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Oral Contraceptives

The Facts

Thousands of studies have been done on the pill. None have been able to prove that the pill causes breast cancer. Taking the pill does not cause infertility problems, either. If you have been on pills for several years, there is no reason to take a vacation from the pill. In fact, the longer a woman takes the pill, the more protection it provides against endometrial and ovarian cancer.

There are many brands of contraceptive pills. Most women are happy with the first kind they take. In most instances, weight change is minimal and unrelated to pill use. Approximately as many women lose weight as gain weight while taking the pill. In some women, however, weight gain is definitely caused by oral contraceptives and can be related to fluid retention or in creased subcutaneous fat. If you notice a weight change of more than 5 pounds, speak with your health care provider. More often women experience temporary side effects of a different nature in the first few months while adjusting to the oral contraceptive. Common complaints include bleeding or spotting on the active pills, breast tenderness, changes in your skin, a mild stomach ache or nausea, and some times, mild mood changes. Most often these side effects go away. If they do not, your health care provider can change the kind of pill you use. Call to make an appointment to discuss a possible pill change.

Taking the pill cannot prevent you from getting sexually transmitted diseases (STDs). In fact, several studies have suggested that use of oral contraceptives was the single strongest predictor of failure to use condoms, even stronger than alcohol. The theory is that if the pregnancy threat is removed, couples are less likely to protect themselves against sexually transmitted diseases.

How to Use The Pill

First, you must decide on a time of day or a consistent daily activity that will help you remember to take your pill. Taking your pill at the same time each day keeps the hormone level in your body at the necessary level to prevent pregnancy. Taking the pill at different times of the day can cause spotting. You will be instructed on what day to start your pills.

  • Sunday start: Start your pack of pills on the Sunday following the first day of your period. If you begin your period on Sunday, start your pills that day. Use a back-up method of birth control such as condoms plus spermacide for the first 2 weeks of your first birth control pill cycle.
  • First day of period: Start your pill pack the very first day of your menstrual period. As with the Sunday start, a back-up method of birth control must be used for the first 2 weeks of your first cycle of pills.

Your pill pack contains 3 weeks of pills with hormones in them and one week of placebo pills. Please make sure to take your pills in the correct order. You will get your period on the placebo week. Most women start their period on Tuesday of the placebo week but it can be as late as Thurs day and as ear ly as Monday. When you get to the placebo week, make sure you have another pack for the next cycle. You must start your next cycle of pills on time. If you start your pill cycle late you must use an other form of contraceptive for 7 days after you start the pills; i.e. condoms and spermacide.

Cautions

If you have diarrhea or vomiting, use another form of birth control while you are ill and for 1 week af ter wards. You may not be absorbing the pill as well as you would if you were healthy. If you vomit within 1 hour of taking your pill, you must re-take the pill. You can take the next pill which will mean that your cycle of pills will end a day earlier. You will need to start your next pack of pills a day early in order to avoid lengthening the hormone free interval of the cycle. Alternatively, you may replace the wasted pill by taking one from a spare pill pack.

Missed Pills: What to do

Take the missed pill as soon as you remember it. Take the next pill at the usual time. If you do not remember until your usual pill time, take the 2 pills together. Additional pregnancy protection is needed for 7 days.

If you miss 2 pills in a row, take 2 pills for 2 days. Return to your regular pill cycle on the 3rd day. Additional pregnancy protection is need ed for the remainder of the pill cycle. Never take more than 2 pills in a 24 hour period.

When to Call Your Health Care Provider

Please call right away if you experience any of the following symptoms:

  • Severe chest pain
  • Shortness of breath
  • A severe headache that makes you dizzy or weak or that happens at the same time as numbness in your face, neck, or arms
  • Temporary blindness or blurred vision
  • Difficulty talking
  • Severe pain in your calf or thigh

Oral contraceptive pills are medication. Always tell your health care provider that you are taking them.

If you are given a prescription for another medication, be sure to ask either your health care provider or your pharmacist about drug interactions with oral contraceptives. In general, drugs such as antibiotics can interfere with the pill's efficacy and a back-up method must be used for every day that you are on the medication plus 1 week. Also, be sure to use sunscreen, as estrogens make you more photosensitive.

If you have any questions or if any of this information is unclear, please be sure to speak with one of the providers in the Women's Health Program. The telephone number for an appointment is 603/646-9401.

Last Updated: 4/5/10