Using the Pill (Not for Contraception)

“The pill” is a tablet that contains hormones that mimic the body’s natural release of hormones.

Without “the pill,” estrogen and progesterone are released from your ovaries. In some people, the release of these hormones causes heavy periods, severe menstrual cramping, and increased acne.

When you are on birth control pills, your body knows that estrogen and progesterone are coming from somewhere else (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 lighten your period, reduce the menstrual cramps and decrease acne development.

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, which can cause the heavy periods, severe cramps and acne to return. 

  • 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 hormone pill at your usual time, take your pill as soon as you remember. Then take the next pill at the usual time. You will be taking two pills that day. This will not alter your menstrual cycle or the prevention of cramps and acne.
  • If you forget to take a hormone pill for one whole day, take two hormone pills the next day at the regular time.
  • If you forget to take a hormone pill for two days, take two hormone pills for each of the next two days.
  • If you forget to take the pill for three days, your ovaries may "wake back up." Start a new pack of pills; you may have an earlier period if you miss three pills.
  • 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 usually occur at the time you take the pill. Taking them at night may lessen these symptoms.

If you are having problems that are making you feel miserable, do not stop taking your pills, but 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 or swelling in the calf of one leg
  • Severe abdominal pain
  • Shortness of breath
  • Never run out of pills. When you start your sugar pills or have one week of pills left, call your pharmacy and ask for a refill. If your pharmacy tells you that you do not have any refills, 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 yours with anyone else. Although most pills work the same way, they may not have the same type of hormones. 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, contact the Teen Health Center at Cincinnati Children's Hospital Medical Center, 513-636-4681.

Last Updated 11/2013