Q&A: The Pill

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THE PILL

No periods

I have been taking the pill for three months now. I haven't been having the week break; I have been carrying it straight on. Can this affect me as I haven't had a period for three months?

You didn't mention which pill you are on or whether your provider suggested that you do this. We cannot answer this without knowing your history. Please talk to the provider who prescribed the pills.

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Missed pill

I have been taking birth control pills (Mircette) since November of 2003. I recently switched to Kariva because of insurance purposes. Since Mircette and Kariva are basically the same thing, the pharmacist did not say anything about using a backup for the first month.

But in the third week of my first month on Kariva I had sex, however during that week I dropped the pill (one of the white ones in the third week) and could not find it. So I missed that pill and took the next one in the pack, which is a green pill, the week I should start my period. I called family planning center and asked should I take an ecp and they said it was not necessary, but she didn't seem to know what she was talking about.

I keep trying to get in touch with my obgyn but haven't been successful. What are my chances of being pregnant? And if I am is it harmful that I am continuing to take my birth control?

Take a home pregnancy test to allay your fears. If you are pregnant, then stop the pill and contact your provider. The next time you have this situation, call the ECP hotline:

1-800-NOT-2LATE

Or visit their website www.backupyourbirthcontrolorg.

Calling the local FP center was a good choice, however, if you were not convinced with the answer you received, you should feel free to ask to speak to someone else, or just GO there and ask to speak to someone. If you tried repeatedly to contact your OB/GYN and they did not return your call, then I would suggest finding another doctor as that is not acceptable. Take care.

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Mononessa is making me moody

I am taking Mononessa. I have noticed that about three quarters of the way around the pack I tend to get very moody and everything in my world looks like it is going wrong. Does the amount of progesterone/estrogen increase, decrease or remain the same as you consume to the end of the pack? Is Mononessa natural or synthetic?

Mononessa has the same amount of hormones throughout the cycle. All birth control pills including this one are synthetic. Your change in mood is not uncommon. See your health care provider for a pill change if this continues.

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Vitamins?

Is it ok to take multivitamins like Enervon-C while taking the contraceptive pill?

I am not familiar with this multivitamin, but generally it is a good idea to take a multi-vit while on the pill.

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First time on pill

This is my first time on the pill, my periods are usually only 5-6 days. I have bled non-stop for 10 days. Is that normal at the beginning?

Yes, it is! Irregular bleeding patterns are common when a woman starts a new contraceptive method. We let people know that it can take two or even three months for your body to get back to a nice, regular bleeding pattern again. If, after three months on this pill, your periods continue to be loooong, we recommend that you check in with your provider. Sometimes a pill switch is needed to get your period to behave.

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How long?

I am on Tri Minulet and I was wondering, for how long one may be on the Pill for contraception purposes?

There is no time limit to taking birth control pills, as long as there are no warning signs of a pending complication such as severe headaches, unexplained pain in chest, arms or legs, swelling of the legs, etc.

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Refuse me the pill?

I want to know if a nurse LEGALLY can refuse me birth control if I do not want an exam. I don't want opinions, I would like facts.

The FDA packaging included with birth control pills does not require an exam. However, health care providers can decide that they will not prescribe the pill without an exam. At minimum a health history (blood pressure) and some lab work must be done and information given out about about how to take the pill and warning signs to look for. Call the health center you went to and ask to speak to a manager to get clarification.

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First month on pills

This is my first month taking birth control pills. My period ended on a Thursday and the health clinic appointment was on the next Tuesday. They decided to put me on Ortho-Novum 777, and punch out the first 2 pills in the pack (Sunday and Monday) so that I could start the pill that day. Since I did not take the first two pills in the pack, how long will it take for the pills to become effective in preventing pregnancy?

Any time a woman starts on birth control pills, we always advise using a back-up method for the first month (condoms, diaphragm etc). This is because the pill is not very strong and it takes a while for it make your body stop ovulating. So even if you started a little late, you should be protected after the first month. You might actually be safe earlier, but we do say back up for the first month.

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Vary pill taking by hours

I have been on Diane 35 for about 6 weeks now. I don't take it at the same time of day (sometimes time differs about 6 hours). My boyfriend and I had unprotected sex three days ago. Is there a chance I could be pregnant?

Ideally, we advise women to take birth control pills at the same time every day. However, if you are varying the time by many hours, it should still have the intended effect of stopping ovulation, which prevents pregnancy. Try to link taking the pill with something you do every day at around the same time, like brushing your teeth! If you miss a pill, take two the next day. If you miss more than that, call your healthcare provider to talk about what to do.

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Grandmother had breast cancer...

I am 22 years old and I am thinking about going on the pill, but I have heard that you shouldn't go on the pill if you have line of breast cancer in your family. My grandmother has died of breast cancer due to hormonal replacement she had taken after a hysterectomy. Should I stay away from the pill or are there pills out there that have very low risk side effects?

At age 22 your risk of breast cancer is extremely low and remains extremely low even with exposure to hormones in birth control pills. There is no contraindication to women with a grandmother who had breast cancer taking oral contraceptives.

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Set of pill questions

I just received my first pack of Ortho Tri-Cyclen and I am confused by the directions, could you please clarify a few things? The directions read: "Sunday Start: Take the first white "active" pill of the first pack on the Sunday after you period starts, even if you are still bleeding. If your period starts on Sunday, start the pack the same day. Use another method of birth control (such as condoms or spermicidal) as a back up method if you have sex anytime from the sunday you start your first pack until the next sunday (7 days) Day 1 start: Take the first white "active " pill of the first pack during the first 24 hours of your period. You will not need to use a back-up method of birth control, since you are starting the pill at the beginning of your period"

Question #1: As I read this "your period starts" on the first day when you stop your menstrual flow (when you stop bleeding). Is this correct? I had always thought you start your period on the first day of your menstrual flow (when you start bleeding). However, if this is correct why would you take the first active pill on the day you start your menstrual flow (day you start bleeding)?

Question #2: I started taking taking the pill on the first Sunday after my menstrual flow stopped ( I stopped bleeding on Friday and took pill #1 -white "active" pill three days later on Sunday) Is this the correct way to take the pill?

Question #3: I am on pill #4 is it safe to have unprotected sex?

This is a complicated set of questions, so we are answering them one at a time:

Question #1: AS I READ THIS "YOUR PERIOD STARTS" ON THE FIRST DAY WHEN YOU STOP YOUR MENSTRUAL FLOW (WHEN YOU STOP BLEEDING). IS THIS CORRECT?

Nope. They really mean after your period starts. As you thought, the start of your period is the first day of your bleeding (menstrual flow). The directions mean take the pill the first day you start bleeding. Starting the pills with your period gives the pill seven days to work on your hormonal system at a point in your cycle when you’re least likely to become pregnant.

Question #2: I STARTED TAKING TAKING THE PILL ON THE FIRST SUNDAY AFTER MY MENSTRUAL FLOW STOPPED ( I STOPPED BLEEDING ON FRIDAY AND TOOK PILL #1 -WHITE "ACTIVE" PILL THREE DAYS LATER ON SUNDAY) IS THIS THE CORRECT WAY TO TAKE THE PILL?

Well, if your period started last Saturday, say, then ideally you would have started on the next day, Sunday. However, if your period started on Monday and finished on Friday, then, yes, you’re following the directions.

QUESTION #3: I AM ON PILL #4 IS IT SAFE TO HAVE UNPROTECTED SEX?

Absolutely NOT. As the directions say, if you haven’t started the pills on the day you started your period, you should use condoms for at LEAST one week (seven full days) after you start the birth control pill. Many providers recommend that women use condoms every time they have sex through the first pill pack as it’s easy to forget pills during that first month of use. And a condom/pill combo is a great idea, as condoms further decrease the chance of unintended pregnancy while providing protection against sexually transmitted infection.

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On pill, light bleeding, had sex

I am taking Cryselle (Lo/Ovral generic). I have been on it for 6 months. But have been on birth control pills for 6 years.

I have bad cramps so my Dr. suggested to skip the placebo pills every other pack to lessen my periods and hopefully help with my cramps. So this month I skipped my placebo pills and started my next pack. I haven't missed a pill and take them around the same time, but I started bleeding anyway and have been bleeding for a while now. I know this is normal for my body to get use to this switch.

So my question is my boyfriend and I had unprotected sex on the 5th day of the new pack (the first time I haven't taken the placebo pills) while my bleeding was light. The bleeding hasn't changed. But I was wondering if I should worry about being pregnant since my body was use to having placebo pills at that time and not hormonal pills and also since my body is out of whack right now? Thank you!

Not to worry. You're absolutely right--it IS normal to have some between-period bleeding when you decide to skip periods (some women skip every other period, some choose to have a period only four times a year), but the bleeding does NOT mean that you aren't getting good contraception from your pill.

When should you worry about being pregnant? If you miss two or more pills in a row and don't use condoms as back-up or if you DON'T have your period when you do take the period week pills, you should consider taking a pregnancy test to rule out pregnancy.

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Changed to the Pill

I was on the patch for a year and decided to stop in July and change to a different form (an oral contraceptive). Since then, I haven't received a normal period again and so have not started up on a new form of BC. In the meantime, since I was not on any BC, I took had to take an emergency contraceptive and experienced a little (normal color) spotting about a week after taking that which was in September. Since then, no sign of a period until this week I am experiencing a little DARK BROWN discharge.

What is this and could I assume its my period and start taking the pill? Also, since going off the pill I feel as though my bowel movements have changed. My stomach always feels upset and I seem to go more often than before going off the pill. They are looser too. Could this all be caused by my body readjusting after going off the pill (i.e. lack of hormones)? HELP!

What you describe here is not uncommon—often when women stop a method, they’ll have a few months of irregular bleeding. Irregular can mean fewer periods or more frequent periods or no period at all for a while. That’s why we recommend that women switch IMMEDIATELY to a new method as soon as they go off a method. (When women switch from the Patch to the pill, we recommend that in the fourth Patch week, women start their pill either on the first day of their bleeding or on the Sunday of that week. If they use a Sunday start, we advise using condoms for at least the first seven days of pills.)

Because you’ve been sexually active without contraception, you may be pregnant now. (Pregnancy can also cause the irregular bleeds you describe, and may also cause nausea. Remember, though, that stress can also cause odd periods and stomach upset.) We recommend that you take a pregnancy test right away to rule out pregnancy. If you’ve had unprotected sex in the past two weeks, we’d then recommend that for the next two weeks you STOP HAVING SEX or you USE CONDOMS EVERY TIME. Then take another pregnancy test to be SURE you’re not pregnant, and then, period or no period, we recommend that you start the pill. If you don’t have a bleed with the period week of pill, we’d recommend that you get in to see your provider to for a quick check to make sure that the lack of normal periods is due to your method switch.

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Can I afford the pill?

I'm interested in the pill. But the cost may be a little much. Me and my boyfriend have talked and we really want to get me on the pill... What should I do?

Go see your local family planning or Planned Parenthood clinic. Most of these clinics (the ones that use federal funding) will charge you based on your income, and often for many people it is very low cost or free (if you qualify). Your best bet is to go to family planning - you will get great health care service, amazing nurses and counselors, and affordable supplies.

Click here to help you find your Family Planning center

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Good pill for me?

I am having problems finding a good birth control pill that works for me. I have tried Lo Ovral and I had spotting on day 12 into my new pack until day 19 for 6 months. Then the gyno put me on regular Ovral and it stopped the spotting but made my period heavier. Some friends of mine suggested Triphasil. What would be your suggestion for a pill that would help my heavy periods while not causing spotting?

Triphasil contains the same progestin as Lo-Ovral and Ovral. This doesn't always help, but I would suggest trying a pill with norethindrone (Ortho 1/35, Norethin 1/35, Norinyl 1+ 35, or Necon 1/35), but give it a three month try. At first you may spot or bleed irregularly, but once that settles down you may have lighter periods than you experience on Lo-Ovral.

Of course everyone is different and what works for one may not work for another...so be patient and try another pill. There are many different options. Hope you find one that works for you!

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IBS and the pill

I have IBS (irritable bowel syndrome), with diarrhea. I heard that frequent diarrhea could lower the effectiveness of the pill. I take Ortho Novum 777 at about 9:00 at night. My IBS is typically bad in the morning or sometimes the afternoon. Usually not during the night, or directly after I take the pill.

Do you think it could effect how the pill is in my system? My IBS is usually just loose stools, not very watery just not formed. However, since I've been in college the food doesn't agree very well and sickness goes around very frequently and I've had watery diarrhea a couple times in the week, usually before I take the pill though, early evening. I'm very worried I'm not as protected as I thought I was.

I know I should probably be using a condom for extra protection if I'm worried and that may be your advice - but if it was making the pill go through my system more quickly, how much would it effect the protection? Thanks for your help.

Diarrhea could potentially decrease the absorption of hormones taken orally for contraception. You could discuss this in more detail with a practitioner although it is hard to pinpoint exactly how much you may or may not be absorbing. If you have had a good experience with hormonal contraception, you may consider using hormonal contraception methods which use different routes for administering hormones into your bloodstream: Ortho-Evra patch (hormones absorbed into the bloodstream by through the skin) or Nuva-Ring (hormones absorbed into the bloodstream through the vaginal wall). Talk with a practitioner to discuss whether or not either of these forms of hormonal contraception would work for you.

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Have to switch pills

I have been taking Ortho-Cyclen 28 day for almost three years now. This is the only pill that my body has been comfortable with (I have tried a lot of them). My insurance quit covering this particular brand of birth control, and I have now been prescribed Ortho-Novum 1/35. I am very worried about switching. What are the differences and similarities between these brands? Is one stronger than the other, and how long will it take my body to adjust to the new brand?

These pills have the same amount and type of estrogen and a slightly different progestin. It should be an easy adjustment.

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Periods heavier during school year

I have noticed that while on Ortho Lo, my period tends to be noticeably heavier during the school year. During the summers, the flow is probably half to one third to the school year flow.

I do not party (drink, drugs, etc.), so one obvious control I can think of is being sexually active. Clearly my boyfriend and I are not sexually active during semester breaks, so the cause could be hormonal, though I can't imagine how.

I checked on the Ortho Lo website, and it said that a more common side effect is a lighter period. But this is only true for me during the summers and winter breaks)--otherwise it's been about the same, if not, heavier, since I started the pill.

Other controls I can think of could be an irregular sleep pattern, college food, or even stress. Probably less so with stress though, as some months are more stressful than others, and I have not noticed a difference at those times.

My question is, does being sexually inactive/active make your period heavier while on Ortho Lo, or is it a variety of other things? If so, what is causing the heavier flow during the school year? Thank you very much.

Thanks for this excellent question. Unfortunately, there's not a whole lot of information out there that helps us answer it with any certainty. As you noted, women on OTC-Lo tend to have lighter periods, because when a woman is on the Pill, her uterine lining tends to be thinner than it would be if she weren't taking hormones. That explains your light summer and holiday periods, but doesn't explain your heavier school year flow.

You've already noted a few of the prime suspects in menstrual changes or irregularities-- stress, change in diet, change in sleep pattern. (Other culprits are weight loss or weight gain, medications, or hormonal problems.) We have had reports (not scientific studies, just reports from clients) of women who have more regular and--yes--heavier periods when they're sexually active. (Interestingly, these women WEREN'T on the pill.) It sounds as if you've hit upon a logical reason for the variation in your period.

We'll continue to research your question, and we'll post more information if we find it!

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Stopped taking Pill and had sex

I had been taking Dianette but I had come off it two days ago as I had reached the end of the pack. I had unprotected sex with my boyfriend two days after I had come off the pill. I then took a Dianette pill the day after, would this have protected me?

No. After the placebo pills are gone, you must start new pack right away. If not, there is a chance you could ovulate and become pregnant. After unprotected sex, taking a pill the next day will not protect you. You could have taken Emergency Contraception which would have protected you more, but not as much as staying on the pill in the first place.

When a new pack is not started on time, it is often best to wait for a period, then start a new pack of pills, but check with your health care provider for details.

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Started Apri...

I just started my 1st pack of pills since being off of them after my 16 month old was born. The brand is Apri and I began on the 1st day of my period. My period has now stopped and I was wondering if this is normal with a 1st day start method? In the past I've always started on the 1st Sunday after my period began so I wasn't sure what to expect beginning the pill on the first day of my period. Thanks for any info you can provide.

Yes, the first day of a menstrual cycle is a common start date. It ensures that ovulation is suppressed in the first cycle.

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Missed pills when sick

I've just started taking combination pills this month and I think I've missed about two pills due to diarrhea. I didn't make up for them because I wasn't sure. My period didn't start until the 4th day of my reminder pills. So for the fresh new pack of pills, am I still immediately protected? Or do I need to use a back-up method for the first week?

Good question! Since it is unclear when in the first pack of pills you missed pills, the safest course would be to use a back-up method for the first seven active pills.

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Antibiotics

I am currently on antibiotics, and am prescribed to take them for 10 days. I know antibiotics can negate the effects of the pill. How long after I stop taking antibiotics will the pill be effective against pregnancy again?

Antibiotic therapy and pills continues to be controversial. Our recommendation is that you use a back up method only during the time you are taking the antibiotics.

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How long to work?

I recently had a medical abortion and was given Ortho Tri Cyclen Lo at my follow-up visit, two weeks after the initial visit. I started taking the pill on Sunday, the day after my follow up. My question is, when will the pill become effective?

The pill will be effective after you have taken at least two weeks of pills.

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Period early

Hello, I have been on the pill for 3-4 months, this month my period started a week before the green pills. I was wondering if I am still protected against pregnancy even though it was early?

Yes, you are still protected as long as you do not miss a pill. Early periods are not uncommon. It should straighten out in the next cycle.

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Pill not available

Hi, I'm asking this question on behalf of my girl friend. She took Alesse 28 for her first month and she can't find this make of pills where we living. What other best make of oral contraceptive pills she can use instead of Alesse 28 and tell us how to start the new make of pills.

Alesse is made by Wyeth-Ayerst and is identical to Levlite by Berlex. Also, if neither of these pills are available do not hesitate to try any other pill that a medical person recommends, as there are many other very good, safe, and low dose birth control pills such as Loestrin Fe 1/20, Ortho-tri-cyclen-Lo, or Mircette.

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Ortho Novum?

I am going to start taking Ortho Novum. How effective is it? I used to take Nordette 29. Do I have a greater amount of milligrams?

You did not mention which strength of Ortho Novum, but nevertheless all the pills are equal in effectiveness. When taken as directed, the Pill is 92-99.7% effective as birth control.

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Cervical ectropion

I am 25 and have recently been diagnosed as having a cervical ectropion which I understand to be a side-effect of taking the pill (I have been taking Cilest for a few years). I am now seriously considering not taking the pill anymore. I am also quite depressed at the moment and think that the pill may be involved as I once became depressed when on Dianette. Will discontinuing the pill help with either of these conditions?

Some women do report an increase in depressive symptoms, moodiness, and other emotional states on Oral Contraceptives. Changing the hormonal dosage or stopping the pill are two options to consider. The cervical ectropion is an effect seen in pill users and not a reason to discontinue or change pills. Please see a qualified women's health provider to discuss this further - they can help you make this decision and also help you decide what form of birth control you may wish to switch to. Good luck.

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Boyfriend doesn't want me to take the Pill

My boyfriend and I both agreed that we want to be sexually active, but we're not going to take any chances. He agrees to wear a condom when the time comes, although I need to have another form of protection for myself to have us feel more comfortable together.

I'm not sure if he's been misinformed or if it's because of his religious beliefs, but he has firmly discouraged me from going on birth control pills because he is convinced of some "side effects" later on in life. If it is my body and will make things safer as well, then why does he feel like it's such a bad idea?

If your boyfriend REALLY doesn’t want to take any chances, two methods of contraception is the best idea. Two methods of contraception ARE better than one, and the combination you’ve picked is a great one. Condoms are the only birth control method that can help prevent sexually transmitted infections and the Pill is a highly recommended safe AND effective method of birth control for most young women.

As for safety, you’ve made a good point. There’s a LOT of misinformation out there about contraceptives. While there are some women for whom birth control pills aren’t a safe choice—women with very high blood pressure or with inherited clotting problems, for example—for MOST women, they’re a great, safe choice.

If your boyfriend has some specific questions about birth control methods, here are two links with lots of useful, accurate information:

PBS.org American Experience article on The Pill-Q&As

Seven Myths About The Pill - Planned Parenthood's website

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Hard time remembering

Should someone in therapy for their mental health, already taking a lot of medications (day/night-in pill form), who has trouble remembering to take them sometimes... and going off to college, consider the pill too dangerous of an option for her?

The pill works best if you do take it at the same time each day. If you tend to miss pills you increase your risk for pregnancy. You might want to consider other birth control options.

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Placebo?

It won't make a difference if you just don't take the placebo pills right? As long as I remember to start the new pack sunday... it makes no difference to your body right?

If the pill is Micronor, there are no placebos and all 28 must be taken to be effective.

So, it depends on the pill you are taking. Check with your provider first. Usually the placebos are put there so you can stay in the routine of taking the pill. Some people don't take them (they see that week as a "break"), but others do so they never forget. It's a personal thing. But, if they ARE placebos, then, yes you can skip them.

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On pill, have pain in abdomen

I am on Ortho-novum 777. This is the second month taking it - I was on Lo-ovral before. One more week and I will be on the placebo pills for my second pack. Last placebo week, it was extremely light but I still got it when I was supposed to (that Tuesday). It lasted normally but it was so light I hardly had to wear a tampon.

I haven't had sex after because I'm so freaked out from the light period. I use condoms every time I just feel worried because of other grinding and stuff. I take the pill correctly. But now, I've been having this pain in my lower abdomen - feels like it's in my bladder... it doesn't burn when I urinate or anything it just hurts on and off and random times. I also don't have to urinate more frequently at all. I am worried this is a sign of pregnancy or something? could this be from the pill?

IS MY PILL WORKING?
It’s not at all unusual to see changes in your period when you start the pill or when you switch to a different pill. One of the most common changes women see is a much lighter--sometimes almost nonexistent--period. It sounds as if you are taking the pill perfectly—one each day and at the same time every day—so the change in your period is most likely your body’s normal reaction to the pill. Given that you’ve also been using condoms every time, your risk of pregnancy is VERY VERY low.

SEE YOUR PROVIDER
Even though we would not be particularly worried about pregnancy from your question, there are two things in your note that make us feel that you should check in with your nurse practitioner or physician. You mention “grinding and other stuff” and feeling pelvic pain “on and off and at random times.” If the “grinding” means you’re feeling pain during sex, then this should be checked out. And if, on top of that, you’re experiencing pelvic pain at any time —even if it’s just on and off—you definitely need to be checked out. While infections--either bladder infections or vaginal infections--are a common cause of pelvic pain, the only way to figure out what’s going on is a visit with your provider.

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Skip a period?

I want to skip my period while using contraceptive pills. What should I do?

Using the pill like this to skip a period can be done once in a while, but it is not recommended that you do it on a regular basis.

When on the pill, your body is "trained" to have a period the week you take the placebos. By having you start right into your next pack of pills (skipping the placebos), you will skip your period that month.

If you do not want to have periods as often, there are other hormonal contraceptive methods you may want to consider. Please see your local family planning center to discuss this.

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Missed pills...might be pregnant

I went away for the weekend with my boyfriend and missed three of my pills. We had sex on the Saturday and then I took my pill on the Sunday and Monday. I then started my period on the Monday (obviously my body thought that this was a break).

I also read that taking the pill could cause harm to the baby if I was pregnant so I stopped taking the pill. My boyfriend and I have now been using condoms. When would be the best time for me to take a pregnancy test?

A pregnancy test will be accurate at 10-14 days after you believe conception occurred, in other words, two weeks after you think you could have become pregnant. By the way, there are no data that support birth defects from taking the pill while pregnant.

In the future consider Plan B, emergency contraception for the window of missed pills and then "restart" the pills ASAP with condom backup for 7-10 days. That will get you back on track. Now, that you have stopped the pill, consult your health care provider to discuss restarting.

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Confusing pill question

I've been on the pill for a little less than a year. I was wondering how the effectiveness of the pill is affected if you switch your weeks around. For example, let's say you take active pills for 5 weeks then placebo for a week then active pills for two weeks etc until you're back on the right schedule. Are you still just as protected? What if you have sex the last day of the 5 weeks of active pills?

The key to making sure that you are fully protected from pregnancy with birth control pills is to not stop the active pills. I am not quite sure what you are trying to do when you say you what to switch your weeks around. I would recommend that you call your health care provider to discuss this. Many women now do not take any breaks on the pill for months at a time. You may wish to consider this option with your provider.

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Just started, no period

I have just completed my first whole pack of Ortho Tri Cyclen Lo and I did not get my period. Now I don't know if this a normal side effect seeing how it's my first time being on the pill, but it seems a little odd to me and well, scares me. The chances of me being pregnant are impossible because I haven't been sexually active. So should I just brush it off and will I get my period next month?

If there is no chance of pregnancy (i.e. you didn't have sex) then continue for the next cycle and look for a period next month. If you do not get one next month, call your provider and discuss it with them.

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On pill, no period

I have been on Ortho-Tri cyclen for a few years now. I started my period on the third week on my pack of pills. So this week which is when I'm suppose to have it there's nothing. I take my pill regularly and never missed one. So should I start my new pack next week like I'm supposed to?? I am confused because this has never happened. Is their a risk I can get pregnant?

Yes, start the new pack at the time you are supposed to start. An early period on the pill after a few years is very normal. You are not at any greater risk of pregnancy if you have not missed any pills or started a new pack late.

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The pill & insurance

I was just wondering - I'm interested on going on the pill just to be safe. I was gonna get it at a family planning clinic and I have CIGNA HEALTHCARE. Is there any way that CIGNA gets birth control free?

CIGNA covers contraception. You most likely will have a co-pay. Family Planning has contraceptive methods on site and the charges are based on your income.

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Hair is thinning

I am presently on Cilest contraceptive, and my hair started thinning, I am concerned that it could be a reaction from the pill, can you please let me know if this could be a side effect from taking Cilest.

You should check with your provider who prescribed your pill as they may want to do some basic lab work to check this. Thinning of the hair may be a possible side effect of oral contraceptive use. Also, long-term dieting can cause this as well. You may consider going on a fish oil supplement - this may help. But, you definitely should talk to your provider and find out what the cause is.

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Pill cycle messed up

I started taking the pill last month, but got my period the week before the placebo pills. I continued to take the placebo pills the following week, and had light spotting after my period. I started taking a new pack this week, but because the first pill of this pack wasn't taken starting the week after my actual period, I started taking it the week after the placebo pills, I'm worried the real pills wouldn't have prevented my ovaries from releasing an egg cause it was started too late because my period was earlier than it should have been. Could this be true?

If you did not start the new cycle of pills when you finished the last placebo pill you are at risk of ovulating this cycle. When you are off the active pills for more that 7 days you are at risk.

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On pill 8 days

I have been on the pill for 8 days so far and I started it on the first day of my period. Two days ago, once my period finished, I had unprotected intercourse with my boyfriend, he ejaculated inside me. My boyfriend thinks I could be pregnant because he doesn't think the pill would be effective yet and since then I have been bleeding small amounts. Is there any chance I could be pregnant if I have been taking my pill at roughly the same time everyday.

Our advice is to use a backup method for the first two weeks you are on the pill. However, your sexual intercourse did occur during a part of your cycle where it would be very unlikely to get pregnant, but if your next period does not come when it should, please see your provider immediately. Breakthough bleeding on the pill is common in the first month. Never hesitate to contact your provider who gave you the pills when you have questions.

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Discharge

I have been on Alesse for three months now and have had a dark brown discharge ever since I started the pill. I am aware that some spotting may occur, but I thought it was only for the first month or so. I have had to wear a panty liner everyday. I went to a doctor and she informed that this was ok and I shouldn't be concerned. But I am, it is gross and I am so embarrassed about it. I never want to have sex because there is always the dark discharge. Can you help?

I would recommend that you get a pill change. Your doctor is right it is not harmful, but it is a nuisance. Call your provider back and tell them you want a change.

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Nausea

I know that nausea can occur when you first start taking birth control pills, but can it still occur after you've taken it for about 3 years? I'm experiencing nausea and I can't think of what else could be causing it.

Yes, nausea can still occur. Please check in with your health care provider or family planning clinic. If they do determine that it is the pill causing your nausea, then they may want you to try a different birth control pill.

Some things to think about: Have you changed the time of day you take your pill? Ways to thwart nausea with the Pill include taking it with meals and at bedtime (vs. in the morning). Again, please see your provider soon.

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Skipped placebo week

I have been taking Alesse 28 for two months. I have been on bc pills for 7 years. This month I wanted to skip my period so I did not take the placebo week and started a new pack. A few days later I began to bleed and have continued to for 14 days now. Next Sunday I will be at the placebo week again, but I don't know if I should take those or start a new pack to stop the bleeding. Please respond so I know what to do.

We ask everyone: Please don't send us urgent questions as we don't always respond promptly - this is posted clearly on the topics page.

This type of bleeding pattern is not unusual. Please consult your health care provider to discuss how to manage this. Take care and good luck

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Did BCPs cause my pregnancy problems?

In September of 2003, I was told by my MD to stop my BCP (Birth Control Pills) because of a high C-Reactive Protein level. I was off for 2 weeks and I conceived while using Spermicide. At my 20 week Sonogram they found several anomalies with my baby’s heart, stomach, colon and genitalia. The Amniocentesis said it wasn’t a genetic problem. The pregnancy was ended at 22 weeks. Is there a connection between the Spermicide and the BCP still being in my system that could have caused this horrible outcome? How long now should I be off BCP before trying to conceive again?

I am so sorry about the loss of your baby. I am not aware of any studies that suggest a connection between the use of spermicides and the fetal anomalies that occurred with your baby.

The usual recommendation is to stop taking the Pill two or three months before you want to start trying to conceive. This allows the hormones contained in birth control pills to leave your system and your natural hormonal cycles to resume.

Also, be sure to take a folic acid supplement -- folic acid helps prevent certain birth defects during the first few months of pregnancy.

You may wish to consider a physician who specializes in high risk pregnancies. Good luck.

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Pill schedule is all askew

I have been on the pill for at least 4 months, but I never took the pill at the same time each day, but in those months I always had a period. Last month I had a period but afterwards I stopped taking the pill for a week when I had unprotected sex. I figured since I hadn't been taking my pill I needed to take the morning after pill, so I went to go get it. The next day I started taking my pills again like normal for a month but my period didn't come on that last day of the pack. On that last day I had unprotected sex and didn't take the pill because I ran out and was suppose to be on my period anyway. Since I still haven't had my period should I still get a new pack and keep taking the pill until I do get my period then start on the another pack after I get my period? Could I still prevent pregnancy if I take a regular pill the next day even though I had sex the day I was supposed to start my period and didn't take a pill?

It is unlikely that the pill is protecting you at this point. Perhaps you would be better served by another hormonal method, such as the Depo shot as it is obvious the Pill may not be working for you. To be most effective, it must be taken exactly per your provider's orders, preferably at the same time each day. A birth control pill user cannot simply decide to not take the pill on a whim - it is a very reliable form of birth control, but it must be taken as directed. Please talk with your health care provider or family planning.

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Pregnant again?

I had an abortion about 2 weeks ago and the doctor gave me birth control pills which I started the day after the abortion. About 2 weeks after I started the pill my boyfriend came inside of me. What are the chances that I'm pregnant again?

If you are taking your pill correctly then you are protected from pregnancy.

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Changed my pill schedule

I am currently on the pill, taking Cilest. I wanted my period earlier, so I stopped taking my pill 4 days early. I did not have sex whilst on my break, however I did have sex 2 days after I started taking the pill again, could I be pregnant? Please help, I'm very worried.

Yes, it is possible to get pregnant if the total time you were off the pill was greater than seven days. A pregnancy test can be done in about two weeks. You can use a test from your local drug store.

Please see your local family planning clinic or the provider that gave you the pills the next time you wish to change your schedule. Also, whenever you are not sure, use condoms as a backup.

Additionally, if this happens again, you can use emergency contraception up to three days after having sex.

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Effectiveness of lower dose pill

Do birth control pills have the same effectiveness when a lower dose is used? I am on birth control pills but not on a high dose.

Yes, all birth control pills have the same effectiveness rates when taken as directed.

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Stop Depo; take Pill

I would like to stop with my Depo injections as I've had horrible side effects. Can I start taking the Pill the day my shot runs out, and is it immediately effective?

You can start the Pill when your next Depo injection is due. The Pill will be effective immediately.

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Stop pills to get pregnant

How long after I stop taking birth control pills should I wait before trying to get pregnant?

You can begin to try to get pregnant as soon as you stop the birth control pills.

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How does going on the pill work?

My boyfriend and I started having sex a couple of weeks ago. We really like each other and we are both ready, but we have talked and we both think it's a good idea that I go on the pill before we have sex again. If worse comes to worse I will talk to my mom about it, but I was wondering if i can get the pill confidentially, and how does it work? Do I come back every so often to get more supplies? Thanks a bunch!

Call your local family planning center. You should be able to get the pill confidentially, however, we encourage you to talk with your parents or a trusted adult. The family planning center counselors will talk with you about what is involved and give you a physical exam first. The staff at family planning can also talk with you about confidentiality and whether or not you should use your parents' insurance (if applicable) as sometimes it can compromise your confidentiality. In general, you can get as many as three to four months of pills at one time then you simply come back in for refills. Keep taking care of yourself!

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Side effects of birth control pill

I have been taking a BCP for six years, Microgynon 30, but a month ago a doctor in Italy told me that this is a very old and strong BCP. Right now I am changing pills and the doctor here in Mexico recommended Minulet, as I am living in Mexico, but I am not sure this BCP is really good. Please, can you recommend me what to do, because I am not trusting the doctors here that much. P.S. I am only using the BCP for not to get pregnant, as I have had the same partner for years.

If the current pill you are on has between 35 and 50 micrograms of estrogen (it should be on the package) then this is a very common, safe level of pill to be taking.

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I have heard from friends that the pill is free.... is that true?

The charges for services at family planning offices are based on income. Most services and supplies, including pills, may be available to clients at no charge if the client meets the income guidelines for services at no charge. In these situations we gladly accept donations.

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Birth Control Pills

Hi! I am currently a freshman and have just gotten involved in a relationship with a guy who has had sex before. He is two years older than me. I know that in order for him to stay with me I will have to give up my virginity. I have known since I was eight years old I want to go to Dartmouth college and become a neonatologist doctor, and I am afraid if I have sex something will go wrong and with my bad luck I will end up pregnant. My mom JUST let me begin dating and so if she knew I was having sex she would FLIP! Is there a way I can get birth control pills, and not have her find out? Thank you for taking the time to read this!

It depends on where you live. We are in Maine, so I can tell you that the law in Maine states that a minor may access health care for the purposes of birth control without parental consent or knowledge. So, yes, you can go to a family planning center or private physician for birth control without your mother finding out.

You are making an important decision regarding whether or not to become sexually involved with this young man. I am impressed with your long term goals and I encourage you to think hard about your reasons before you make the choice to become "sexually active." Is it what YOU really want or are you doing it just so you won't lose a boyfriend? Think about whether you feel it is appropriate to have someone pressuring you into having sex in order to keep the relationship - is this the type of person you want to be with? Good luck and take care.

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Changing pills

Hey, I'm asking this on behalf of my girlfriend. We have been sexually active for around 2 months now. She was on a certain type of pill, but it was found that it was causing depression. She since changed pills and is now on the new ones. Two weeks after being on the new ones we had sex (each time she has been on the pill and I have used a condom) and all was good. She skipped about 6 pills worth to have her period earlier but it never came. I just would like to know if skipping pills can do this? She was getting cramps etc as normal, and she took the different colored pills, but it never came? She was worried that some how she could be pregnant and bought a test kit but it said she was not.

Any info would be greatly appreciated!!

Skipping active pills (pills with hormones in them vs. the other colored pills that are meant to be taken during your period) can result in no bleeding, but can also increase the chance of ovulation and thus the risk of pregnancy. Without more information on actually what week she skipped, it is difficult to comment further. Please tell your girlfriend to call her health care provider to discuss the situation. Good luck and kudos to you both for putting such careful thought and effort into your contraception.

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Contraception pill for skin

Hi please help me. I use the contraceptive pill for my skin, and for protection. I have suffered from mild/ moderate acne for a few years now. I have been on Dianette which worked really well, but as I was on it for 3 years my doc said I have to change. I have tried Yasmin which was ok, but it didn't really help my skin that much. My doctor has now put me on Tri-Minulet, he told me this will help my skin. Is this true, as I don't believe him? Also I'm concerned that it is a 3rd generation pill!! Please could you tell me what other pill I could try for my skin. I found on the internet Diane 35 and Ortho Tri Cyclen which looked excellent, but my doctor couldn't find them on his computer. I'm at my wit's end here. Please help me. Is Tri Minulet any good? Could it help my skin, or make it worse? Damsel in distress .....

All birth control pills will help acne. Ortho Tri Cyclen is the only one with FDA approval to state that it can help skin clear up.

I advise contacting your local family planning clinic and talking with them about which pill would be best for you. They prescribe birth control pills every day and will be familiar with the most up-to-date pills and will help you choose. Additionally, in many cases, pills are less expensive through family planning clinics, so you might save some money. You can have the clinic contact your doctor for your records so they can have the most up-to-date information on your reproductive health history. Also, most family planning clinics take insurance and operate on a sliding-fee scale, meaning you pay what you can afford. Good luck and congratulations for taking care of yourself!

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Bleeding during sex while on Alesse

I recently began taking Alesse because my boyfriend and I have started to have sex and we wanted to be safe. About three days ago we were having sex and I didn't know it until we were done but I bled, a lot. I have never bled before during intercourse and I was wondering why I would be now. Is it something to do with the pill, or is it just because I'm "new" to sex and maybe he was being too rough without knowing? It really scared me, and we have stopped having sex for a while but the next time we decide to do it, I'm afraid I'm going to bleed again. What should I do?

It could be bleeding from the pill. If you did not have any pain during sex then I would see if it happens again. If it does make an appointment with your local family planning clinic - or whoever prescribed Alesse - and they can answer your questions and either figure out what is wrong, perhaps give you a different pill to try, or set your mind at ease. Good for you for taking responsibility and using contraception! Take care and never hesitate to call your family planning center with these types of questions.

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Can I tan?

I was wondering if I can still tan while I'm on the birth control pill (Alesse) and I also wanted to know if I could take the weight loss pill Xenadrine??

Before you take any medications that are not prescribed, please consult your healthcare provider, especially with nutritional supplements and diet aids. Do not take more than the dosage indicated on the label.

In answer to your questions, yes, you can tan (remember - tanning ages your skin prematurely, so always use sunscreen of at least level 15), and no, there is not any published data indicating any drug-to-drug interactions between the pill and Xenadrine. Please seek the advice of your health care provider before taking Xenadrine.

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Needles

This is a pretty foolish concern regarding the pill. I want to go on it very badly, but the counselor at the clinic said I would have to have an examination to get it. Does any part of the examination involve blood work (finger pricking, blood tests, etc.) or anything involving needles? I am absolutely petrified of them, and it's actually keeping me from going in to get birth control, although I know I need to use it. Please respond.

I commend you for knowing what is right. Yes, you definitely should be on birth control if you are having sex and don't want to become pregnant!

Blood work or needle "sticks" are not a routine part of an exam for the pill at family planning. In fact, you can get birth control pills for three months without an exam-as long as you make an appointment for one. So make an appointment to go in to your local family planning clinic and talk to the staff - you'll find them warm and friendly and willing to listen to all your concerns.

In the meantime, please use condoms! They are readily available, effectively prevent pregnancy and sexually transmitted infections, and they don't involve needles in any way! Stay safe.

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Lost one of my pills!

I dropped my pill and can't find it. What do I do??? Please help!

Take the next pill in the pack and continue to the end of the pack. You will be one pill short. Before you finish the pack, call your health care provider or family planning center for further advice (they can probably give you one pill to complete your pack). If you have missed taking pills and are not already using condoms with your pills use them now.

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Can you get the Pill without having your parents find out? If so where?

Although it is always good to talk to a trusted adult, yes, you can get the pill without you parents knowing about it. The best way to learn more is by contacting the family planning center in your area -- on this page there are links in the green bar to the right to help you find your clinic. Also, below you'll find more information about the pill.

In the meantime, make sure you are using an alternate method of birth control! Remember, the pill doesn't protect you against sexually transmitted infections, but condoms do! Stay safe.

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How does the nurse at family planning decide if you can take the pill?

The first thing that happens when you visit a family planning clinic or your own health care provider is that they will talk about your medical history with you.

Then, you will have a general physical exam. This includes using a stethoscope to listen to your heart, a blood pressure check, and checking your weight. Additionally, often you will be asked to provide a urine sample -- one major reason for this is to determine that you are not pregnant, but there are many other things that are tested for as well, such as the possibility of diabetes (which would not necessarily prevent you from taking the pill), or possibly a urine infection.

Before the pill can be prescribed (and once per year while on the pill) you have to have a gynecological examination. The major parts of this exam are a PAP smear, a breast exam (as they do this they usually teach you how to do it yourself), abdominal, and pelvic checks.

Based on the outcome of this exam, the provider will decide whether or not you are a good candidate for the pill. There are some conditions that can prohibit some women from taking the pill. If you are put on the pill, the provider will work over time to adjust the dosage, if necessary, so you can have best prescription for your body.

Don't be shy! Ask questions! Bring a list of them with you. This is the time to learn about your body and about the pill -- use it to your advantage.

Go to our Resources & Links page for some very good information on contraception. Good luck!

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