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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.

Advantages

  • Predictable regular menstrual cycles
  • Highly effective
  • Does not interfere with sex
  • Usually lighter menstrual bleeding and less cramping
  • May decrease PMS symptoms
  • Protection from ovarian cysts, ovarian cancer and uterine cancer
  • May improve acne
  • Can be taken continuously to decrease the number of periods

Disadvantages

  • Need to remember to take pill daily
  • Some women experience unscheduled 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 within five days after the start of the menstrual cycle, a woman is protected right away. If the pill is started on another day of the cycle, it is important to use a back-up contraceptive method for 1 week.

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 increases the risk of serious cardiovascular side effects from 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 return to fertility usually occurs within one month, however 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 anytime 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

  • Availability: Available at Student Health Services by prescription
  • Failure Rate: Typical use: 8%; Perfect use: 0.3%

Recommended Resources

 

Online Birth Control Education
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last reviewed: Spring 2005