Birth Control Pills

Your Guide to Birth Control: The Pill

How does the pill work?

Normally a woman becomes pregnant when an egg released from her ovary (the organ that holds her eggs) is fertilized by a man's sperm. The fertilized egg attaches to the woman's womb (uterus), where it receives nourishment and develops into a baby. Hormones in the woman's body control the release of the egg from the ovary and prepare the body to accept the fertilized egg.

The Pill contains a small amount of man-made hormones. These hormones work with the natural hormones to prevent pregnancy. Some forms of the Pill stop the body from releasing an egg from the ovary. Others work by making the lining of the womb too thick or too thin to accept the fertilized egg.

Seasonale contains a combination of two hormones commonly used in other oral contraceptives, but in significantly lower doses.

Where can I get birth control pills?

Birth control pills are only available with a doctor's prescription.

How are the pills packaged?

You will receive a set of pills packaged in a thin case. Pill packs contain either 21 or 28 pills. Twenty-one-day pill packs contain 21 active pills. Twenty-eight day pill packs contain 21 active pills and seven sugar pills. The pill packs are marked with the days of the week to remind you to take a pill every day. The seven sugar pills in the 28-day pill pack are added so that you are reminded to start a new pill pack after 28 days.

A package of Seasonale contains 84 active pink tablets and 7 inactive pills.

How do I take the first pill pack?

You must wait until your period begins to start taking the Pill. Ask your doctor when you should start your pill pack. You will begin your pill pack after you have your period. If you still have your period on the day that you have been told to start your pill pack, go ahead and start the pill pack. You will get your next period about 25 days after starting the pill pack.

It's best to take the pills at the same time every day. Take the pill each day either before breakfast or at bedtime.

Seasonale works similarly. You begin taking it on the first Sunday after the onset of your period. If your period starts on a Sunday, start Seasonale that day. Then you take 1 of the active tablets a day for 84 consecutive days. This is followed with 7 days of placebo.

When do I start another pill pack?

You will start each new pill pack on the same day of the week. For example, if you start your first pill pack on a Sunday, you will start your next pill pack on a Sunday.

If you are on the 21-day pill pack, start the new pill pack 7 days after you finished the old pill pack. If you are on the 28-day pill pack, begin the new pack after taking the last pill in the old pack.

Start your new pill pack as scheduled above, whether or not you get your period or are still having your period.

How soon does the pill work?

Your body will need about 1-3 months to adjust to the Pill. Use another form of birth control, such as condoms (rubbers) and foam, during the first month. After the first month, you can just use the Pill for birth control.

What if I forget to take a pill?

If you forget to take a pill, take it as soon as you remember. If you don't remember until the next day, go ahead and take 2 pills that day. If you forget to take your pills for 2 days, take 2 pills the day you remember and 2 pills the next day. You will then be back on schedule. If you miss more than 2 pills, wait for your next period and start a new pill pack as did when you first started taking the pill.

Any time you forget to take a pill, you must use another form of birth control until you finish the pill pack. When you forget to take a pill, you increase the chance of releasing an egg from your ovary. If you miss your period and have forgotten to take one or more pills, get a pregnancy test. If you miss 2 periods even though you have taken all your pills on schedule, get a pregnancy test.

Are there side effects associated with the pill?

Yes, although the majority are not serious. They include:

Nausea
Weight gain
Sore or swollen breasts
Small amount of blood, or spotting, between periods
Lighter periods
Mood changes

The following side effects, easily remembered by the word "ACHES," are less common but more serious. If you experience any of these, contact your doctor immediately. If you cannot reach your doctor, go to an emergency room or urgent care center for evaluation. These symptoms may indicate a serious disorder, such as liver disease, gallbladder disease, stroke, blood clots, high blood pressure or heart disease. They include:

Abdominal pain (stomach pain)
Chest pain
Headaches (severe)
Eye problems (blurred vision)
Swelling and/or aching in the legs and thighs

Can any woman take the pill?

The pill can be taken safely by most women, but is not recommended for women who are over the age of 35 and smoke, but it can be used until menopause, if you don't smoke cigarettes. In addition, you should not take the pill if you have had:

Blood clots
Inflammation in the veins
Serious heart or liver disease
Unexplained vaginal bleeding
Cancer of the breast or uterus
Sickle cell anemia
If you are not sure if you are affected by one of these conditions, ask your doctor. Also, inform your doctor if you have a first-degree relative (parent, brother, sister, child) who has had blood clots in the legs or lungs.

Is it OK to take other drugs while taking the pill?

Some drugs can stop the Pill from working properly. Tell your doctor about all of the medicines you are taking.

What are mini pills?

These are pills that contain only one hormone (progestin).

How do mini pills work?

Mini pills work by thickening the cervical mucus so the sperm cannot reach the egg. The hormone in the pills also changes the lining of the uterus, so implantation of a fertilized egg cannot occur. In some cases, mini pills stop ovulation (the release of an egg). A pill is taken every day.

How effective are mini pills?

If Mini Pills are used consistently and correctly, they are about 95% effective.

Points to keep in mind when taking the pill

Keep another form of birth control, like foam and condoms, on hand in case you forget to take a pill.
Carry your pills with you if you don't always sleep at the same place.
Get your pill refills soon after you start the last pill pack. Don't wait until the last minute.
Birth control pills are medication. Always tell your doctor or pharmacist you are on the pill if you see him or her for any reason.
You are less likely to forget your pills if you take them in the morning when you get up.

For a complete guide to sexual health for your patient visit WebMD Health

Reviewed by the doctors at The Cleveland Clinic Department of Obstetrics and Gynecology.

Edited by Charlotte E. Grayson, MD, Oct. 2003.