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All About the Pill

"The pill” refers to one of the various forms of birth control that is taken orally (by mouth). Combined oral contraceptives have been on the market for more than 35 years and are the most popular form of reversible birth control in the United States. This form of birth control is called reversible because it suppresses ovulation (the monthly release of an egg from the ovaries) by the combined actions of the hormones, estrogen and progestin.

  • Effectiveness of the birth control pill

    If you remember to take the pill every day as directed, you have an extremely low chance of becoming pregnant – in fact, the overall failure rate of the combined pill is 0.1%. The pill's effectiveness may be reduced if you are taking other medications, such as certain antibiotics. Be sure to discuss this with your physician. Besides preventing pregnancy, the pill offers additional benefits. As stated in the labeling, the pill can make periods more regular. It also has a protective effect against ovarian and endometrial cancers, and against pelvic inflammatory disease, an infection of the fallopian tubes or uterus that is a major cause of infertility in women.

    The decision whether to take the pill should be made in consultation with your health professional as theydo carry some risks.

  • If you miss a pill

    Anytime you miss a dose (or doses) of your oral contraceptive medication, you may experience abnormal bleeding during that menstrual cycle. If you are on a 28 -day prescription and missed a dose in the 21 – 28 day range, you are fine.

    These tablets are actually “inert” – they don’t contain any active ingredient. The only reason to be concerned if you missed on these days, is that you may have a pattern of not remembering, could it be that there were other missed days? Make sure you double-check.

    The following chart is a guide for other missed dose scenarios. Your health care provider is the best source of guidance on prescribed medication, and this is by no means a substitute for their expert advice.

  • Emergency Contraception

    Emergency contraception is birth control that prevents pregnancy after sex.  It is sometimes called the morning after pill.  If you think your birth control failed, you didn’t use contraception or you were forced to have sex, you can use emergency contraception right away or up to five days after sex.

    The effectiveness rate for Emergency Contraception is 75% when used within 72 hours after having unprotected sex.

    Emergency contraception is not as effective as birth control used before or during sex. This form of contraception should not be used as your only protection against pregnancy. 

    In the United States, emergency contraception pills are available without prescription for women and men 17 years of age and older.  You may call your provider for advice and or a prescription that is specific for you.  If you are unable to see your provider, you may visit a pharmacy and ask for “Plan B-one Step” or “Next Choice.”

    As with any oral contraceptive, certain medications may reduce the overall effectiveness of this birth control method.  Be sure to speak to your health care provider or pharmacist about your medications.

    Never use this method of preventing unplanned pregnancy unless a urine pregnancy test has confirmed that you are not pregnant. If you know you are pregnant, do not use emergency contraception. Discuss your concerns with your health care provider immediately.

    In addition to pregnant women, those with a medical history of high blood pressure, blood clots, or breast cancer should not use this method to prevent unplanned pregnancy.

    Side effects to taking these extra high doses of hormones. These include cramping, nausea, and vomiting.

  • The Minipill

    In addition to the combined pill (estrogen and progestin combined), there is another type of oral contraceptive called the "minipill." Although taken daily like combined oral contraceptives, minipills contain only the hormone progestin and no estrogen. They work by thickening cervical mucus to prevent sperm from reaching the egg. They also keep the uterine lining from thickening, which prevents a fertilized egg from implanting in the uterus.

    These pills are slightly less effective than combined oral contraceptives – the overall failure rate is 0.5% when used according to manufacturer directions. Minipills can decrease menstrual bleeding and cramps, as well as the risk of endometrial and ovarian cancer and pelvic inflammatory disease.

    Because they contain no estrogen, minipills don't present the risk of blood clots associated with estrogen in combined pills. They are a good option for women who can't take estrogen because they are breast-feeding or because estrogen-containing products cause them to have severe headaches or high blood pressure.

    Side effects of minipills include menstrual cycle changes, weight gain, and breast tenderness.

  • Risks and side effects of the birth control pill

    Current oral contraceptive have fewer risks associated with them than earlier versions. Most oral contraceptives pills contain estrogen and progesterone.

    You should not use use a combined contraceptive if you have any of the following medical problems:

    • Deep venous thrombosis (blood clots in veins)
    • Embolism (clots in lung, eye, or brain)
    • Cardiovascular disease (heart disease, high blood pressure, or stroke)
    • Breast cancer
    • Severe active liver disease or liver tumors
    • Blood clotting disorder
    • Certain types of severe headaches
    • Diabetes with complications

    The Pill may not work as well for women taking certain drugs to control epilepsy or if you are on antibiotics.  Call  your provider’s office if you are placed one these medications to be sure that you do not need back up contraception.

    Women who smoke, especially those over 35 will need close evaluation and monitoring while they are on the pill ,.

    Side effects of the pill, which often subside after a few months' use, include nausea, headache, breast tenderness, weight gain, irregular bleeding, and depression.

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