Combination Birth Control Pills: Care Instructions

Overview

Combination birth control pills are used to prevent pregnancy. They give you a regular dose of the hormones estrogen and progestin.

You take a pill every day to prevent pregnancy.

Birth control pills come in packs. The most common type has 3 weeks of hormone pills. Some packs have sugar pills (they do not contain any hormones) for the fourth week. During that fourth no-hormone week, you have your period. After the fourth week (28 days), you start a new pack.

Some birth control pills are packaged in different ways. For example, some have hormone pills for the fourth week instead of sugar pills. This is called continuous use. Taking hormones for the entire month causes you to not have periods or to have fewer periods. Others are packaged so that you have a period every 3 months. Your doctor will tell you what type of pills you have.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you use it safely?

How to take the pill

• Follow your doctor's instructions about when to start taking your pills. If you start your pills within 5 days of starting your period, you don't need to use a backup method of birth control. If you start your pills any other time, use backup birth control, such as a condom, or don't have vaginal sex for 7 days.
• Take your pills every day, at about the same time of day. To help yourself do this, try to take them when you do something else every day, such as brushing your teeth.
• You can use the pill continuously and skip your period. When you get to the week that you take hormone-free pills, skip those pills and instead start right away on your next pill pack. Continue to take your pill every day. Talk to your doctor if you have any questions.
• Check with your doctor before you use any other medicines. This includes over-the-counter medicines, vitamins, herbal products, and supplements. Birth control hormones may not work as well to prevent pregnancy when combined with other medicines.

If you forget to take a pill

Always read the label for specific instructions, or call your doctor. Here are some basic guidelines:

• If you miss 1 hormone pill, take it as soon as you remember. Ask your doctor if you may need to use a backup birth control method, such as a condom, or not have vaginal sex.
• If you miss 2 or more hormone pills, take one as soon as you remember you forgot them. Then read the pill label or call your doctor about instructions on how to take your missed pills. Use a backup method of birth control or don't have vaginal sex for 7 days. Pregnancy is more likely if you miss more than 1 pill.
• If you had vaginal sex, you can use emergency contraception to help prevent pregnancy. The most effective emergency contraception is an intrauterine device, or IUD (inserted by a doctor). You can also get emergency contraceptive pills. You can get them with a prescription from your doctor. Or you can get them without a prescription at most drugstores.

What should you think about when using combination pills?

Some pros of using the pill

• These pills work better than barrier methods, such as condoms and diaphragms.
• They may reduce acne and heavy bleeding. They may also reduce cramping and other symptoms of PMS (premenstrual syndrome).
• The pills let you control your periods. You can schedule your periods to be every month or every few months. Or you can choose not to have them at all. You may take pills that continue to give you hormones during the whole month (continuous use). This protects against pregnancy and is also a safe way to avoid having your period. This may help if you have painful periods.
• You don't have to interrupt sex to use the pills.

Some cons of using the pill

• You have to take a pill at the same time every day to prevent pregnancy.
• Combination pills don't protect against sexually transmitted infections (STIs), such as herpes or HIV/AIDS. You can use a condom to reduce your risk of getting an STI.
• They may cause changes in your period. You may have little bleeding, skipped periods, or spotting. If you're using pills that give you hormones for the whole month, your periods will stop. But you may still have breakthrough bleeding. This usually isn't harmful and may decrease over time.
• They may cause mood changes or less interest in sex.
• Combination pills contain estrogen. They may not be right for you if you have certain health problems.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if you have:

• Sudden, severe chest pain.
• Difficulty breathing.
• Sudden, severe headache.

Call your doctor now or seek immediate medical care if you have:

• Severe pain in your belly.
• Headaches that:
  • Happen more often.
  • Are getting worse.
  • Start with auras, such as seeing spots, wavy lines, or flashing lights.
• Signs of a blood clot, such as:
  • Pain in the calf, back of the knee, thigh, or groin.
  • Swelling in the leg or groin.
  • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You think you might be pregnant.
• You think you may be depressed.
• You think you may have been exposed to or have a sexually transmitted infection.