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Obstetrics and Gynecology

Birth Control Pills

Birth control pills (also called oral contraceptives or "the pill") are used by millions of women in the United States to prevent pregnancy. The pill is safe and effective for most women.

About Birth Control Pills
Birth control pills are a type of hormonal birth control. With these methods, a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur. The hormones also cause changes in the cervical mucus and uterus that help prevent pregnancy.

The pill must be prescribed by a doctor. It is a very effective form of birth control. When women use the pill correctly, fewer than one in 100 will get pregnant over one year. However, about three in 100 typical users (3 percent) will become pregnant.

Combination Pills
Combination birth control pills contain the hormones estrogen and progestin (a synthetic form of the hormone progesterone). There are many different brands with different doses of hormones. This gives a woman a choice in finding a pill that is right for her.

How They Work
Estrogen and progestin, which are produced in the ovaries, affect the menstrual cycle and fertility. By altering the natural levels of these hormones, birth control pills can affect ovulation and other reproductive functions.

How To Take Them
You can start taking the pill on the first day of your period. You will not need a backup method of birth control.

For convenience, many pill users start taking the pill on the Sunday after their periods start. You can start even if you are still bleeding.

Pills only work if you take them correctly. Do not skip pills for any reason even if you bleed between periods or feel sick.

If You Miss a Pill
You may forget to take a pill once in a while. If you forget to take one pill, take it as soon as you remember.

Take the next pill at the normal time. It is okay if you have to take two pills in the same day.

If you forget to take two or more pills, use a backup method of birth control.

If you miss some pills, you may have some spotting or light bleeding even if you make up the missed pills. These side effects are not harmful.

The combination birth control pill has benefits in addition to preventing pregnancy. The pill also helps to keep your periods regular, lighter, and shorter and reduces menstrual cramps.

Side Effects
Some women have side effects when they are on the pill. These may include:

Most side effects are minor and often go away after a few months of use.

Some women should not use birth control pills. The pill may not be a good choice for women who smoke and are older than age 35 years and have certain health problems or have a family history of certain health problems. Talk to your doctor about whether the pill is a good choice for you.

Although rare, the pill can cause severe illness in some women. The most serious problem is cardiovascular disease, such as blood clots in the legs or lungs, heart attack or stroke.

Progestin-Only Pills
Some women may want or need to take another type of birth control pill that contains only progestin. It does not contain estrogen. It is called the progestin-only pill or the minipill. This type of pill is not as effective as pills that contain estrogen.

How They Work
Progestin-only pills contain only a small dose of progestin about 25 percent to 70 percent of the amount in the combination pill. Minipills prevent ovulation in about one-half of a woman's menstrual cycles. They also change cervical mucus. The mucus thickens, making it hard for sperm to penetrate the cervix.

How To Take Them
The minipill comes in packs of 28 pills. All the pills in the pack contain hormones. It is important not to miss a pill.

Progestin-only pills do not offer the same benefits that pills with estrogen offer. Most people who choose the progestin-only pill do so because there are reasons they should not take estrogen.

Side Effects
Women who take the progestin-only pill may have more bleeding or spotting days than women who take birth control pills that contain estrogen.

The progestin-only pill must be prescribed by a doctor. A total of three to six women per 100 will get pregnant while on the progestin-only pill. Pregnancy rates are increased in women who weigh more than 130 pounds.



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