Birth Control Pills (Oral Contraceptives)
Birth control pills, also called "oral contraceptives" or "the pill", can be take by women to prevent becoming pregnant.
Birth control pills require a prescription from your doctor or health care provider.
All women who take birth control pills should get a medical check-up at least once each year.
A woman's menstrual cycle is controlled by several hormones, including estrogen and progesterone. Birth control pills are made of similar hormones that prevent the ovaries from releasing eggs and/or being fertilized by sperm.
Types of Birth Control Pills
Most women are prescribed "combination pills" that contain varying amounts of both estrogen and progestin (a hormone similar to progesterone).
Unlike “the pill,” the mini-pill only has one hormone –– progestin. Taken daily, the mini-pill thickens cervical mucus, which keeps the sperm from joining the egg. Less often, it stops the ovaries from releasing an egg. The effectiveness of the progestin-only pill is slightly less than the combination pill.
Mothers who breastfeed can use the mini-pill. It won’t affect their milk supply.
The mini-pill is a good option for women who:
- Can’t take estrogen
- Are older than 35
- Have a risk of blood clots
The mini-pill must be taken at the same time each day. A backup method of birth control is needed if you take the pill more than 3 hours late. Antibiotics may reduce how well the pill works in some women. Talk to your doctor about a backup method of birth control if you need to take antibiotics.
Extended Cycle Oral Contraceptive
More recently, a type of birth control pill has been developed so that a woman has only few periods each year.
It is usually taken for 3 months, followed by one week of inactive pills. Most women will have only 4 periods each year, but there may be spotting between periods.
Seasonale®, Seasonique® and Lybrel® are are brand names of this type of birth control pill.
Extended or continuous use birth control pills have been used for many years to treat endometriosis, dysmenorrhea, and menstruation-associated symptoms. Some studies have suggested that women who experience premenstrual-type symptoms during the "off-week" of standard birth control pills may experience fewer symptoms when placed on an extended cycle regimen.
What to Expect from Birth Control Pills
Birth control pills are very effective when taken every day. About 2 to 3 pregnancies occur a year out of 100 women who never miss a pill. Skipping days makes this form of contraception less effective.
Certain medication, and supplements can also make the pill less effective. Talk to your doctor to be sure that any medications or over-the-counter vitamins/supplements take do not interfere with your birth control pills.
?It is important to remember that birth control pills do not protect a woman against sexually transmitted infections (STDs). A barrier type of contraception, such as a condom, should be used to reduce the risk of infection with chlamydia, herpes, genital warts, and other sexually transmitted diseases.
Fertility usually returns to normal within 3 - 6 months of stopping the pill. However, some women will regain fertility immediately after the pill is stopped. So women who wish to avoid becoming pregnant should use an alternative form of contraception as soon as they stop using the pill.
Other Health Benefits
Many women who do not need contraception may still choose to take birth control pills because of other health benefits that they provide, including:
- reduced menstrual cramps
- lighter menstrual periods
- acne treatment
- osteoporosis prevention
- breast growths (non-cancerous)
- ectopic pregnancy
- endometrial and ovarian cancers
- iron deficiency anemia
- breast and ovarian cysts
- premenstrual symptoms (PMS), including headaches and depression
Safety of Birth Control Pills
Most women can use birth control pills safely. But all medications have some risks, so safety is a concern when choosing a birth control method. Certain conditions increase the risk of serious side effects. Some of these conditions may even rule out using the pill. Talk with your doctor to find out if the pill is likely to be safe for you.
You should not take any kind of birth control pill if you have had breast cancer or think you might be pregnant.
You should not take the progestin-only pill if you have blood clotting problems that are not being treated successfully.
You should not take the combination pill during prolonged bed rest or if you have any of the following medical conditions:
- have diabetes that is not well controlled
- have high blood pressure
- smoke and are 35 or older
- smoke and have high blood pressure
- get migraine headaches with aura
- have certain inherited blood-clotting disorders
- have had blood clots or vein inflammation
- have had a heart attack, stroke, or angina
- have had serious heart valve problems
- have lupus with certain conditions
- have serious liver disease or have had liver cancer
Everyone I know is on the pill. Are they safe?
Today’s pills have lower doses of hormones than ever before. This has greatly lowered the risk of side effects. But there are still pros and cons with taking birth control pills. Pros include having:
- More regular and lighter periods
- Fewer menstrual cramps
- A lower risk of ovarian and endometrial cancers, pelvic inflammatory disease (PID), noncancerous ovarian cysts, and iron deficiency anemia
Cons include a higher chance, for some women, of:
- Heart disease, high blood pressure, and blood clots
- Nausea, headaches, sore breasts, and weight gain
- Irregular bleeding
Many of these side effects go away after taking the pill for a few months. Women who smoke, are older than 35, or have a history of blood clots or breast or endometrial cancer are more at risk of bad side effects and may not be able to take the pill. Talk with your doctor about whether the pill is right for you.
Will birth control pills protect me from sexually transmitted infections (STIs), including HIV/AIDS?
No, they won’t protect you. Birth control pills and most other birth control methods will not protect you from sexually transmitted diseases, including HIV (the virus that causes AIDS). They only protect against pregnancy.
The male latex condom is the best birth control method that also can protect you from STIs, including HIV. If you are allergic to latex, polyurethane condoms are a good alternative. If your partner can’t or won’t use a male condom, female condoms also create a barrier that can help protect you from STIs.
It is important to only use latex or polyurethane condoms to protect you from STIs. "Natural” or “lambskin” condoms have tiny pores that may allow for the passage of viruses like HIV, hepatitis B, and herpes. If you use non-lubricated male condoms for vaginal or anal sex, you can add lubrication with water-based lubricants (like K-Y jelly) that you can buy at a drug store. Never use oil-based products, such as massage oils, baby oil, lotions, or petroleum jelly, to lubricate a male condom. These will weaken the condom, causing it to tear or break. Use a new condom with each sex act.
Reference: Center for Disease Control and Prevention
Last updated September 7, 2016