WHAT IS THE BIRTH CONTROL PILL?
What is the Birth Control Pill?
The birth control Pill is probably the most well-known birth control, and the first of all the hormonal birth control methods. It is far from the best one, however. It is 99.7% effective when used perfectly, but most women forget to take it now and then, so typical effectiveness is only 91%. You need to use it every single day, ideally at the same time, for it to be the most effective!
To avoid confusion, I made a separate post for the Mini-Pill, which has different hormones from the Pill. The Mini-Pill is progesterone ONLY, or called the Progesterone Only Pill (POP). The traditional Pill is COMBINED estrogen and progesterone, otherwise called the Combined Oral Contraceptive (COC).
It’s a big pain to have to think about and carry around for many women. If you have other medications you take every day, it would be easier to add this in. Most women who need birth control are young and healthy, however.
Other reasons for not taking the pill “perfectly” include using other medications that interfere with the pill’s effects such as seizure meds or antibiotics, being sick and vomiting, or not being able to refill the prescription to start a new pack right away.
It’s for this reason that I strongly recommend the longer acting birth control options. The Patch, the Ring, the Shot, the Implant/Rod and the IUD, all are easier to use and you don’t have to think about them every day. The best ones are the Implant/Rod and the IUD, which last for years without you needing to do anything once they’re put in.
If you do decide on the Pill, I recommend setting a daily timer on your phone so you take it at the same time every day. Some people can swallow them without water, but I would suggest always carrying the pills and some liquid with you.
The Pill usually comes in a pack of 28, but only 21 of them contain any medicine, the other 7 are actually blank/”sugar pills”. They are different colors so you won’t get confused.
During these 7 days, you will have bleeding like a period, since you won’t be exposed to the hormones for those 7 days. This is called a “withdrawal bleed” because it happens when the hormones are “withdrawn” (taken away). This is not a real period since it does not have an egg in it since birth control hormones keep you from ovulating.
You can choose to just not take a pill at all for those 7 days, but it’s good to keep the habit of taking a pill every day.
You can “control your periods” by choosing to SKIP the blank/sugar pills. If you keep taking the pills with hormones in them, you can skip having a “withdrawal bleed”/fake “period”. If you have a vacation or important event at a certain time, you can take the pills in a way that allows you to control when you have a “period.” There are certain types of pills that let you have a “period” only once a season (Seasonique), or even once a year (Lybrel)! Ask your doctor.
This does not always work perfectly, however. Every body is different, and especially when you start taking hormones, you can have light bleeding or spotting, sometimes for weeks or months, while your body adjusts. If you are trying to control your “periods” but are having difficulty, talk with your doctor, since there are many different types of pills you can try, with different hormone doses.
Some women like the feeling of having a period every month, and others do not. It’s completely up to you. Contrary to popular belief, you do NOT need to have a period every month to “clean everything out”!! There is NO HARM to your health to never have periods again! All hormonal birth control thins the lining of your uterus, so cells do not build up as much.
If you keep skipping periods, at some point you may have some “Breakthrough Bleeding”/spotting, which means bleeding despite using the hormones. If it bothers you, you can do a sort of reset by giving your body 1 week without added hormones.
Like all other hormonal birth control methods, you need to wait at least 7 days for it to take effect. You are not protected from pregnancy until after 7 days of using this! So use backup methods such as condoms, abstinence, or even overlapping with certain other hormonal birth controls is fine.
Side effects include headaches, nausea, bloating, and breast tenderness. There are many different types of pills, so you can ask your doctor to try a type with lower hormone levels, which tends to have fewer side effects. There are also types that have different amounts of hormones in each pill of each pack, to try to better mimic your natural hormone ebbs and flows. These are called “Bi-phasic” or “Tri-phasic” pills, vs. “Monophasic” ones that deliver the same amount in every pill. These might be better tolerated since they try to simulate what your body naturally does during your menstrual cycle. The downside is that the lower dose pills might not be as great at regulating your “periods.”
Because of the estrogen in it, the Pill is NOT safe to use in certain cases, such as for women with migraine headaches with an “Aura” (changes that signal the headache is coming on), smokers over age 35, women who’ve just had a baby less than 4-6 weeks ago, or anyone with a previous blood clot or stroke. There are many other conditions that you can learn more about here. MAKE SURE TO GO THROUGH YOUR MEDICAL HISTORY THOROUGHLY WITH YOUR DOCTOR BEFORE STARTING ON THIS BIRTH CONTROL!!!
If you forget and miss a day, you can take two Pills the next day to try to catch up, but this is less effective than if you had not missed it at all. If you miss 2 days, you can take 2 Pills as soon as you remember, and then 2 the next day. Any longer gap than that cannot be caught up on. You should just restart taking the Pill once a day and use a backup birth control method for 7 days.
That’s it for the Pill! As always, feel free to message me with any questions or concerns!