How does the pill work?
Oral contraceptives work primarily by suppressing ovulation (the release of an egg from the ovary). They also thicken the cervical mucus (making it difficult for sperm to penetrate) and cause the uterine lining to be thinner (making implantation of a fertilized egg unlikely).

How effective is it?
Oral contraceptives are more than 97% effective in preventing pregnancy.

How is the pill taken?
Sunday start: Start the pill on the first Sunday after your period begins. If your period begins on a Sunday, start your pills that day.

First day: Start the pill on the first day of your menstrual period. Use the stickers provided in the pill pack to label your start day.

Take one pill at about the same time each day until you have taken the pills in one cycle pack. You should have your period sometime during the fourth week of pills. Always start your new pack of pills on the same day of the week. EXAMPLE: IF YOU STARTED CYCLE 1 ON A SUNDAY, YOU WILL START A NEW CYCLE 4 WEEKS LATER ON A SUNDAY. To prevent an unplanned pregnancy before the pills become effective use extra protection (i.e. condoms) during the first cycle of pills.

What if I forget to take my pill?
The effectiveness of oral contraceptives is dependent on taking the pill consistently every day, so pick a time of day that does not vary by more than 4 hours. Keep in mind your schedule on the weekends when choosing a time of day to take your pill.

If you miss one pill - Take the missed pill as soon as you realize you've missed it. Take the next pill as regularly scheduled. Take the pills with food to minimize nausea. Use a back-up method of birth control for at least seven days after the missed pill.

If you miss two pills in a row - Take two pills as soon as you remember and take two pills the next day. Take the pills with food to minimize nausea. Use a back-up method for at least 7 days after the missed pills.

If you miss 3 or more pills in a row - Stop the pill and wait for your next period. Begin a new pack of pills either as a Sunday start or the first day your period begins (see above).

What are the benefits of taking the pill?
The pill is a very reliable method of birth control and is convenient to use. Over 50,000,000 women use the pill, giving them greater control over their lives by freeing them from unintended pregnancies. In addition, there are many noncontraceptive benefits associated with OC use:

• Reduced risk of ovarian and endometrial cancers.
• Reduced risk of pelvic inflammatory disease (PID) and ectopic pregnancy.
• More regular menstrual periods and lighter flow leading to less iron-deficiency anemia.
• Less painful menstruation.
• Decreased risk of benign breast disease.
• Acne improvement.
• Prevention and/or treatment of such conditions as endometriosis and polycystic ovarian syndrome (PCOS).

What are possible side-effects?

• breast tenderness - usually mild and may disappear in a few months.
• nausea - infrequent and may be minimized by taking the pill with food or at bedtime.
• weight gain or loss - infrequent and usually less than 5 pounds.
• spotting between menses - most often caused by forgetting to take one or more pills.
• mood changes, headaches, depression.
• vaginal yeast infections.

Are there any serious risks associated with pill use?
The serious risks associated with oral contraceptive use occur rarely. Serious risks, which can be life threatening, include blood clots, stroke or heart attacks. Cigarette smoking increases the risk of serious side effects, especially if you are more than 35 years old. Women who use hormonal contraceptives are strongly advised not to smoke. Women with the following medical conditions should not use the pill:

• Blood clotting disorders or history of blood clots such as deep vein thrombophlebitis
• Current or past history of heart disease or blockage of blood vessels
• Severe high blood pressure
• Diabetes with blood vessel complications
• Headaches with focal neurological symptoms
• Recent surgery with prolonged bed rest
• Known or suspected cancer of the breast or personal history of breast cancer
• Undiagnosed abnormal uterine bleeding
• History of jaundice (yellow pigment to the skin) during pregnancy or with prior hormonal contraceptive use
• Acute or chronic liver disease with abnormal liver function
• Liver tumors or cancer
• Known or suspected pregnancy

CAN I TAKE OTHER MEDICATIONS WHILE I AM ON THE PILL?

Certain drugs may interact with the pill to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include Rifampin, drugs for epilepsy such as barbiturates (for example, Phenobarbital) anticonvulsants such as topiramate (Topamax), carbamazepine (Tegretol), phenytoin (Dilantin), phenylbutazone (Butazolidin), certain drugs used in the treatment of HIV or AIDS and possibly some antibiotics, With the exception of ampicillin and tetracycline, there is no known conclusive evidence that antibiotics in general do interfere with the effectiveness of hormonal contraceptives. There are however, anecdotal reports that women have become pregnant while using antibiotics but a cause and effect relationship has not been shown. The herb known as St. Johns Wort may also make the pill less effective.

As with all prescription products, you should tell your health care provider about any other medications you are taking. You may need to use non-hormonal back-up birth control methods when taking certain other medications. You may also need back-up if you have severe vomiting and/or diarrhea.

DOES THE PILL PROTECT ME AGAINST SEXUALLY TRANSMITTED INFECTIONS?

The birth control pill does not protect you from sexually transmitted diseases including HIV. Health Services recommends the use of latex condoms in combination with the pill to protect yourself from STDs.

DANGER SIGNALS: CONTACT HEALTH SERVICES IMMEDIATELY IF YOU HAVE ANY OF THE FOLLOWING SYMPTOMS:

• Unusual pain or swelling in the arms or legs
• Sharp chest pain or shortness of breath
• Severe abdominal pain
• Severe headaches
• Sudden change in vision
• Fainting or dizziness
• Heavy, prolonged vaginal bleeding

Information associated with these serious risks is discussed in the detailed leaflet given to you with your supply of pills. Notify your provider if you notice any unusual physical disturbances while taking the pill.

Resources:
Managing Contraceptive Pill Patients, Richard Dickey, M.D., 10th Edition, 2000
Clinical Guidelines in Family Practice, Uphold and Graham, 3rd Edition, 1998




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Smith College Health Services // Northampton, Massachusetts 01063 // (413) 585-2800