Oral contraceptive pills, more commonly known as birth control pills, are a widely used and very effective way to prevent pregnancy. They work by preventing ovulation, which is the time during your cycle when a mature egg is released from the ovary and made available to become fertilized. Too often, these are prescribed with very little instructions and they may leave you with some questions. In this post I am talking about the combination pill, which contains both estrogen and progestin.
1. What are the risks?
Taking birth control pills for longer periods of time can increase your risk of cervical cancer and breast cancer. Because of the decreased estrogen dose in birth control pills today, more recent studies actually show no link to birth control pills and breast cancer. In contrast, extended birth control use can actually DECREASE the risk of ovarian cancer and uterine cancer. Other risks include high blood pressure, blood clots, or stroke. This risk is higher if you are obese, if you smoke, or if you are older than age 35. Birth control pills are not recommended for smokers 35 or older because of the increased risk of cardiovascular disease and stroke.
2. What are the possible side effects?
Most people are afraid that birth control pills will cause weight gain. Studies have shown that the effect of the pill on weight is very small, if it has any effect at all. This is because of the lower estrogen levels used in today's formulas. It can, however, cause you to retain more fluid. Other possible side effects include nausea, irregular bleeding, mood changes, headaches, and breast tenderness. These side effects will typically go away after 2-3 months. If not, talk to your healthcare provider about switching to a different method of birth control.
3. When do I begin a pack?
There are a few options here. You may either 1) Start your pack on the first day of your period. You don't need a backup method. 2) Start your pack on the first Sunday after your period begins. You will need a backup method for the first 7 days. 3) Start your back today. You will need a back up method for 7 days.
4. Do I need to take it at the same time every day?
Yes. But if you forget to take a pill, take it as soon as you remember. I always recommend setting an alarm on your phone to go off at the same time each day!
5. Is it okay to stop having a period?
Yes. The period that you get with the pill is not a true period. Its actually withdrawal bleeding, which looks like a period. Some people may not get this at all when on the pill, and studies have show that its ok! If you want to avoid a "period" for a special vacation, its ok to skip the placebo pills and go straight to a new pack of active hormones.
6. What are some benefits from taking the pill besides preventing pregnancy?
There several other reasons why your healthcare provider may recommend birth control pills for you. Sometimes the pill is prescribed for acne. Hormonal acne typically presents as pimples on the chin or the jawline. Birth control pills can help regulate your hormones to reduce this kind of acne. If you have a condition called Polycystic Ovarian Syndrome (PCOS), you may have irregular periods and your provider may prescribed birth control pills to help regulate your period or reduce the symptoms of PCOS. If you have very heavy bleeding or severe cramping during your cycle birth control pills can help to decrease the bleeding, and it can lessen the severity of your cramps. You may also be prescribed the pill for other medical conditions, including ovarian cysts or endometriosis.
7. How effective is the pill?
The pill is 99% effective in preventing pregnancy when they are used correctly. It is more effective if its taken at the same time every single day.
8. Can antibiotics decrease the effectiveness of the pill?
Rifampin is the only antibiotic that has been shown to decrease the effectiveness of birth control pills. This is mostly prescribed to treat tuberculosis or meningitis.
There are many other options for birth control, including the progestin-only pill, intrauterine devices, birth control patches, and implants that go underneath the skin. Talk to your provider about which method would be best for you!