The ovaries produce two hormones that affect a woman's menstrual cycle: estrogen and progesterone. Most birth control pills, commonly referred to as oral contraceptive pills or OCPs, contain both of these hormones. They work primarily by stopping the process of ovulation (preventing the release of an egg). OCPs are 99% effective when used correctly. Most failures occur when a pill is missed or not absorbed. For patients who follow these directions carefully, the pill is one of the most effective reversible contraceptives currently available. Progesterone-only pills ("the minipill") are also available. These pills are frequently recommended if you are breast-feeding or are extremely sensitive to estrogen. The minipill is not as effective as the regular OCP in preventing pregnancy.

Benefits of the pill include, easy to use, convenience, reversible and it's non-contraceptive benefits. These include decreased menstrual flow and cramps, reduction in the risk of uterine and ovarian cancer, decreased acne, decreased incidence of fibrocystic breast lumps, decreased pelvic inflammatory disease and tubal infections, decreased anemia and fewer ovarian cysts.

1. Choose a backup method of birth control (such as condoms, diaphragm, or foam) to use with your first pack of pills because the pill may not fully protect you from pregnancy during the first month. Keep this backup method handy and use it in case you:
   1. Run out of pills
   2. Forget to take your pills
   3. Discontinue pill use
   4. Need protection from transmission of sexually transmitted diseases, particularly the virus that causes AIDS (the condom is recommended).
   5. Start your pills late
   6. Take antibiotics

    

2. There are several ways to start taking your pills. Use one of the following approaches:
   1. Start the first pill on the first Sunday after your period begins. (best method)
   2. Start your pill on the day your period begins.
   3. Start your pill on the fifth day after your period begins.
   4. Start your pill today if there is absolutely no chance that you could be pregnant.

    

3. Take one pill a day until you finish the pack then:
   1. If you are using a 28-day pack begin a new pack immediately. Skip no days between packages.
   2. If you are using a 21-day pack, stop taking pills for 1 week and then start your new pack.

    

4. Try to associate taking your pill with something you do at about the same time every day, like brushing your teeth in the morning, eating a meal, or going to bed. Keep the pill near the place where you engage in the selected activity. Establishing a routine will make it easier for you to remember. The pills work best if you take one at the same time every day. Check your pack of pills each morning to make sure you took your pill the day before. If you have bleeding between periods, try to take your pills at the same time every day. If you have light bleeding between periods for several cycles (after the first three months), call the doctor's office for advice. If you forget your pills for a day or two, follow the instructions below:
   1. If you miss one pill, take the forgotten one (yesterday's pill) as soon as you remember it, and take today's pill at the regular time. Although you probably won't get pregnant, use your backup method until your next period to be safe.
   2. If you miss two pills in a row, take two pills as soon as you remember and two pills the next day. You may have some spotting. Use your backup method of birth control until your next period.
   3. If you miss three or more pills in a row, start your backup method of birth control immediately. Your ovaries probably will produce an egg (ovulation), and without a backup contraceptive you could become pregnant. Ask yourself, "Am I good pill user?" A method of contraception other than birth control pills may be better for you. To continue your pills: Take two pills for 3 days and use your backup method of birth control until you have your next period. OR Stop taking pills from your old pack of pills. Start a new pack of pills the Sunday after you missed three or more pills, even if you are bleeding. Use your backup method of contraception for the first 2 weeks that you are on your new pack of pills.

    

5. If you have severe diarrhea or vomiting lasting several days, begin using your backup method of birth control on your first day of diarrhea or vomiting and continue using it until your next period. Periods tend to be short and scanty on pills, and you may see not fresh blood at all. A drop of blood or a brown smudge on your tampon or underwear is considered a period.
   1. If you have not missed any pills and you miss your period without any signs of pregnancy, pregnancy is unlikely. Consider doing a home pregnancy test for reassurance.
   2. If you forgot one or more pills and miss a period, do a home pregnancy test.

    

6. If you see a physician or any health-care provider for any reason, be sure to mention that you are taking birth control pills.

    

7. Learn the pill danger signs. If you smoke cigarettes, you should be especially careful. You should STOP SMOKING. Contact the doctor immediately if any one of these danger signs (or "aches") appears:
   1. Abdominal pain (severe)
   2. Chest pain (severe)
   3. Headache (severe)
   4. Eye problems - blurred vision or vision loss
   5. Severe leg pain - calf or thigh

    

8. You should not take birth control pills if you have any of the following conditions
   1. heart attack or stroke
   2. blood clots in the legs, lungs or eyes
   3. known or suspected cancer of the breast or sex organs (uterine lining, cervix or vagina)
   4. liver tumors
   5. chest pain (angina)
   6. unexplained vaginal bleeding
   7. yellowing (jaundice) of the whites of your eyes or of your skin while on the pill
   8. if you are pregnant

   

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