Using the Pill for Contraception

The birth control pill is a method that uses oral tablets to prevent pregnancy. The pills contain hormones that mimic the body’s natural hormone release.

Without birth control pills, estrogen and progesterone are released from your ovaries. When you take birth control pills your body knows that estrogen and progesterone are coming from somewhere else (from the pills).

Because your ovaries don't need to release hormones, they "take a little nap." While they're "napping," they don't release hormones, and don't release an egg, which is how they work to prevent pregnancy.

Forgetting pills or taking them at different times of the day can cause the ovaries to "wake up." When that happens, the ovaries release hormones and may release an egg, which may result in pregnancy. Missing pills can also cause irregular periods.

  • Start your first pack of pills as directed. You may be told to start on the first day of your next period, or on the Sunday after your next period begins, or on the day you are in the clinic / office.
  • After starting the pill, continue taking one pill every day. There should not be any days that you don't take a pill.
  • With birth control pills, the first 21 days are hormone pills and the last seven are usually sugar pills (placebo) to keep you from forgetting to take pills every day. Most people start their periods on the second or third day of the last row of pills.
  • If you are taking the pills with an extended cycle (no sugar pills), your doctor or nurse practitioner will tell you when to expect your period.

If you forget to take a pill:

  • If you forget to take a pill at your usual time, take your pill as soon as you remember. Then take the next pill at the usual time. You will take two pills that day; this will not interrupt the menstrual cycle or birth control protection.
  • If you forget to take a pill for one whole day, take two pills the next day at the regular time.
  • If you forget to take a pill for two days, take two pills for each of the next two days. You will have to use a back-up method of birth control for seven days.
  • If you forget to take the pill for three days, your ovaries may "wake back up." Discard the old pack and start a new pack of pills. You may have a period early if three pills are missed and you will have to use a back-up method of birth control (condoms) for seven days.  

If you have questions about what to do with missed or late pills, call the triage nurse, 513-636-4681, option 2. 

Most people don't have any side effects with birth control pills. However, during the first three months, you may experience:

  • Bleeding or spotting during the hormone pills. This is called breakthrough bleeding and is usually worst during month one, less during month two, and by month three most people have regular periods during the last week of pills. If breakthrough bleeding continues after month three, you may need a different pill. Also, breakthrough bleeding may occur if you frequently forget to take pills.
  • Other problems are not common, but you may have nausea, breast tenderness, headaches, or mood changes. If they occur, they are usually mild and don't last long. These problems often occur when you take the pill. Taking it at night may lessen the symptoms.  

If you are having problems that are making you feel miserable, do not stop taking your pills; call the triage nurse, 513-636-4681, option 2.  

Birth control pills do not cause weight gain. 

  • Severe headaches (the worst headache you've ever had)
  • Dizziness
  • Vision changes
  • Chest pain
  • Pain in the calf of one leg
  • Severe abdominal pain
  • Shortness of breath
  • Birth control pills do not protect against sexually transmitted diseases. Use condoms every time you have sex.
  • Never run out of pills. Call your pharmacy to get a refill when you start your reminder pills or have one week of pills left. If the pharmacy tells you that there are no more refills allowed, call the triage nurse and ask for a refill.
  • If we gave you samples of pills and you will run out of pills before your next visit, call the triage nurse and we will call a prescription to your pharmacy.
  • Never take someone else's birth control pills or share your pills with anyone else. Although all pills have the same goal (to prevent pregnancy), they may not all have the same type of hormones in them. Serious problems can result.
  • If you are having a problem, don't just stop taking the pill. Call the triage nurse.
  • There are many different types of birth control pills. If you are unhappy with the one you are taking, call the triage nurse and we can find another pill that might be better for you. 

If you have questions, call the Teen Health Center at Cincinnati Children's Hospital Medical Center, 513-636-4681.

Last Updated 11/2013