Oral Contraception Information

Oral contraceptive pills (OCPs) are medicines taken to prevent pregnancy. OCPs are taken by mouth, and they work by:

• Preventing the ovaries from releasing eggs.
• Thickening mucus in the lower part of the uterus (cervix), which prevents sperm from entering the uterus.
• Thinning the lining of the uterus (endometrium), which prevents a fertilized egg from attaching to the endometrium.

OCPs are highly effective when taken exactly as prescribed. However, OCPs do not prevent STIs (sexually transmitted infections). Safe sex practices, such as using condoms while on an OCP, can help prevent STIs.

Before starting OCPs

Before you start taking OCPs, you may have a physical exam, blood test, and Pap test. However, you are not required to have a pelvic exam in order to be prescribed OCPs. Your health care provider will make sure you are a good candidate for oral contraception. OCPs are not a good option for certain women, including women who smoke and are older than 35 years, and women with a medical history of high blood pressure, deep vein thrombosis, pulmonary embolism, stroke, cardiovascular disease, or peripheral vascular disease.

Discuss with your health care provider the possible side effects of the OCP you may be prescribed. When you start an OCP, be aware that it can take 2–3 months for your body to adjust to changes in hormone levels.

Follow instructions from your health care provider about how to start taking your first cycle of OCPs. Depending on when you start the pill, you may need to use a backup form of birth control, such as condoms, during the first week. Make sure you know what steps to take if you ever forget to take the pill.

Types of oral contraception

The most common types of birth control pills contain the hormones estrogen and progestin (synthetic progesterone) or progestin only.

The combination pill

This type of pill contains estrogen and progestin hormones. Combination pills often come in packs of 21, 28, or 91 pills. For each pack, the last 7 pills may not contain hormones, which means you may stop taking the pills for 7 days. Menstrual bleeding occurs during the week that you do not take the pills or that you take the pills with no hormones in them.

The minipill

This type of pill contains the progestin hormone only. It comes in packs of 28 pills. All 28 pills contain the hormone. You take the pill every day. It is very important to take the pill at the same time each day.

Advantages of oral contraceptive pills

• Provides reliable and continuous contraception if taken as instructed.
• May treat or decrease symptoms of:
  • Menstrual period cramps.
  • Irregular menstrual cycle or bleeding.
  • Heavy menstrual flow.
  • Abnormal uterine bleeding.
  • Acne, depending on the type of pill.
  • Polycystic ovarian syndrome.
  • Endometriosis.
  • Iron deficiency anemia.
  • Premenstrual symptoms, including premenstrual dysphoric disorder.
• May reduce the risk of endometrial and ovarian cancer.
• Can be used as emergency contraception.
• Prevents mislocated (ectopic) pregnancies and infections of the fallopian tubes.

Things that can make oral contraceptive pills less effective

OCPs can be less effective if:

• You forget to take the pill at the same time every day. This is especially important when taking the minipill.
• You have a stomach or intestinal disease that reduces your body’s ability to absorb the pill.
• You take OCPs with other medicines that make OCPs less effective, such as antibiotics, certain HIV medicines, and some seizure medicines.
• You take expired OCPs.
• You forget to restart the pill on day 7, if using the packs of 21 pills.

Risks associated with oral contraceptive pills

Oral contraceptive pills can sometimes cause side effects, such as:

• Headache.
• Depression.
• Trouble sleeping.
• Nausea and vomiting.
• Breast tenderness.
• Irregular bleeding or spotting during the first several months.
• Bloating or fluid retention.
• Increase in blood pressure.

Combination pills are also associated with a small increase in the risk of:

• Blood clots.
• Heart attack.
• Stroke.

Summary

• Oral contraceptive pills are medicines taken by mouth to prevent pregnancy. They are highly effective when taken exactly as prescribed.
• The most common types of birth control pills contain the hormones estrogen and progestin (synthetic progesterone) or progestin only.
• Before you start taking the pill, you may have a physical exam, blood test, and Pap test. Your health care provider will make sure you are a good candidate for oral contraception.
• The combination pill may come in a 21-day pack, a 28-day pack, or a 91-day pack. The minipill contains the progesterone hormone only and comes in packs of 28 pills.
• Oral contraceptive pills can sometimes cause side effects, such as headache, nausea, breast tenderness, or irregular bleeding.