Combination Birth Control Pills for Teens: Care Instructions

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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 care for yourself at home?

How do you take the pill?

  • Follow your doctor's instructions about when to start taking your pills. Use backup birth control, such as a condom, or don't have intercourse for 7 days after you start your pills.
  • 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.
  • Use a condom every time you have sex. Use them from the beginning to the end of sexual contact.

What 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 intercourse. It's best to always use a condom when you have 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 intercourse for 7 days. Pregnancy is more likely if you miss more than 1 pill.
  • If you had intercourse, you can use emergency contraception as a way to prevent pregnancy. The most effective emergency contraception is an IUD (inserted by a doctor). You can also get emergency contraceptive pills. You can get them with a prescription from your doctor or without a prescription at most drugstores.

What else do you need to know?

  • The pill can have side effects.
    • You may have very light or skipped periods.
    • You may have bleeding between periods (spotting). This usually decreases after 3 to 4 months. If you're using the pill continuously, you won't have periods. But you may still have breakthrough bleeding. Talk to your doctor if you have problems with breakthrough bleeding. Even if you have this bleeding, the pill should still work well.
    • You may have mood changes, less interest in sex, or weight gain.
  • The pill may reduce acne, heavy bleeding and cramping, and symptoms of premenstrual syndrome.
  • Check with your doctor before you use any other medicines, including over-the-counter medicines. Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take. Birth control hormones may not work as well to prevent pregnancy when combined with other medicines.
  • The pill doesn't protect against sexually transmitted infections (STIs), such as herpes or HIV/AIDS. Use a condom every time you have sex. Use them from the beginning to the end of sexual contact.
  • You should never feel pressured to have sex. It's okay to say "no" anytime you want to stop.
  • It's important to feel safe with your sex partner(s) and with the activities you are doing together. If you don't feel safe, talk with an adult you trust.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have severe belly pain.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have blurred vision or other problems seeing.
  • You have a severe headache.
  • You have severe trouble breathing.

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.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.