The document provides an overview of birth control pills, highlighting their history since FDA approval in 1960, various types, and how they function to prevent pregnancy. It explains the health benefits and risks associated with birth control pills, along with the importance of doctor prescriptions and insurance coverage. The summary also touches on understanding the menstrual cycle and how to effectively use the different types of birth control pills available.

1. BIRTH CONTROL PILLS
Overview
Since the U.S. Foodand Drug Administration(FDA) approved“the pill”in1960, ithas become the most
popularandone of the most effective formsof reversible birthcontrol everinvented.AccordingtoThe
GuttmacherInstitute,amongU.S.womenwhouse birthcontrol,more than27 percentuse the pill.A
2013 National HealthStatisticsReportsaysthat82 percentof womenwhouse contraceptionhave used
the pill at some point.e mostpopularandone of the mosteffective formsof reversible birthcontrol ever
invented.AccordingtoPlannedParenthood,amongU.S.coupleswhouse birthcontrol,more than30
percentuse the pill.
In recentyears,birthcontrol pillshave changedtoinclude lesshormones,resultinginfe
Since the U.S. Foodand Drug Administration(FDA) approved“the pill”in1960, ithas become th
werside effects.Infact,almostall healthywomenwhodon’tsmokemayuse birthcontrol pills,
regardlessof theirage.Unlike the originaloral contraceptives,low-dose pillshave few healthrisksfor
mostwomenandevenoffersome healthbenefits,suchaslighterperiods(whichreduceriskof ),less
severe menstrual crampsandlesseningof acne breakouts.
Birthcontrol pillsdocarry some healthrisks.Forexample,if youare over35 andsmoke or have certain
medical conditionssuchasa historyof bloodclotsor breastorendometrialcancer,yourhealthcare
professionalmayadvise againsttakingoral contraceptives.Also,birthcontrol pillsdonotprotectyou
fromsexuallytransmitteddiseases(STDs),includingHIV (humanimmunodeficiencyvirus),the virusthat
causesAIDS,or HPV,the human papillomavirusthatcan cause cervical cancer.
Unlike formsof birthcontrol soldoverthe counter,youneeda healthcare professional’sprescriptionto
purchase birthcontrol pills,andmanyhealthinsurerscovertheircost.The one exceptionisthe
emergencybirthcontrol pill,PlanBOne-Step,whichissoldoverthe counter.
UnderstandingYour Menstrual Cycle
At the beginningof eachmenstrual cycle,levelsof the hormone estrogenbegintorise.Estrogenhelps
thickenthe bloodyliningof the uterus(endometrium) toprepare forafertilizedegg.Once estrogen
levelspeak,about14days intothe menstrual cycle,one of the ovariesreleasesone ormore eggs—this
release iscalledovulation.
Afterovulation,levelsof anotherreproductivehormone—progesterone—risetohelpprepare the
uterusto receive afertilizedeggbythickeningitslining.The eggtravelsthroughthe fallopiantubes
towardthe uterus,andif the egg isfertilizedandsuccessfullyimplantsitself inthe uterine lining,
conception(pregnancy)takesplace.If conceptiondoesnotoccur,bothestrogenandprogesterone
levelsdrop,signalingthe nowthickeneduterinebloodyliningtosloughoff orshed,andmenstruation
begins.

2. How Birth Control PillsWork
Birthcontrol pillsare asyntheticformof the hormonesprogesteroneandestrogen.Theyprevent
ovulationbymaintainingmore consistenthormone levels.Withoutapeakinestrogen,the ovarydoesn’t
getthe signal torelease anegg.Rememberthatnoeggmeansno possibilityforfertilizationand
pregnancy.
The pill alsothickenscervical mucussothe spermcannotreach the egg.It makesthe liningof the uterus
unreceptive tothe implantationof afertilizedegg.
How to Take Birth Control Pills
There are a fewdifferentwaysyoucanstart to take birth control pills.Discussthe prosandconsof the
followingmethodswithyourdoctor:
 You can start takingthemon the firstday of your period,inwhichcase youwon’tneedbackup
birthcontrol.
 You can start takingthemthe Sundayafteryour periodstarts,inwhichcase you will need
backupbirthcontrol forsevendays.
 You can start takingbirthcontrol pillsonthe day theyare prescribed,inwhichcase youwill
needtomake sure you’re notpregnantandyou will needtouse backupbirthcontrol forthe
firstmonth.If you have a negative pregnancytestandithasbeenat least10 to 11 days since
youlast had intercourse,youcanbe nearlysure youare notpregnantand itis OKto start the
pill.
No matterwhenyoustart takingbirthcontrol pills,youwill needtostarteach new packon the same
day of the weekthatyou beganyourfirstpack. For example,if youstarttakingyourbirthcontrol pillson
a Monday, youwill alwaysbegintakingthemonaMonday.Keepinmindthat birthcontrol pillsonly
workif you take themeveryday.Theydo notaccumulate or collectinyourbody,whichiswhy youmust
take a pill everyday!Youshouldn’tskippills(onpurposeorbyaccident) orstop takingthem, evenif
you’re nothavingsex often.Alsobe aware thatcertainmedications,suchascertainantibioticstakenfor
a longtime,can make yourbirth control pillslesseffective.If youregularlyhave diarrheaorvomiting,
that can interfere withabsorptionof the pill.If youmissapill orhave gastrointestinal problemsorare
takingmedicationthatcouldinterfere withyourbirthcontrol pills,use abackupmethodforthe rest of
your cycle.Justremember,don’tstopyourbirthcontrol pills.
Types ofBirth Control Pills
The three most commontypesof birthcontrol pillsare combinationpillsandprogesterone onlypills
(POP).Combinationpillscontainbothestrogenandprogestin.Eachpill inthe packcontainsa
combinationof these twohormones.ProgesteroneOnlyPillscontainnoestrogen.Calledthe progestin-
onlypill,or“mini-pill,”it’sideal forbreastfeedingwomenbecause estrogenreducesmilkproduction.It’s
alsoideal forwomenwhocannottake estrogen.Bothtypesare equallyeffective,andyoushouldwork
withyourdoctor to determine the one that’srightforyou.There are alsoand emergencycontraceptive

3. pills,whichare notintendedtobe usedregularlyasacontraceptive.Theyare designedtoprevent
pregnancyafterunprotectedsex (whenstandardcontraceptivesfail ornomethodwasused).
Health BenefitsofBirth Control Pills
Birthcontrol pillsprovidecertainhealthbenefitsinadditiontopreventingpregnancy.Before youstart
takingoral contraceptives,discussthe healthbenefitswithahealthcare professional.Some of the main
healthbenefitsof birthcontrol pillsinclude animprovedmenstrual cycle (lessbleedingandcramps),
decreasedriskof certain typesof cancers,protectionfromovariancystsand an improvedcomplexion.
Risks & Side Effectsof Birth Control Pills
Despite the factthat theyare safe for mostwomen,BCPsdocarry some healthrisks.Forexample,if you
are over35 and smoke orhave certainmedical conditionssuchasa historyof bloodclotsor breastor
endometrial cancer,yourhealthcare professionalmayadvise againsttakingBCPs.Also,birthcontrol
pillsdonotprotect youfromsexuallytransmitteddiseases(STDs),includingHIV (human
immunodeficiencyvirus),the virusthatcausesAIDS,orHPV,the humanpapillomavirusthatcancause
cervical cancer.
Unlike otherformsof birthcontrol soldover-the-counter,youneedahealthcare professional’s
prescriptiontopurchase BCPs,and manyhealthinsurerscovertheircost.The one exceptionisthe
emergencybirthcontrol pill,PlanBOne-Step,whichissoldoverthe counter.
Types ofPills
The three most commontypesof birthcontrol pillsare:
1. CombinationPills
Whenyouhear the term “birthcontrol pill,”itmostoftenreferstooral contraceptivescontaining
estrogenandprogestin.Eachpill inthe packcontainsa combinationof these twohormones.
Combinationbirthcontrol pillsmaybe monophasic,where eachof the active pills containsthe same
amountof estrogenandprogestinandall the pillswill be the same color,ormultiphasicwhere the
active pillscontainvariedamountsof hormonesdesignedtobe takenatspecifictimesthroughoutthe
pill-takingschedule.The multiphasicpillswill be differentcolorstoindicate the hormonal dose changes.
There are a fewdifferentwaysyoucantake combinationpills—for21 days,28 days,91 days or
continuously.
 28-day pills(21 active;7 inactive):With28-daypills,youtake apill at the same time eachday for
28 days.Usually,the first21 pillscontainhormones,andthe lastsevenpillsare placebopills.
Duringthe weekwhenyoutake the lastsevenpills,youwill getyourperiod.Once you’ve
finishedall the pillsinyourpack,you’ll starta new packof 28 pills.
 28-day pills(24 active;4 inactive):Andnow tIncreasinglypopularare thehree pill packs
containing24 days of hormone pillsandfourdaysof placebopills,sometimesresultingina

4. shorter,lighterperiod.sThe hormone pillsmaycontainacombinationof drospirenone,a
progestin,andethinyl estradiol (Yaz,Beyaz,Gianvi,Loryna,andNikki) ora combination
norethindrone,anotherprogesterone,andethinyl estradiol(acombinationof drospirenone,a
progestin,andethinyl estradiol;Beyaz,whichcontainsthe same hormonesasYazplusa daily
dose of folicacid;and Loestrin24 Fe,GeneressFe andMinastrin24 Fe)acombinationof ethinyl
estradiol andnorethindrone,anotherprogesterone) contain24daysof hormonesandfourdays
of placebopills,usuallyresultinginashorterperiod.
 21-day pills:If yourbirthcontrol pack contains21 pills,youwill take one pillatthe same time
each dayfor 21 days andthenwaitsevendaysto start a new pack. Duringthese sevendays, you
will getyourperiod.Itmaynot start until youhave takentwoor three of the placebosugarpills.
 91-day pills:Alsocalledextended-use pills,theyare marketedunderthe brandnames
Seasonale,Seasonique,LoSeasonique,JolessaandQuasense.This dose regimencallsfortakinga
pill atthe same time everydayfor91 days.The first84 pillscontainhormones,andthe last
sevenare placebo(sugar) pillsoraverylow dose of estrogento helpcontrol some period
symptoms.Yougetyour periodwhenyou take the sugarpills,soyouif you optfor extended-use
pills,youonlygetyourperiodfourtimesayear.But youmay have some lightbleedingor
spottingof bloodas yourbodyadjuststo the extended-use pills.
 Continuousbirthcontrol pills:Lybrel is the firstThe FDA has -approvedcontinuous-usebirth
control pillsthatcontainethinyl estradiol andlevonorgestrel.BrandnamesincludeLybrel,
Alesse,Lessina,Nordette,Triphasil-28,Triphasil-21,andothers.Itis a monophasicpill
(containingthe same levelsof estrogenandprogestinthroughoutthe entire pill-taking
schedule) thatcomesina28- or 21-day pack and isdesignedtobe takencontinuously,withno
breakbetweenpillpackets.Thatmeansyouwon’thave aperiod.Youmay have some spotting
or breakthroughbleeding,particularlywhenyoufirststartusingLybrelcontinuousbirthcontrol
pills.Butmostwomenwill have nobleeding(orhardlyany) bythe endof a year.
In orderto skiptheirperiods(inotherwords,tocreate continuousbirthcontrol pillsontheirown),
some womentake their21-daypillscontinuouslyorrefrainfromtakingthe sugarpillsinthe 28-daypack
so theyare onlyevertakingpillsthatcontainhormones.Thismayworkbestforwomenusing
monophasicpills.If you’re consideringthisoption,discussitfirstwithyourhealthcare provider.
Additionally,be aware thatinsurance maynotcover pillsusedinthisway.
Advantages of combinationpills:
 reduce riskof ovariancancer and endometrial cancer
 preventectopicpregnancy(pregnanciesthatoccuroutside the uterus,usuallyinthe fallopian
tube)
 decrease menstrual bloodloss,painandcramps
 make premenstrual symptomslesssevere
 helpregulate menstrualcycles
 improve acne

5.  preventbone densitylossinwomenwhohave attainedtheirpeakbone mass(generallywomen
over30)
 decrease riskof ovariancysts
 improve excessivebodyhair,particularlyonthe face,a conditioncalledhirsutism
 improve endometriosis
 decrease benignbreastdisease orbreastcysts
 effectsare reversible withquickreturntofertility
 treat the emotional andphysical symptomsof premenstrual dysphoricdisorder(PMDD),a
severe formof PMS.Onlytwo combinationOCs—YazandBeyaz—have beenshowntobe
clinicallyeffectiveforthisuse.Bothcontainthe progestindrospirenone andethinyl estradiol,a
formof estrogen,andBeyazcontainsanaddeddailydose of folicacid.
Disadvantages
 couldcause nausea,vomiting,headachesand/orspotting,particularlywiththe firstfew cycles
 may leadtohighblood pressure/hypertension(verysmall increasedrisk)
 may cause bloodclotsina small percentage of users
 may cause a slightincrease instroke risk
 may contribute tothe formationof gallstonesandrare benignlivertumors
Possible side effects:
 nauseaand vomiting
 headaches
 irregularbleeding
 weightgainor weightloss,if youchange youreatinghabitsafteryoustarttakingthe pill
 breasttenderness
 increasedbreastsize
Askyourself the followingquestionstodetermineif combinedbirthcontrol pillsare agood optionfor
you:
 Are you the type of personwhocan remembertotake a pill everyday?
 If you are at riskfor sexuallytransmittedinfections,will youuse condoms?
 Do youneedrelief fromendometriosis,severe menstrual painoranemia?
 Do yousufferfromPMDD?
 If you smoke,are youunder35?
 If breastfeeding,isyourbabysix monthsorolder?
 Do youhave highbloodpressure?
 Have you done well withcombinationpillsinthe past?
2. Progestin-OnlyPills(POP)

6. Thistype of pill containsnoestrogen.Calledthe progestin-onlypill,or“mini-pill,”it’sideal for
breastfeedingwomenbecauseestrogenreducesmilkproduction.It’salsoideal forwomenwhocannot
take estrogen.Progestin-onlypillsprimarilyworkbypreventingovulation,thinningthe endometrium
and thickeningthe cervical mucus,therebypreventingspermfromenteringthe uterus.However,with
progestin-onlybirthcontrol pills,ovulationisn’tconsistentlysuppressed,sothe actionsoncervical
mucusand the endometriumare the critical factors.Towork effectively,theymustbe takenata certain
time every24 hours.
Advantage of POPs
 decreasedmenstrual bloodloss
 decreasedmenstrual crampsandpain
 can be usedbybreastfeedingwomenimmediatelyafterdelivery
 an optionforwomenwhocannot use estrogen,suchas those whoare over35 and still smoke
 easilyreversible.
Disadvantages:
 irregularbleedingpatterns,spottingorbreakthroughbleeding
 mustbe takenat the same time everyday
 do notprotect againstsexuallytransmittedinfections;womenatriskmustuse condoms
 increasedriskof follicularcystsonthe ovaries
 may be slightlylesseffectivethancombinationoral contraceptives.
Possible side effects:
 amenorrhea(absence of amonthlyperiod)
 irregularbleeding
 tenderbreasts
 nausea
 headaches
Askyourself the followingquestionstodetermineif POPsare the rightchoice foryou:
 Are you the type of personwhocan remembertotake a pill atexactlythe same time everyday?
 Will irregularbleedingorspottingbotheryouorinterfere with intimacy?
 Are you breastfeeding,butfeel thatyouneedcontraception?
 If you are at riskfor sexuallytransmittedinfections,will youuse condomsforprotection?
 Do youneedto avoidtakingestrogen?
3. EmergencyContraceptive Pills(ECP).
ECPs are not intendedtobe usedregularlyasacontraceptive.Theyare designedtopreventpregnancy
afterunprotectedsex (whenstandardcontraceptivesfail ornomethodwasused).There are three FDA-

7. approvedemergencycontraceptionpillsinthe UnitedStates:PlanB One-StepandNextChoice,all of
whichcontainthe progestinlevonorgestrel,andulipristal acetate tablets,soldunderthe brandname
“ella.”
ellacan preventpregnancywhentakenorallywithinfivedays(120 hours) afterunprotectedsex.Itisa
progesterone agonist/antagonistwhose likelymaineffectistoinhibitordelayovulation.ellacutsthe
chancesof becomingpregnantbyabouttwo-thirdsforatleast120 hours afterunprotectedsex,studies
have shown.
PlanB One-Stepshouldbe takenwithin72hoursof unprotectedsex.Recentresearchshowsthatthe
levonorgestrel pillsmaybe effective upto120 hoursafter unprotectedsex butare more effective the
soonertheyare taken.NextChoice workssimilarlytoPlanBOne-Step,butconsistsof atwo-dose
regimen,withthe firstdose takenwithin72hours of unprotectedsex andthe second12 hours later.
Newerstudiesindicate thatbothpillsmaybe takentogetherassoonaspossible afterunprotectedsex.
You can buy the levonorgestrelemergencycontraceptivepillsoverthe counterwithoutaprescription.
You mustask for themat the pharmacy counter.ellaisavailableonlybyprescription,butwomencould
keepa supplyathome.
The website andhotlinesalsoprovide informationonwhichpharmaciessell emergencycontraceptives
because notall pharmaciescarry them.
In addition,certainregularoral contraceptive pillpackscanbe usedfor emergencycontraceptionif you
take several pillsatthe same time (the exactquantitydependsonthe brand),butmake sure youcheck
withyourhealthcare professional forproperdosage andtiming.
To learnmore about howECPs workand how to getthem, ask yourhealthcare professional or
pharmacist.Or visitthe Internetsite foremergencycontraceptionoperatedbythe Associationof
Reproductive HealthProfessionalsandthe Office of PopulationResearchatPrincetonUniversity
(ec.princeton.edu).
Advantages of ECP:
 reducesthe chance of unintendedpregnancy
 can be obtainedeasily—PlanBOne-Stepisavailableoverthe counter
 can be obtainedinadvance andkepthandyincase of an emergencysuchascondom breakage,
missedoral contraceptives,late contraceptive injectionsorforcedsex.
Disadvantages:
 timing,because youmusttake ellawithin120hours of havingunprotectedsex orPlanB One-
Stepor NextChoice within72hoursof havingunprotectedsex.The sooneryoutake emergency
contraceptionafterunprotectedintercourse,the more effective itis.That’swhyit’sagood idea
to have a supplyof emergencycontraceptive pillsavailable shouldthe needarise.

8. Possible side effects:
 nauseaand vomiting
 dizzinessandfatigue
 headache
 an earliernextperiod,or,inrare instances,alaternextperiod
 breasttenderness
 abdominal painduringmenstruation
Askyourself the followingquestionstodetermineif youshouldhave ECPsonhandor know where to
findthem:
 Have you evermade love unexpectedly,withoutprotection?
 Have you everbeenforcedtohave sex?
 Has a partnerhad a condombreak,slipor come off?
 Have you everforgottentotake several birthcontrol pills?
 Has a partnerevertoldyouit wasOK to have unprotectedsex becausehe wouldpulloutbefore
ejaculation?(Pregnancyisstillpossiblewithoutejaculation.)
 Has your diaphragmslipped?
 Have you beenlate foryour birthcontrol shot(Depo-Provera) andhadunprotectedsex?
Benefits
Birthcontrol pillsprovidecertainhealthbenefitsinadditiontopreventingpregnancy.Before youstart
takingoral contraceptives,discussthe healthbenefitsandriskswithahealthcare professional.Likeany
othermedication,birthcontrol pillscancause side effects;theymayinteractwithothermedications
youmay take;or theymay not be a good choice foryou because of yourpersonal healthhistory.Some
of the mainhealthbenefitsandrisksassociatedwithbirthcontrol pillsare listedbelow:
 Preventpregnancy.Firstandforemost,birthcontrol pillsare one of the mosteffectiveformsof
reversiblebirthcontrol.If usedcorrectly,the oddsare thatonlyone in1,000 womenislikelyto
getpregnantin the firstyearof use.However,the actual failure rate iseightin100 due primarily
to missedpillsorfailure toresume pillsafterthe seven-daypill-free period.
 Improve yourmenstrual cycle.Birthcontrol pillscanimprove yourmenstrualcycle inatleast
fourways,including:
 lessbleedingduringperiods;one productisdesignedtoeliminateyourperiodsentirely
 more regularand consistentmenstrualcycle patterns
 relief frompelvicpainduringmenstruation
 relief fromprimarilymood-relatedsymptomsof premenstrual dysphoricdisorder(PMDD),a
conditionthatcausesmanyof the same symptomsasPMS, but withmore intensity.Two
combinationoral contraceptives,calledYazandBeyaz,have beenapprovedbythe FDA for use
as oral contraceptivesandastreatmentsforthe emotional andphysical symptomsof PMDD.

9. Both containdrospirenone,aprogestinandethinyl estradiol,aformof estrogen,andBeyaz
containsan addeddailydose of folicacid
 Preventcancer.Birthcontrol pillshave beenshowntoprotectwomenfromovariananduterine
cancer, andpossiblyfromcolorectal cancer.
 Protectyoufrom ovariancysts.If youtake birthcontrol pills,youmayhave a lowerriskfor
developingovariancyststhanwomenusingnonhormonal methodsof contraception,suchas
diaphragmsor condoms.Womenusinglow-dose pills(20mcg of estrogen) ormultiphasicpills
may notget the same benefit.
 Improve acne.
Risks
 Heart attack and stroke.A June 2012 studypublishedinthe New EnglandJournal of Medicine
foundthe riskof sufferingaheartattack or stroke isverylow inwomenwhotake low-dose oral
contraceptives,butthatriskriseswithage andwithpillscontaininghigherestrogendoses.The
researchersinvolvedinthe studyalsostatedthatnew-generationlower-doseestrogenbirth
control pillsare far saferthanearlierversionsof the pill.However,the researcherssaidwomen
age 35 or olderwhohave riskfactorsfor heartattack andstroke,suchas obesityorhighblood
pressure,mightwanttoconsidera formof birthcontrol otherthan the pill.
 Migrainesandstroke.Womenwhotake oral contraceptivesandhave a historyof migraineshave
an increasedriskof stroke comparedtononuserswithahistoryof migraine.Yourriskisgreatest
if you have migraineswith“aura”—neurologicsymptomsrelatedtovision,suchasblurred
vision,temporarylossof visionorseeingflashinglightsorzigzaglines.Asaresult,the World
HealthOrganization(WHO) hasconcludedthatwomenwithmigraines withaurashouldnottake
birthcontrol pills.Forwomenoverage 35 whoget migraineswithoutaura,the risksof oral
contraceptive use usuallyoutweighthe benefits.Forwomenunder35, the AmericanCongress
of ObstetriciansandGynecologistsandthe WorldHealthOrganizationstate thatcombinedbirth
control pillsmaybe consideredforwomenwithmigrainesonlyif theydonotexperience aura,
do notsmoke and are otherwise healthy.
 Venousthromboembolism(VTE).Thisrare conditioncausesclotstoforminyour bloodvessels
and can cause symptomsincludingpain,swellingandvaricose veins,andmayblockthe flowof
blood.The riskmay varywiththe type of progestinusedinthe pill.Smokingandobesitymay
alsoincrease thisrisk.
 Worsensevere diabetes.The estrogeninbirthcontrol pillsmayincrease glucose levelsand
decrease the body’sinsulinresponse,while the progestininthe pillsmayencourage
overproductionof insulin.Use of birthcontrol pillsbydiabeticwomenshouldbe limitedto
those whodo notsmoke,are youngerthan35 andare otherwise healthywithnoevidence of
persistenthighbloodpressure,kidneydisease,visionproblemsorothervasculardisease.
 Possible accelerationof gallbladderdisease.Estrogenmaycause bile tobecome oversaturated
withcholesterol,whichcanleadtogallstones.
 No decreasedriskof sexuallytransmitteddiseases.Birthcontrol pillsdonotprotectagainst
sexuallytransmitteddiseases(STDs).Butwomenwhouse birthcontrol pillsare lesslikelyto

10. develop symptomaticpelvicinflammatorydisease (PID),whichisaninfectionof the uterus,
fallopiantubesorotherreproductiveorgans.PIDisa complicationof STDs,especiallychlamydia
or gonorrhea,andmay make youinfertile orcause chronicpain.If youare at riskfor contracting
an STD, youshouldalsouse condoms.
Possible druginteractions
Some drugscan reduce the effectivenessof oral contraceptives.Likewise,oral contraceptivescan
interfere withthe effectsof some drugs.
These include:
Seizure medications:phenytoin,carbamazepine,primidone,phenobarbital,topiramate,oxcarbazepine,
barbiturates
 Tuberculosismedicationrifampin
 Antifungal druggriseofulvin
 Bronchodilatorssuchastheophylline
 St. John’swort
If you take any medicationeitheronashort- or long-termbasis,be sure toaskyourhealthcare
professionalorpharmacistaboutpossible interactionswithbirthcontrol pillsandhow youshouldavoid
or manage them.
For example,youmayneedtouse anadditional contraceptive (suchascondoms) asa backup
contraceptive methodortake a higherorlower-dose pill formulation.
Facts to Know
1. Birthcontrol pillsare extremelyeffective atpreventingpregnancyif usedcorrectlyand
consistently.Forexample,onlyone in1,000 womenwho use the pill asprescribedislikelytoget
pregnantinthe firstyear of use.
2. The pill worksmainlybypreventingovulationorbythickeningthe mucussurroundingthe
cervix,whichhelpsblockspermandthinsthe liningof the uterussoif an eggis fertilized,it
wouldhave trouble implanting.
3. The pill isone of the mostcommonforms of birthcontrol.AmongU.S. coupleswhouse birth
control,more than 27 percentcurrentlyuse birthcontrol pills.
4. The most seriousside effectof the pill continuestobe anincreasedriskof cardiovascular
disease.Thisriskisparticularlyhighincertaingroups,likewomenwhosmokeandare over35.
5. You may notknowit,but the pill can helpyourhealth.Forexample,birthcontrol pillscan
improve menstrual problemslike heavybleeding,pelviccrampsandpain,premenstrual
syndrome andirregularcycles.Theycanpreventlossof bone densityandreduce the riskof
ovariancysts.Pill use can alsoprotectyoufrom uterine andovariancancer.
6. Newerlow-estrogenbirthcontrol pillsdonotcarry the risk of increasedbreastcancerthat
higher-doseestrogenpillsdid.AnAugust2014 studypublishedinCancerResearchthatlookedat

11. breastcancer riskand birthcontrol pill use inwomenages20 to 49 foundbreastcancerrisk was
higherinwomenwhohadpreviouslytakenhigh-dose estrogenbirthcontrol pills,butnotin
womenwhohadtakenlow-dose estrogenpills.
Key Q&A
1. I’dlike touse the pill forcontraception,butI’mworried.Are theysafe?Birthcontrol pillscanbe
usedsafelybymostwomenandcan evenprovide healthbenefitsotherthanpregnancy
prevention.The mostseriousside effectof the pill continuestobe an increasedriskof
cardiovasculardisease incertaingroups,suchaswomenover35 who smoke.
2. I’ve heardthat birthcontrol pills“trick”the bodyintothinkingitispregnant.Whatdoesthat
mean?The mostwidelyusedbirthcontrol pill iscomposedof estrogenandprogestin,the two
keyhormonesof pregnancy.A pregnantwoman’splacentaproduceshighamountsof both
these chemical messengers,sendingthe bodyasignal tostopovulating.Afterall,if the woman
isalreadypregnant,whyisthere a needforanotheregg?Thissame signal issentwhena
womantakesbirthcontrol pillsbecause the levelsof estrogenandprogestinare constant—
remember,itisthe peakinestrogenthatcausesovulation.Whenawomanisthroughwithher
three weeksof active pills,the hormonesdropastheywouldnaturallyandshe beginsher
period.
3. My healthcare professional gave me the mini-pill asIwasleavingthe hospital withmynewborn
and saidto start rightaway.I thoughtI had to waitsix weeksaftergivingbirth?Confusionover
thisisunderstandable,because healthcare professionalsdon’tall agree aboutwhen
breastfeedingwomen shouldstarttakingprogestin-onlypills(POP),orthe “mini-pill.”According
to the AmericanCongressof ObstetriciansandGynecologists(ACOG),youcanstart using
progestin-onlybirthcontrol pillsimmediatelyafterchildbirth.If youchoose abirthcontrol pill
that containsestrogen,youshouldwaituntil you’ve establishedbreastfeedingforat leastone
month.Keepinminda lactatingwomanwhose baby’ssole nutritionisfrombreastmilkwon’t
ovulate inthose firstsix weeks.Manywomendiscontinue full breastfeedingwithinthe firstsix
weeks,whichmeanstheycanovulate before six weekspostpartum.Because manywomen
don’treturnto theirhealthcare professional atthistime,theywouldn’tbe able togeta
prescriptionforbirthcontrol whenthey needit.
4. I’ve beenusingbirthcontrol pillsforseveral years.DoIneedto stopfor a while andgive my
bodya break?Because the hormonesinpillsdon’tbuildupinthe body,there’snoneedtotake a
breakfrom usingthem.There are alsosome healthbenefitsthatwouldendif youdiscontinue
takingthe pills.
5. Whendo missedpillsmatterthe most?The pillsyouhave toworrymost aboutmissingare the
onesrightbefore andrightafterthose sevenplacebopillsinyourpack.Knownas the pill-free
interval, the placebosare designedtobe takenthe weekyouhave yourperiodtohelpyoustay
inthe rhythmof takinga pill everyday.If youstarta new packlate or take longerthanseven
days“pill free,”youmightovulate andcouldbecome pregnant.Readthe package insertthat
came withyourpills;itwill explainwhattodo aboutmissedpills,orcall yourhealthcare
professional.Inthe meantime,use backupcontraceptionjusttobe safe.Ingeneral,if youmissa

12. pill,take itas soonas yourememberandthencontinue takingone pill eachdayasprescribed
(dependingonwhenyoumissedyourpill,youmaytake twopillsonthe same day).If you miss
twoor more pillsinthe firstweekof yourpill cycle andyouhave unprotectedintercourse during
thisweek,considerusingemergencycontraception.
6. How doemergencycontraceptivepillswork?Dotheycause an abortion?Scientistshave
identifiedseveralwaysthatemergencycontraceptivepillslikelypreventpregnancy.How they
workin yourcase will dependonwhere youare inyour monthlycycle andthe emergency
contraceptive youchoose.Theymaypreventordelayovulationjustasregularbirthcontrol pills
wouldif theyare takenearlyina woman’scycle.If ovulationhasalreadyoccurred,theymay
interfere with fertilizationof anegg or the implantationof afertilizedegginthe uterus.ECPs
won’tworkif implantationhasalreadytakenplace,whichiswhyit’simportanttotake them
within72 hoursof unprotectedsex,if possible.Thatisalsothe reasonECPsare not considered
an abortion;theyhave noeffectona pregnancyalreadyestablished.
7. I’m48 andgettingclose tomenopause.CanIstill use the pill?Unlessyousmoke orhave risk
factors forheart disease,suchasobesityorhighbloodpressure,yes.If youdon’thave anyof
these riskfactors,low-dose birthcontrol pills(those with20mcg of estrogen) are agood option
for the yearsjustprior to menopause-calledthe menopause transitionor“perimenopause.
Irregularor heavyperiodscanbe commonduringperimenopause,andpillscanhelpregulate
them.Low-dose birthcontrol pillsalsomaypreventbone loss,potentiallyprovidingprotection
frombone disease.
8. Are chronic headachesareasonNOT to take birthcontrol pills?Notnecessarily.Migraine
headachesare the type of headachesthatcause healthcare professionalsthe mostconcern
whenitcomesto usingbirthcontrol pills,andeventhenonlyif the patienthasmigraine with
“aura”-a type of migraine thatcausesvisual disturbances.Somewomenfindtheirmigraines
improve once theystarton birthcontrol pills,especiallyif those migrainesprecedetheir
menses.Butkeepinmindthatpillsuserswithahistoryof migraine headache have anincreased
riskof stroke comparedtononuserswitha historyof migraine.Yourriskisgreatestif youhave
migraineswith“aura”-neurologicsymptomsrelatedtovision,suchasblurredvision,temporary
lossof visionorseeingflashinglightsorzigzaglines.Asaresult,the WorldHealthOrganization
(WHO) has concludedthatwomenwithmigraineswithaurashouldnottake birthcontrol pills.
For womenoverage 35 whoget migraineswithoutaura,the risksof oral contraceptive use
usuallyoutweighthe benefits.Forwomenunder35,the AmericanCongressof Obstetricians and
Gynecologistsandthe WorldHealthOrganizationstate thatcombinedbirthcontrol pillsmaybe
consideredforwomenwithmigrainesonlyif theydonotexperience aura,donotsmoke andare
otherwise healthy.
9. A friendof mine gotpregnantwhile usingthe pill,andshe saiditwasbecause she wastaking
antibiotics.What’sthe deal?Often,the blame forcontraceptive failure isplacedonashortstint
of antibioticuse.Anecdotal reportsaboundregardingthe reductioninpill effectivenesscaused
by antibioticssuchasampicillinandtetracycline,andsome studiesfindlowerlevelsof estradiol
(a formof estrogen) inthe bloodof womentakingtheseantibiotics,butnostudieshave been
able to prove these claims.Studiesare clear,however,regardingdrug interactionsbetween
birthcontrol pillsandsome othermedications,suchasanti-seizuremedicationsanddrugsused

13. to treat tuberculosis.Askyourhealthcare professional orpharmacistaboutpossible drug
interactionsthatmayalterthe effectivenessof eitheryourbirthcontrol pillsoranother
medicationyouare takingor are prescribed.
10. I’ve heardthat it’spossible toskipthe placebopillsandstarta new pill packrightaway.Is that
true?
Yes,there are several reasonstoconsiderskippingthe pill-free interval.Youcouldactuallyskipthe
placebosandtake onlythe hormone pillsforthese reasons:
 unacceptablyheavyorpainful periods
 severe premenstrual sideeffectsincludingdepression
 endometriosis
 convenience(forexample,if youwanttoavoidhavinga periodduringvacation)
For more informationvisitusourwebsite:http://www.healthinfi.com