Health Topics
Oral Contraceptives (the pill)
Online Birth Control Education
Oral contraceptives contain synthetic hormones and there are two types, combination pills and progestin-only pills. Combination pills contain both estrogen and progestin and mainly work by preventing the ovaries from releasing eggs (ovulation) and by making the lining of the uterus thinner. They also thicken the cervical mucus, which helps to prevent the entry of sperm into the uterus. Progestin-only pills primarily work by thickening the cervical mucus and less often they prevent ovulation. Taking birth control pills daily maintains the level of hormones that is needed to prevent pregnancy and the contraceptive effect begins after 7 days of starting the pill.
Advantages
- Highly effective
- Does not interfere with sex
- Predictable regular menstrual cycles
- Usually lighter menstrual bleeding and less cramping
- May decrease PMS symptoms
- Lowers the risk of uterine and ovarian cancer
- May improve acne
Disadvantages
- Need to remember to take pill daily
- Some women experience irregular bleeding (usually resolves in 2-3 cycles)
- Significant higher risk for medical complications in smokers
- Offers no protection against sexually transmitted infections
Minor Side Effects
- Breast tenderness
- Nausea
- Mood changes
- Breakthrough spotting or bleeding
- Rarely, pigmentation of facial skin
More serious side effects (rare)
- Blood clots in the legs, lungs, heart or brain
- Benign liver tumors
- Heart attack and stroke
Starting the Pill
A health care provider will suggest how to start the pill. If the pill is started on the first day of the menstrual cycle, a woman is protected right away. If the pill is started on another day of the cycle, using a back-up contraceptive method for 1 week is recommended.
The Pill and Medications
The antibiotic rifampin may make the pill less effective but other antibiotics do not change the effectiveness of the pill. Certain anti-seizure medications and Griseofulvin taken for fungal infections may interact with the pill.
Cigarette Smoking and the Pill
Cigarette smoking incresases the risk of serious cardiovascular side effects from the use of combination birth control pills. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in smokers over 35 years of age.
Return of Fertility
After stopping the oral contraceptive pill, it may take 3-6 months to return to regular ovulation and menstrual cycling. The pill is a reversible birth control method and does not cause infertility. Pregnancy can occur anythime pill taking is discontinued.
Warning Signs of Birth Control Pills
Pills have been studied extensively and they are very safe. However, very rarely birth control pills lead to serious problems. The following are the warning signals to watch out for while using the pill.
- Abdominal Pain (severe)
- Chest Pain (severe), cough, shortness of breath
- Headache (severe) with blurred vision, weakness, difficulty speaking
- Eye problems-vision loss or blurring
- Leg Pain (severe)
If you have one of these symptoms, it may or may not be related to the pill. It is important to check with your health care provider as soon as possible.
Availability & Efficacy
- Available at Student Health Services by prescription
- Failure rate: Typical use: 8%; Perfect use: 3%
Recommended Resources
- The Pill (Planned Parenthood)
- Progestin Only Pill (Feminist Women's Health Center)
- Missed Birth Control Pill Guidelines (UC Davis Student Health Services)
Online Birth Control Education |
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last reviewed: Spring 2005

