How to properly take birth control pills

Overview

Birth control pills come in packs. There are several ways you can start taking your first pack of pills. Talk with your doctor about when to start taking your pills.

• Quick start. During your medical appointment, take your first pill as soon as you get the pack from your doctor. Take the second pill the next day. During the first 7 days of pills, use a backup method of birth control, like a condom.
• Sunday start. Pick a Sunday to take your first pill, so that you don't have periods on the weekends. During the first 7 days of pills, use a backup method of birth control, like a condom.
• Fifth-day start. On the fifth day of your menstrual period, take your first pill.

The most common type of pack has 3 weeks of hormone pills. Some packs have sugar pills for the fourth week. During that fourth no-hormone week, you have your menstrual period. After the fourth week (28 days), you start a new pack.

Some birth control pills are packaged so that you take hormone pills continuously for a period of time. With pills packaged in this way, you may not have a monthly period or you may only have a period every couple of months.

Your daily pill routine

Take your birth control pills every day, at about the same time of day. To help yourself remember to take your pills and prevent pregnancy, try these easy tricks.

• Pick a time to take your pill.

  Link up your "pill time" with something you do every day, like brushing your teeth, eating a meal, or going to bed.

• Use your calendar.

  Mark the days when you will start new packs. You might even want to cross off each day you take your pill.

• Check your pack again.

  Each morning, check your pack to be sure you took yesterday's pill. If you find you've missed one, take it right away.

Credits

Current as of: November 22, 2021

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine

What is the birth control pill (the pill)?

The pill is taken every day to prevent pregnancy. It contains hormones (estrogen and progestin) that are like a woman’s natural hormones. They stop the ovaries from releasing an egg. You can’t get pregnant if you don’t release an egg.

How well does the pill work?

• There’s about an 85% chance of getting pregnant after 1 year of having unprotected sex.
• With typical use (not following the exact directions) the pill is 91% effective.
• With perfect use (you follow the exact directions all the time) the pill is 99.7% effective.
• Most pregnancies happen because people forget to take their pills.
• The pill doesn’t protect you from sexually transmitted infections (STIs) or HIV.
• Use a condom every time you have sex (vaginal, oral, anal) to lower your risk of STIs and HIV.

How do I start taking the pill?

You need a prescription from your health care provider. If you start the first hormone pill on:

• day 1 of your period, it works right away to prevent pregnancy
• any other day, use a backup form of birth control (e.g., condoms, abstinence) for 7 days

How do I use the pill?

To use a 28‑day pack:

Take 1 pill each day at the same time. The 28‑day packages come in different ways:

• first 21 pills have hormones and the last 7 pills are hormone‑free
• first 24 pills have hormones and the last 4 pills are hormone‑free
• first 26 pills have hormones and the last 2 pills are hormone‑free

You’ll usually get your period 2 to 3 days after starting the hormone‑free pills. You’re still protected from pregnancy during this time.

When the pack is done, start a new pack the next day. Always start your new pack of pills on time, even if your period hasn’t ended. Your period should stop in a few days.

If you don’t have a period, start your new pill pack and see your health care provider.

To use a 21 - day pack:

• Take 1 pill each day at the same time for 21 days.
• When the pack is done, wait 7 days before you start a new pack. You’ll get your period when you aren’t taking pills (hormone‑free days). You’re still protected from pregnancy during this time.
• The hormone‑free days must not be longer than 7 days. At the end of the hormone‑free days, start a new pack. Always start your new pack of pills on time , even if your period hasn’t ended. Your period should stop in a few days.
• If you don’t have a period, start your new pill pack and see your health care provider.

What are the benefits of the pill?

• Your period may be more regular, lighter, and/or shorter with less cramping.
• The pill may lower your risk of ovarian and endometrial cancer.
• The pill may help with acne and painful periods (dysmenorrhea).
• It’s safe to use the pill for many years. There is no need to “take a break” from the pill.
• You can get pregnant as soon as you stop using the pill.

What are the side effects of the pill?

There’s a chance (more likely in the first 3 months) that you might have:

• headaches
• tender breasts
• bloating
• upset stomach (nausea)
• moodiness
• slight weight gain or loss
• spotting or bleeding between periods

If you have any side effects, don’t stop taking the pill. Talk to your health care provider. Most side effects get better within 3 months.

Can the pill cause blood clots?

When taking the pill, there’s a small risk of blood clots in the legs, lungs, heart, and/or the head.

The risk is higher depending on your:

• age
• weight—if you’re obese
• history (or family history) of blood clots, heart attack, or stroke
• history of smoking (especially people older than 35 who smoke)
• history of migraines with aura or other nervous system problems affecting speech, vision, movement, or sensations
• risk factors for heart disease (e.g., high blood pressure, diabetes, high cholesterol)
• history of other medical problems (ask your health care provider about this)

The risk of getting a blood clot is higher during pregnancy and right after having a baby than when taking the pill. The risk for blood clots might be different depending on the type of progestin in your pill.

What symptoms do I need to watch for?

Go to the nearest emergency department or call 911 if you have:

• trouble breathing
• a very bad headache
• sudden numbness in the face, arms, or legs (often only on one side of the body)
• very bad pain in your abdomen, chest, or legs
• eye problems (e.g., sudden blurry vision or loss of vision)
• sudden problems with walking or balance
• sudden confusion or trouble understanding what people say to you

What if I forget to take my pills?

Missing any pills can increase your risk of pregnancy. Your risk is increased if you miss a pill right at the start or the end of your pack. If you need help deciding what to do talk to your health care provider, read the chart below, or go to Sex & U, click on games and apps, and look for stay on schedule.

If you took a pill less than 48 hours ago:

• take it as soon as you remember (this might mean you take 2 pills on the same day)
• continue taking 1 pill every day at the same time
• you’re protected from pregnancy

If you took your last pill more than 48 hours ago:

Did You Know

• You have the right to make the decision to have sex or not.
• Plan ahead and talk to your partner about how to protect yourself and lower your risk of pregnancy, STIs, and HIV. Use a condom every time you have sex.
• Many sexual health clinics offer some types of birth control for no cost for people who qualify.
• Talk to your health care provider to see if the pill is right for you (e.g., just had a baby, breastfeeding, medical problem).
• Tell your health care providers (e.g., doctor, pharmacist) if you’re on the pill to make sure you’re protected from pregnancy if you take other medicine.
• If you vomit within 1 hour of taking the pill, take the next pill in your package. This means you’ll start your next pack of pills 1 day early.
• There are smart phone apps to help you remember to take your pill.

For More Information

• Health Link – Health Advice 24/7: 811
  

Current as of: November 2, 2018

How do you take birth control pills effectively?

How do you take birth control pills for the first time?

Do you have to wait for your period to start birth control?

How exact does the pill need to be taken?