least the first *7 days*.

h3(#backup). When to use backup birth control

h4. Vomiting & diarrhea

If you vomit within two hours of taking your pill, take another pill as the first pill may not have been absorbed properly by your body. Use a back-up method for 7 days.

If diarrhea persists for more than a two days, continue to take the pill but use a back-up method for the rest of the package.

h4. Conflicting medications

There are some medications and herbal remedies that may make the pill less effective. Some of these include:

* some antibiotics
* Rifampin and Griseofulvin
* some anti convulsants (Barbituates including phenobarbital and primidone, Phenytoin, Carbamazepine, Toprimate, and Vigabatin)
* St. John’s Wort

If you are not sure whether the medication you are taking interferes with the pill, “call us”:/about/contact/ or a pharmacy, and use a back-up method for the rest of the package.

h3(#danger). Danger signals for birth control pill users

Call your doctor or go to the nearest medical treatment centre if you have any of the following symptoms while taking birth control pills:

* Severe abdominal pain
* Chest pain or shortness of breath
* Headaches (severe), blurred vision or loss of vision
* Severe pain in calf or thigh

h3(#missed-pills). If you miss a pill

There is evidence that ovulation may occur if birth control pills are missed for as little as 12 hours. Therefore, it is advisable to use a backup method such as condoms if a pill is missed for more than 12 hours and to consider emergency contraception.

Island Sexual Health Society recommends the following guidelines for clients who have missed pill(s).

There are two different sets of instructions based on whether this is the only episode of missed pills in your current package or if there has been more than one episode of missed pills in your current package. *Please ensure you are following the correct set of instructions*.

h4. If this is the first time you’ve missed pills in your current package

If you’ve *missed one pill*…

* If the missed pill is from the 1st week of your pill package:
** if you have had intercourse in the last 5 days, take the “emergency contraceptive pill (ECP)”:/ec as soon as possible and then take your next birth control pill on the next day
** if ECP is not needed, take the missed pill and today’s pill immediately (2 pills at once)
** take the remainder of package as normal
** use back-up birth control for 7 days
* If the missed pill is during the second or third week of package:
** take one missed pill and today’s pill immediately (2 pills)
** take remainder of package as normal
** no need for ECP or back-up
* If the missed pill is from the fourth week of package (sugar pills):
** skip the missed placebo pills
** take remainder of package as normal
** no need for ECP or back-up

If you’ve *missed 2 to 4 pills*…

* If the missed pills are from the 1st week of your pill package:
** if you have had intercourse in the last 5 days, take the “emergency contraceptive pill (ECP)”:/ec as soon as possible and then take your next birth control pill on the next day
** if ECP is not needed, take one missed pill and today’s pill immediately (2 pills)
** take remainder of package as normal
** use back-up for 7 days (until 7 active pills have been taken in a row)
* If the missed pills are from the second week of your package:
** take one missed pill and today’s pill immediately (2 pills)
** take remainder of package as normal
** use back-up for 7 days (until 7 active pills have been taken in a row)
* If the missed pills are from the third week of your package
** start a new package of pills
** use back-up for 7 days (until 7 active pills have been taken in a row)
** although you may have spotting, be sure to continue to take pills
* If the missed pills are in the fourth week of your package (sugar pills)
* skip the missed placebo pills
* take remainder of package as normal
* no need for ECP or back-up for 7 days

If you’ve *missed 5 pills* during any week of your package…

* if you have had intercourse in the last 5 days, take the “emergency contraceptive pill (ECP)”:/ec as soon as possible and then start a new pack on the next day
* if ECP is not needed, take one missed pill and today’s pill immediately (2 pills)
* start a new package of pills
* use back-up for 7 days (until 7 active pills have been taken in a row)

h4. If you’ve had more than one episode of missed pills

If you’ve had more than one episode of missed birth control pills in your current package, follow these instructions.

If you’ve had no intercourse in the last 5 days

* take 2 active pills immediately
* use a back up method for 7 days
* finish the pill pack by taking one pill daily
* if you’ve missed more than four pills in a row, skip the placebo pills in this pack and start a new pack immediately

If you have had intercourse in the last 5 days

* use the “emergency contraceptive pill (ECP)”:/ec immediately
* restart birth control pills the next day to finish the pack
* use a back up method for 7 days
* if you’ve missed more than four pills in a row, skip the placebo pills in this pack and start a new pack immediately