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Combination Birth Control Pills

How do birth control pills work?
A birth control pill is a daily pill which will need to be taken at the same time every day to be effective. It contains hormones that prevent ovulation. These hormones can also cause other changes in your body that help prevent pregnancy, including a thickening of cervical mucus that decreases sperms mobility and a thinning of the lining of the uterus that makes implantation less likely. You will be taking a combination birth control pill, which contains the hormones estrogen and progestin. The first 21 pills contain hormones and are sometimes referred to as "active" pills. Depending on the type of birth control pill you are taking, the last 7 pills may be different combinations of estrogen-only pills or "inactive" (hormone-free) pills. Some pills may have hormones in only 3 days of the last row of pills, while others may have hormones in all pills. You will have a cycle sometime in the last week of pills.

When do I start taking birth control?
You should use a backup method of birth control for the first 7 days after you begin taking the pills. You should starting taking your birth control pills on Sunday after the beginning of your cycle. Example: If your cycle begins on a Wednesday, you will begin taking the pills the following Sunday, even if you are still bleeding.  If you start you cycle on Sunday, begin taking the birth control pills on that Sunday.

What should I expect after I start taking birth control?
After you start taking birth control pills, you should expect some breakthrough bleeding for the first few months; however, this should improve after 3 months of taking the birth control pills. If it does not improve, you should call your doctor's office. Many women have spotting or light bleeding when they miss a birth control pill, even if they make it up later. After taking the pills for several months, you may not have a cycle every month, especially when taking birth control with only 4 inactive pills.

What are the side effects of birth control pills?
Birth control pills may cause nausea, breast tenderness, water retention, increased blood pressure, mood changes and headaches. The antibiotic Rifampin along with anticonvulsants and barbiturates may reduce effectiveness of birth control. If you take this antibiotic and/or barbiturates and anticonvulsants, use condoms for birth control. Birth control does not protect against from HIV or STDs. There is a 1/10,000 risk of blood clots. You should call you doctor's office if you have pain, redness or swelling in one/both of your calves.

What should I do if I miss a pill?
Missing a pill enhances your risk of getting pregnant and having breakthrough bleeding. If you forget to take one "active" pill, you should take the missed pill as soon as possible. If you miss 2 "active" pills in week one or two, you should take 2 pills as soon as possible, then take 2 pills the following day, then return to the regular schedule. You should use another form of contraception for the remainder of the month. If you forget to take 2 pills in a row during the third week or 3 tablets in a row at any time, you should throw away the rest of the pack and start a new one without a pill-free week. You should also use a backup method of birth control for 7 days. Your period might not start this month as it is expected, but if you do not have your periods 2 months in a row, you should visit your doctor for you may be pregnant. If you forget to take one of the "inactive" pills, just skip it and take another one as it scheduled. If you miss a tablet there is a risk to become pregnant if you have intercourse in the next 7 days, so you MUST use a backup form of birth control.