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Birth Control Pills

What is it?

"The pill" is a medication used to prevent pregnancy. The pill typically refers to combined birth control pills which use two hormones, estrogen and progestin, to pre­vent pregnancy.  The hormones in the pill thicken cervical mucus and prevent a woman’s ovaries from releasing an egg (ovulation).  It is very safe and has many health benefits when taken correctly.  The pill is one of the most effective means of preventing pregnancy.  The failure rate is between 1-8% per year.

How do I begin?

  • Start taking them today or "quick start"
  • Start them on the first day of menstrual bleeding or
  • Start them on the first Sunday after your menstrual bleeding begins.

Pill packages have "active" pills (with hormones) and placebo pills (no hormones).  The number of placebo pills can vary depending on the type of pill used.  Your menstrual period should occur during the placebo pills due to lack of hormones.  You are still protected from pregnancy during the placebo pills.  Continuous use pills are also available. These pills reduce the number of scheduled days of bleeding by reducing the number of placebo pills or eliminating them completely. Please ask your medical provider about continuous pills if you wish to limit or postpone your days of bleeding.

When should I take pills?

Take your pills at the same time each day. This will help you to remember to take your pills and gives you the most protection against pregnancy.  Plan to take the pills with something else you do every day, such as brushing your teeth, eating dinner, going to sleep, or set an alarm to help you remember to take them on time. 

What if I forget to take the pill?

If you forget a pill, take it as soon as you remember.  Even if this means taking two pills in one day, you should take the missed pill as soon as possible. If you miss the first or last active pill of the pack there is an increased risk of pregnancy, so be sure to use a second method of contracep­tion for 7 days of active pills. If you miss 2 pills in a row, you may want to consider emergency contraception. Read the package information for instructions on missed pills or call your health care provider if you have any questions.

When do the pills become effective?

With your first cycle of pills, use a backup contraceptive method (such as condoms) or abstain from vaginal inter­course for the first 7 days of pill use. Use condoms if you have trouble remembering to take your pill on time be­cause you may be at risk for pregnancy.  Be sure to read the pill package insert for detailed information about your pills.

Are there other times I need to use supple­mental contraception?

Use condoms in addition to pills if:

  • you want to decrease your risk of infection
  • you suspect you or your partner have a  sexually transmitted infection
  • you missed taking pills
  • you ran out or stopped the pills abruptly
  • you were late starting your new pills
  • you had severe vomiting or diarrhea
  • you have to take mediations that lower the body’s ability to absorb contraceptive hormones  (Check with the provider who prescribed the medication)

If you have had sexual intercourse that was unprotected, consider emergency contraception, which is available at the IUHC, M-F, 8:00 a.m. - 4:30 p.m. or over the counter at pharmacies.

What if I lose a pill?

You should take another pill of the same color. If that’s not possible, you may take the next pill from your package, even if it’s not the same color.  Taking a placebo as a re­placement pill will not provide protection against pregnan­cy.

What can I expect my periods to be like?

Your periods will generally be lighter, shorter, and with less cramping.  A normal period while using the pill could be as little as one day of light bleeding or spotting. You may even skip periods.  This is common if you take a pill that has fewer than 7 placebo pills.  If you are sure you have taken all your pills on time, don't worry.  If you skip two periods in a row, see a health care provider.  Do NOT stop your pills unless directed to do so. 

What additional health benefits can pills provide?

In addition to protection against unwanted pregnancy, the pill may be beneficial to your health in a number of ways.  These positive health benefits range from protection against cer­tain cancers to reduced incidence of various other diseases.  Some of these benefits can have long-term impact even after pill use is stopped. 

They may provide REDUCED RISK of:

  • endometrial cancer 
  • ovarian cancer 
  • ovarian cysts 
  • benign (fibrocystic) breast disease 
  • pelvic inflammatory disease (PID) 
  • ectopic pregnancy 
  • iron deficiency anemia 
  • menstrual cycle irregularities  
  • menstrual cramps 

Pills may also improve acne and enhance sexual enjoyment.

Who shouldn’t take pills?

Talk to your health care provider if you’ve had a history of blood clots, heart attack or stroke, cancer of the breast, cervix or uterus, jaundice, migraine with aura or if you are currently pregnant.

What are possible complications?

Birth control pills increase the risk of blood clots in veins and arteries. The risk of a blood clot is extremely small in young, healthy women. The highest risk is seen in older women and women who smoke. However, pregnancy confers an even greater risk of blood clots than does taking birth control pills. Clots in the veins can cause thrombophlebitis (mostly in the leg) and pulmonary embolism (a blood clot that travels to the lungs). Clots in arteries cause heart attacks or strokes. Know the warning signs of these problems (see below) and get medical evaluation immediately.


  • A Abdominal pain that is severe and cannot be explained
  • C Chest pain that is severe or sudden or shortness of breath
  • H Headache that is unusual or suddenly severe with numbness or weakness
  • E Eye problems such as blurred vision, flashing lights or blindness
  • S Severe leg pain in the calf or thigh with redness and heat

We advise women to quit smoking if they want to use birth control pills.

What about spotting or bleeding between periods?

Some degree of spotting or bleeding between periods is not uncommon and tends to disappear after the first few cycles. You should continue your pills. If you are worried or the bleeding is heavy, call your health care provider. Bleeding or spotting may also be due to missing pills or taking them at irregular times.

Other problems?

It is true the pill may produce minor discomforts among some women who use it such as:

  • Nausea
  • Skin changes (either improvement or worsening of acne)
  • Change in amount of vaginal secretion
  • Temporary fluid retention
  • Emotional changes, depression or change in sexual drive. If depression occurs, consult a health care provider.
  • Breast tenderness/increase in size
  • Missed periods
  • Weight gain with most pills is not common
  • Birth control pills may also cause elevated blood pressure, migraines, gall bladder problems and very rarely a benign liver tumor.

Most problems are temporary lasting from one to three months. You must have a blood pressure check after starting pills.  At that time the decision will be made by you and your health care provider to either continue the pills or change to a different type of pill or birth control method.  It is difficult to predict whether you will have side effects from taking the pill.

Pills and Pregnancy

If you decide that you want to get pregnant, see your health care provider for preconception counseling.  Start taking prenatal vitamins or folic acid 30 days before trying to get pregnant.  Once you stop pills, your fertility returns to normal rapidly.  For some women there may be a delay of up to several months before normal periods resume.  See your health care provider if you do not have a period within 3 months of stopping pills.  If you accidentally get pregnant while on pills, there is no increased risk of miscarriage or birth defects.


Birth control pills do not protect against the transmission of sexually transmitted infections including HIV (AIDS).  Use latex condoms for increased protection against the transmission of sexually transmitted infections including HIV (AIDS).