Birth Control Pills

Also known as the pill, combination birth control pills are oral contraceptives that contain estrogen and progestin. Combination birth control pills suppress ovulation, thus keeping your ovaries from releasing and egg.

Combination birth control cause changes in the cervical mucus and the lining of the uterus (endometrium) to keep sperm from joining the egg. Different types of birth control pills contain different doses of estrogen and progestin.

Some combination birth control pills, called continuous or extended-cycle pills, give you the ability to reduce the number of periods you have every year. If you would like to use combination birth control pills, your health provider can help you decide which type is right for you.

Here are the most common reasons to take combination birth control pills.

Combination birth control pills are a reliable type of contraception that is also easily reversed. Fertility can be returned immediately after stopping combination birth control pills.

Combination birth control pills also come with no contraceptive benefits, such as:

• Decreased risk of ovarian and endometrial cancers, ectopic pregnancy, ovarian cysts, and benign breast disease
• Improvement in acne
• Less severe menstrual cramps (dysmenorrhea)
• Reduction in androgen production caused by polycystic ovary syndrome
• Reduction in heavy menstrual bleeding due to uterine fibroids and other causes, as well as a reduction in related iron deficiency anemia
• Relief from premenstrual syndrome (PMS)
• Shorter, lighter and more predictable periods or, for certain types of combination pills, fewer periods each year
• Better control of monthly cycle and a reduction in hot flashes for women in perimenopause.

Combination birth control pills come in various mixtures of active and inactive pills, including:

• Conventional pack: This is the most common type of birth control pills, it contains 21 active pills and 7 inactive pills. Formulations containing 24 active pills and 4 inactive pills, also known as a shortened pill-free interval, are also available. A pill is taken every day and a new pack is started when the previous pack is completed (every 28 days) Bleeding occurs every month during the week in which you take the last four to seven inactive pills.

• Continuous dosing or extended cycle: These combination birth control pills typically contain 84 active pills and seven inactive pills. Bleeding generally occurs four times a year during the week the week in which you take the inactive pills. A 365-day pill is also available. This pill must be taken every day at the same time. For some women, periods stop altogether. For others, periods become significantly lighter.

Continuous dosing or extended cycle pills may offer additional benefits of suppressing menstruation, such as:

• Prevention and treatment of excessive bleeding related to uterine fibroids.
• Prevention of a menstrual migraine.
• Reduction in the menstruation-associated worsening of certain conditions including seizures and asthma.
• Relief from pain related to endometriosis.

Combination birth control pills are not appropriate for every woman.

Your health care provider may suggest a different type of birth control instead of combination birth control pills for the following reasons:

• If you are in the first month of breastfeeding.
• If you are older than 35 and smoke.
• If you have a history of stroke or heart disease.
• If you have a history of or current deep vein thrombosis or pulmonary embolism.
• If you have poorly controlled high blood pressure.
• If you have migraines with aura.
• If you have a history of breast cancer.
• If you have liver disease.
• If you have diabetes-related complications, such as retinopathy or neuropathy.
• If you have unexplained uterine bleeding.
• If you will be immobilized for a prolonged period of time because of major surgery.

Along with taking combination birth control pills comes potential risks.

According to estimates, 9 out of 100 women taking combination birth control pills will get pregnant in the first year of use. With a perfect use as directed, the pregnancy rate can be as low as 1 out of 100 women per year.

Although taking combination birth control pills during early pregnancy does not increase the risk of birth defects, it is advised to stop taking birth control pills as soon as you suspect that you might be pregnant.

Combination birth control pills will not protect you from any sexually transmitted infections.

They can also cause the following side effects:

• Breast tenderness
• Headaches
• Nausea
• Elevated blood pressure
• Breakthrough bleeding or spotting (more common with continuous or extended-cycle pills)

Some side effects, including nausea, headaches, breast tenderness and breakthrough bleeding can only last a few months.

Combination birth control pills increase the risk of some conditions. Some of these complications can be serious.

They include the following:

• Blood clots in the legs
• Worsening of gallbladder disease
• Heart attack and stroke (these complications are aggravated by smoking)
• Liver tumors

Consult your health care provider as soon as possible if you’re taking combination birth control pills and have the following:

• Breast lump
• Depression
• Abdominal pain
• Difficulty speaking
• Chest pain
• Fainting
• Seizure
• Eye problems, such are blurred, double vision or loss of vision
• Jaundice (Yellowish discoloration of the skin)
• Severe allergic skin rash.
• Severe mood swings
• Severe leg pain or swelling
• New or worsening headaches
• Two missed periods or signs of pregnancy

In order to prepare for the taking combination birth control pills, you will need to make a request for a prescription for combination birth control pills from your health care provider.

Your health care provider will check your blood pressure and make a review of your medical history, including asking about the specific medications you are taking. Your health care provider will also ask about your concerns and preferences in order to determine which type of combination birth control pill is the best for you.

Health care providers usually recommend pills with the lowest dose of hormones that will provide pregnancy protection and maximizing important non-contraceptive benefits simultaneously and also minimizing side effects.

Although the amount of estrogen in combination pills can be as low as 10 micrograms (mcg) of Ethinyl estradiol, most pills contain about 35 mcg. Women who are particularly sensitive to hormones may benefit from taking a pill with a lower dose of estrogen. However, the low-dose pill can lead to more breakthrough bleeding than many other pills.

Combination pills are put into categories based on whether the dose of hormones stays the same or varies:

• Monophasic: In this type of combination birth control pill, each active pill has the same levels of estrogen and progestin.
• Biphasic: In this type of combination birth control pill, active pills have two different combinations of estrogen and progestin.
• Triphasic: In this formulation, active pills contain three different combinations of estrogen and progestin. In certain types, the progestin content steadily increases, while in others, the progestin levels remain the same and estrogen levels rises.

Here you can find out what to expect from your combination birth control pills.

Make sure you make a consultation with your health care provider about a starting date.

If you apply the quick-start method, you can take the first pill in the pack immediately. If you use the Sunday start, you will take your pill on the first Sunday following the start of your period. When you use the quick start or Sunday start, use a backup method of contraception for the first seven days that you take combination birth control pills.

If you use the first-day start method, you will take your first pill on the first day of your next period. No backup method of contraception is required.

Pick a time to regularly take the pill. It is advisable to set up a routine and follow it to keep you from missing any pill. For instance, you can consider taking your pill when you brush your teeth in the morning. For maximum effectiveness, you must take combination birth control pills at the same time every single day.

Follow your health care provider's instructions carefully. Birth control pills only work if you use them correctly, so make sure you understand how you're supposed to use them.

If you are using conventional combination birth control pills and would like to have regular periods, you will take all of the pills in your pack, the active and the inactive ones and start a new pack the day after you finish your current one. If you want to avoid monthly periods, ask your health care provider about how to take the pills and how many active pill packs you can take in a row.

Be cautious with missed pills. If you miss an active pill, take it as soon as you remember, even if it signifies taking two active pills in the same day. Take the rest of the pack as usual and use a backup method of contraception for seven days if you missed your pill by more than 12 hours.

If you miss more than one active pill, take the last pill you missed right away. Take the rest of the pack as usual and use a backup method of contraception for seven days.

If you've had unprotected sex, consult your health care provider about emergency contraception.

Don't take breaks between packs. Always have your next pack ready before you finish your current pack. If you vomit within two hours after taking a combination birth control pill or have severe vomiting and diarrhea for two or more days, proceed as if you've missed a pill.

If you do not understand your combination birth control pills results, consult with your doctor.

You will be able to avoid pregnancy if this method is applied as instructed.