Oral Contraceptive Pills

Before beginning oral contraceptive pills (OCPs), be sure you understand the benefits, the possible problems, and the danger signs you should watch for when using OCPs.

How do OCPs work?
The pill contains 2 hormones, estrogen and progesterone - similar to hormones produced by a woman's body. These hormones prevent ovulation, that is, stop your ovaries from releasing an egg. Therefore, the male sperm has nothing to fertilize and you will not get pregnant.

How effective is the pill?
If the pill is taken "perfectly", it is 99.9% effective. Perfect use is not missing any pills and following all instructions perfectly. For "typical" pill users, the pill is about 95% effective.

What are some benefits of taking the pill?
Predictable, regular menstrual cycles with decreased cramping and bleeding, decreased acne, decreased pre-menstrual changes, decreased risk of pelvic inflammatory disease (PID) and ectopic pregnancies. OCPs also reduce the risk of non-cancerous breast disease and some forms of cancer.

What are the possible side effects of OCPs?
Some of the common side effects are listed here, as well as what you should do if you experience them. Remember, most side effects resolve by the end of the first or second cycle.

• Nausea - take the pill at night or with small amounts of food.
• Weight gain of 1-3 pounds can be expected when beginning the pill.  A weight gain of over 10 pounds should be reported to the clinic.
• Breast tenderness or fullness.
• Headaches - if severe, call the clinic immediately.
• Spotting between periods - if this does not resolve after 2 to 4 cycles, call the clinic.
• Missed or shorter periods are expected.  If you have no period and have not missed any pills, call the clinic for instructions but, DO NOT STOP TAKING YOUR BIRTH CONTROL PILLS.  If you have missed one or more pills or miss two periods in a row, you may be pregnant.  Come to the clinic for a pregnancy test.
• Mood changes - if this becomes a problem, call the clinic.
• Changes in sex drive - usually this is better because the fear of getting pregnant is gone.
• Vaginal changes - usually there is an increase in the amount of vaginal secretions.  If you notice burning, itching, or an odor with discharge, call the clinic.

How do I begin taking OCPs?  Follow these steps:

1. Start pills the first Sunday after your period begins, even if you are still bleeding.
2. If your period starts on a Sunday, begin taking birth control pills that day.
3. Once you start, you will always take 1 pill every day without stopping.
4. Use another method of birth control in addition to your pill for the first 7 days of your first cycle.
5. Your period will start while taking the last week of pills.  Do not stop taking the pills if it should start sooner.
6. You will always start your new pack of pills on Sunday.
7. Remember to take your pill at the same time every day, morning, afternoon or night.
8. If you forget to take your pill at the time you decided, take it as soon as you remember even if it's the next day.  Remember to take your regular pill for that day and use another method of birth control for 7 days.
9. If you forget your pill for 2 days, take 2 pills for 2 days and then take 1 pill each day as usual.  Use another method of birth control along with your pill for seven days.
10. If you miss 3 or more pills, call the clinic.  Remember to use another method of birth control.  If you have unprotected sexual intercourse during this time, ask about emergency contraception.
11. Remember, get into the routine of taking your pill at the same time everyday.  This is an important way to protect yourself against unplanned pregnancy!
12. Remember to use another method of birth control if you are taking anticonvulsants or St. John's Wort.  If you are experiencing diarrhea or vomiting, use a back-up method for 7 days.

PILL WARNING SIGNALS:  IF YOU SHOULD HAVE ANY OF THE FOLLOWING, CALL THE CLINIC RIGHT AWAY, OR DURING THE NON-CLINIC HOURS, CALL YOUR DOCTOR OR GO TO THE NEAREST EMERGENCY ROOM.

A - Severe abdominal pain
C - Severe chest pain or shortness of breath
H - Severe headaches
E - Eye problems:  blurring, spots before the eyes, blindness
S - Severe leg pain