Birth Control Pill

Are Birth Control Pills Right for Me?

All of us who need birth control want to find the method that is best for us. And every woman has different needs when choosing a method. Whether you’re thinking about starting the birth control pill, you’re on the pill, you’re a concerned partner, or you’re someone who’s just curious about it, you may have many questions. Here are some of the most common questions we hear women ask about the pill. We hope the answers help you decide if it is right for you.

What Are Birth Control Pills?

Birth control pills are a kind of medication that women can take daily to prevent pregnancy. They are also sometimes called “the pill” or oral contraception.

How Do Birth Control Pills Work?

It's pretty common for people to be confused about how birth control pills work. Here’s what it boils down to: birth control pills are made of hormones. Hormones are chemicals made in our bodies. They control how different parts of our bodies work.

Some birth control pills contain two hormones — estrogen and progestin. These are called combination pills. Some are progestin-only pills.  Most women on the pill take combination pills.

The hormones in the pill work by keeping a woman’s ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. The hormones in the pill also prevent pregnancy by thickening a woman’s cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

Some people say that the pill works by keeping a fertilized egg from attaching to the lining of the uterus. But there is no proof that this actually happens.

How Effective Are Birth Control Pills?

Effectiveness is an important and common concern when choosing a birth control method. Birth control pills are very effective. Combination pills work best when taken every day. Progestin-only pills must be taken at the same time every day. That keeps the correct level of hormone in a woman’s body.

• Less than 1 out of 100 women will get pregnant each year if they always take the pill each day as directed.
• About 8 out of 100 women will get pregnant each year if they don’t always take the pill each day as directed.

The pill may be slightly less effective for women who are very overweight. Talk with your health care provider if you are concerned about how well the pill may work for you. 

Certain medicines and supplements may make the pill less effective. These include

• the antibiotic rifampin — other antibiotics do not make the pill less effective
• certain medicines that are taken by mouth for yeast infections
• certain HIV medicines
• certain anti-seizure medicines
• St. John's wort

Vomiting and diarrhea may also keep the pill from working. Ask your health care provider for advice. Use a backup method of birth control — like a condom, female condom, diaphragm, sponge, or emergency contraception (morning after pill) — until you find out you don’t need to.

Keep in mind the pill doesn’t protect against sexually transmitted infections. Use a latex or female condom to reduce the risk of infection.

How Safe Are Birth Control Pills?

Most women can use birth control pills safely. That’s one of the things that make it the most popular method of reversible birth control in the U.S. It is a lot safer than childbirth, for example.

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. Talk with your health care provider about your health and whether the pill is likely to be safe for you.

There are many other methods of birth control that may be safe for you if you cannot take the pill. Read about other methods to find one that may be right for you.

What Are the Benefits of Birth Control Pills?

Taking the pill is simple, safe, and convenient. It does not interfere with having sex. Many women say it improves their sex lives because it helps them feel more spontaneous.

Women who do not need birth control often choose to take the pill for the other benefits it offers. Combination and progestin-only pills

• reduce menstrual cramps
• make periods lighter 
• offer some protection against pelvic inflammatory disease, which often leads to infertility when left untreated

The combination pill offers many other benefits, including some protection against

• acne
• breast growths that are not cancer
• ectopic pregnancy
• endometrial and ovarian cancers. Protection increases with each year of use.
• iron deficiency anemia
• ovarian cysts
• premenstrual symptoms, including headaches and depression
• vaginal dryness and painful intercourse related to menopause

Combination pills can be used to control when and how often you have your period. Some pills are specially packaged for women to have only a few periods a year. Other pills can also be used continuously to prevent having periods.

What Are the Disadvantages of Birth Control Pills?

Many of us like to weigh the benefits against the risks of taking a medicine. Now that you’re familiar with the benefits, let’s look at the possible disadvantages.

Possible Side Effects of the Pill

Some women may have undesirable side effects while taking birth control pills. But many women adjust to the pill with few or no problems. 

Some of the most common side effects usually clear up after two or three months. They include

• bleeding between periods (most often with progestin-only pills)
• breast tenderness
• nausea and vomiting

Nausea and vomiting may be helped by taking the pill in the evening or at bedtime. But do not stop taking the pill because you feel sick to your stomach — you will be at risk of pregnancy if you do.

The hormones in the pill may change a woman’s sexual desire.

It’s important that you find a method that won’t make you feel sick or uncomfortable. If you continue to experience side effects after taking the pill for three months, talk with your health care provider about changing your prescription.

After stopping the pill, it usually takes one or two months for a woman’s periods to return to the cycle she had before taking the pill. Once in a while, a woman may have irregular periods or no periods at all. This may go on for as long as six months after stopping. This is more likely if her periods were irregular before starting the pill.

Serious Side Effects of the Pill

Many women have concerns about the possible risks of taking birth control pills.  Serious problems do not occur often. And progestin-only pills have a lower risk of serious side effects than combination pills. 

Combination pill users have a slightly greater chance of certain rare, but serious, problems than nonusers. These problems, that may be fatal in very rare cases, include heart attack, stroke, having a blood clot in the legs, lungs, heart, or brain, or developing high blood pressure, liver tumors, gallstones, or yellowing of the skin or eyes (jaundice). 

The risk for these problems increases if you

• are age 35 or older
• are very overweight
• have certain inherited blood-clotting disorders
• have diabetes
• have high blood pressure
• have high cholesterol
• need prolonged bed rest
• smoke

Serious problems usually have warning signs. Report any of these signs to your health care provider as soon as possible:

• a new lump in your breast
• aura — seeing arching, bright, flashing zigzag lines that develop slowly and don't last long
• headaches that are different, worse, or happen more often than usual
• no period after having a period every month
• pain in your abdomen or chest
• severe depression
• severe headaches
• shortness of breath or coughing up blood
• unusual swelling or pain in your leg or arm
• unusually heavy bleeding from your vagina
• yellowing of the skin or eyes
  

How Do I Get Birth Control Pills? How Much Do Birth Control Pills Cost?

First, you’ll need to get a prescription. Your health care provider will discuss your medical history with you, check your blood pressure, and give you any other medical exam that you may need. If you need an exam, it may cost about $35–$250.

Birth control pills may be purchased with a prescription at a drugstore or clinic. They cost about $15–$50 a month.
Medicaid and private health insurance may cover the pill. Family planning clinics usually charge less than private health care providers.

How Do I Take Birth Control Pills?

It depends on what kind of pill you are taking. Most combination pills come in 28-day or 21-day packs. Both types have 21 "active" pills that contain hormones. The last seven pills in 28-day packs of combination pills are called "reminder" pills. They do not contain hormones.

In 21-day packs, one pill is taken every day for three weeks in a row. No pills are taken for the next week, and then a new pack of pills is started.

Talk with your health care provider about what day is best for you to start using the pill.

Some combination pills contain a few months’ worth of active pills. They are specially packaged to reduce the number of periods a woman has each year. Women can also take the active pills in 21-day or 28-day packs continuously to reduce how often they have periods. 

Progestin-only pills come only in 28-day packs. All progestin-only pills are active.

With combination pills, you’ll get your period during the fourth week — unless you choose to avoid menstruation by using active combination pills during the fourth week, as well.

With progestin-only pills, you may

• get your period the fourth week
• get no periods
• have bleeding on and off throughout the month

The hormones in birth control pills prevent pregnancy throughout the entire month — even during the fourth week.