Content

• Steps
• Part 1 of 4: How to choose birth control pills
• Part 2 of 4: How to start taking the drug
• Part 3 of 4: How to take oral contraceptives
• Part 4 of 4: If you forget to take a pill
• Tips
• A warning

Oral contraceptives are hormonal drugs that prevent pregnancy, and their mechanism of action varies depending on the type of contraceptive. Combined oral contraceptives prevent the maturation of the egg in the ovary, thicken cervical mucus, thereby inhibiting the passage of sperm, and thinning the endometrium of the uterus to prevent fertilization of the egg. One-way progestin-only contraceptives (called mini-pills) thicken cervical mucus and thin the lining of the uterus. Some mini-drinks also prevent ovulation. Although colloquially all oral contraceptives are referred to as "hormonal pills," this group of drugs includes several types of drugs. If you have not used birth control pills before and want to be sure that you are taking them correctly (this is necessary for reliable protection against pregnancy), you need to explore all possible contraceptive options and discuss them with your gynecologist.

Attention:the information in this article is for informational purposes only. Talk to your healthcare professional before using any home remedies or medications.

Steps

Part 1 of 4: How to choose birth control pills

1. 1 Discuss your options for contraception with your gynecologist. Modern medicine offers many safe and effective methods of female contraception. Contraceptive pills are one of the most common methods of protection against unwanted pregnancies due to their availability and relatively low cost. Nevertheless, it is important to discuss the issue of contraception with a gynecologist, since the choice of a particular drug depends on the woman's health status, chronic and previous diseases, as well as on her lifestyle and further reproductive plans.
   • The modern pharmaceutical industry produces two types of oral contraceptives. Combined oral contraceptives contain two types of hormones: estrogens and progestins. One-way progestin-only drugs, called mini-pills, are contraceptives that only use a progestin.
   • Combination drugs are also divided into two large groups. Monophasic contraceptives are drugs in which each pill contains the same amount of hormones. In two-, three- and four-phase preparations, the quantitative content of estrogen and progestin is calculated individually for each phase of a woman's menstrual cycle.
   • Combined contraceptives also include micro-dose contraceptives. Each tablet of such a drug contains no more than 20 micrograms of ethinyl estradiol (conventional birth control pills contain about 50 micrograms of the hormone). Microdosing contraceptives are indicated for women with hypersensitivity to hormonal drugs, especially estrogen. However, it should be borne in mind that these drugs sometimes cause bleeding in a woman in the middle of the cycle.
2. 2 Assess your health status. Although doctors very often recommend combined contraceptives to their patients, there are a number of contraindications that limit the use of these convenient drugs. See your doctor to help you decide if these contraceptives are right for you. Your doctor will most likely tell you that you should not take combined oral contraceptives if one or more of the following conditions apply to you:
   • you are breastfeeding;
   • you are over 35 and smoke;
   • you have high blood pressure;
   • you are genetically predisposed to or suffer from deep vein thrombosis, pulmonary embolism, or blood clots;
   • you have a history of breast cancer;
   • have a history of cardiovascular disease or stroke;
   • you have diabetes or other diseases related to glucose metabolism;
   • you have liver or kidney disease;
   • you have a history of vaginal and uterine bleeding of unknown origin;
   • you have increased blood clotting;
   • you have systemic lupus erythematosus;
   • you have migraines with aura;
   • you are about to undergo major surgery with prolonged bed rest after surgery;
   • you are taking anti-TB drugs, anticonvulsants, or drugs based on St. John's wort.
   • Your doctor will likely tell you not to take mini-pills if you have breast cancer, have unexplained uterine or vaginal bleeding, or are taking anticonvulsant or anti-TB drugs.
3. 3 Consider the benefits of taking combined oral contraceptives. Many women prefer this method of contraception to all others as it has many benefits. However, it must be remembered that taking these drugs comes with certain risks. When choosing the best method of preventing unwanted pregnancies, you need to consider the pros and cons of combined oral contraceptives. The benefits of taking these medicines:
   • very effective in preventing pregnancy when used correctly (99%);
     • if you do not follow the instructions for taking the drug, the risk of pregnancy during the first year of taking combined contraceptives increases to 8%;
   • reduce cramps during menstruation;
   • reduce the risk of inflammatory diseases of the fallopian tubes;
   • reduce the risk of developing malignant neoplasms of the ovaries and endometrium;
   • regulate the menstrual cycle and reduce menstrual bleeding;
   • reduce the appearance of acne;
   • help to increase bone mineral density;
   • reduce the synthesis of androgens (male sex hormones) that cause polycystic ovarian disease;
   • protect against ectopic (tubal) pregnancy;
   • Reduce the risk of anemia and iron deficiency by reducing menstrual blood loss
   • prevent the development of ovarian and mammary cystosis.
4. 4 Consider the possible risks associated with taking combined oral contraceptives. Along with the many benefits of taking these drugs, there are also potential risks that you need to discuss with your doctor. The likelihood of developing such consequences is very low, but they pose a serious threat to the health and life of a woman. It should be noted that the risk of developing dangerous diseases while taking contraceptives increases if a woman smokes or suffers from certain diseases. Disadvantages of combined oral contraceptives:
   • do not protect against sexually transmitted diseases and HIV (condoms must be used to protect against these infections);
   • increase the risk of heart attack and stroke;
   • increase the risk of blood clots;
   • increase the risk of high blood pressure;
   • increase the risk of developing liver tumors, cholelithiasis and hepatosis;
   • increase soreness of the mammary glands;
   • may cause nausea and vomiting;
   • contribute to an increase in body weight;
   • cause headache;
   • provoke the development of depression;
   • can cause menstrual irregularities.
5. 5 Consider the possible benefits of using a progestin-only oral contraceptive (mini-pill). Mini-pills (they contain only progesterone) have fewer positive properties than combination drugs, but they also have fewer side effects and contraindications. Talk to your gynecologist about how effective progestin-only oral contraceptives will work for you:
   • Can be taken even if you have health problems such as an increased risk of blood clots, high blood pressure or migraines, or if you are at risk for heart disease.
   • can be taken while breastfeeding;
   • reduce cramps during menstruation;
   • help to reduce blood loss during menstruation;
   • reduce the likelihood of inflammatory diseases of the fallopian tubes.
6. 6 Consider the potential negative effects of taking a mini-drink. Although the use of progestin-only oral contraceptives is associated with a lower risk of serious illness than with combined contraceptives, there is still a small likelihood of serious side effects. Talk to your doctor about how the benefits of these drugs will offset the risk of serious illness. Disadvantages of drugs include:
   • lack of protection from sexually transmitted infections and HIV (use condoms to prevent infection with these diseases);
   • they are less effective than combined contraceptives;
   • if you forget to take another pill and deviate from the usual time of taking the drug by more than three hours, you need to use additional methods of contraception;
   • provoke bleeding in the middle of the cycle (more often than when using combined contraceptives);
   • increase soreness of the mammary glands;
   • May cause nausea and vomiting
   • increase the risk of polycystic ovarian disease;
   • less protection against ectopic pregnancy than combination drugs;
   • sometimes aggravate acne;
   • contribute to an increase in body weight;
   • provoke the development of depression;
   • increase the growth of unwanted hair on the face and body;
   • cause headaches.
7. 7 Consider if you want to adjust your menstrual frequency. If your health condition allows you to take oral contraceptives, you can choose the ones that work best for you.If you are going to take combined oral contraceptives (which are most often chosen by modern women), this method will also allow you to reduce the number of menstrual cycles per year.
   • Contraceptives that lengthen the menstrual cycle make it possible to reduce the frequency of menstrual bleeding by up to three to four times during the year. Some women take drugs on a schedule that will stop menstruation altogether.
   • Traditional oral contraceptives do not interfere with your menstrual cycle. In this case, you keep your regular periods every month.
8. 8 Find out how your birth control pills interact with other medicines. Tell your gynecologist about all medications and dietary supplements that you are taking - the doctor will be able to assess whether these medications have an effect on the effectiveness of hormonal contraception. Some medications have been found to interact with oral contraceptives and decrease their contraceptive properties. Among them it is necessary to mention:
   • some antibiotics, including penicillin and tetracycline;
   • certain anticonvulsants;
   • certain drugs used to treat HIV;
   • anti-tuberculosis drugs;
   • St. John's wort and preparations based on it.
9. 9 Tell your doctor what medications you are currently taking. Before your doctor gives you a prescription for certain birth control pills, tell them about any medications, vitamins, and dietary supplements you are currently taking. Some medicines can interact with contraceptives, and contraceptives and certain medications can interfere with each other's effectiveness and increase side effects. Be sure to notify your doctor if you are taking any of the drugs below:
   • thyroid hormone preparations,
   • benzodiazepines (including diazepam (Sibazon))
   • prednisolone preparations,
   • tricyclic antidepressants,
   • beta-blockers,
   • anticoagulants (drugs that thin the blood, such as Warfarin Nycomed)
   • insulin

Part 2 of 4: How to start taking the drug

1. 1 Follow your doctor's instructions. Always follow the advice of the doctor who prescribed the drug for you. The rules and schedule for taking birth control pills vary from drug to drug. Some tablets must be started on a specific day of the cycle, while others must be taken on a specific schedule. Read the instructions carefully to get started, and then move on to the next steps.
   • If you do not follow the rules for taking the drug, this can significantly reduce their effectiveness and increase the risk of unwanted pregnancy.
2. 2 Stop smoking. If you smoke while taking hormonal contraceptives, your body is in serious danger. It has been proven that the combination of these two factors leads to the formation of blood clots in the blood vessels, which can cause instant death. So if you are over 35 and smoke, you will have to stop taking combined contraceptives.
   • If you smoke, quit this destructive habit. Even if you smoke very rarely - at parties or with friends who smoke - this can have serious consequences. If you don't smoke now, under no circumstances start.
3. 3 Start taking birth control. You may need to start taking the drug on a specific day of your cycle or at a specific time, depending on the specific type of oral contraceptive you are prescribed. Be sure to ask your doctor when you need to take the first pill of the drug. Usually the recommendations are based on certain general principles.
   • You can start taking combined oral contraceptives on the first day of your period (first day of your period).
   • You can also start taking combined oral contraceptives on the first Monday after your period starts.
   • After giving birth (without caesarean section), you must wait three weeks before starting the combination contraceptive, provided that you are not breastfeeding.
   • If you have a clotting predisposition or are breastfeeding, there should be at least six weeks after birth before you can start taking combined contraceptives.
   • Combined contraceptives can be taken immediately after a miscarriage or abortion.
   • Remember on which day of the week you took the first combination contraceptive pill, and always start taking the first pill in a new pack on the same day.
   • You can start taking mini-pills (one-way progestin-only contraceptives) at any time. If you plan to have vaginal sex within 48 hours of using the mini-pill, consider using additional contraception.
   • You must take mini-pills at the same time every day. Choose a time when you are guaranteed to remember your pill, such as when you wake up in the morning or before you go to bed.
   • One-way progestin-only contraceptives can be taken immediately after a miscarriage or abortion.
4. 4 Be aware that in some cases, pregnancy can occur even with the use of oral contraceptives. If you start taking birth control pills on the first day of your period, they will provide effective protection against pregnancy right away. If you start taking contraceptives on any other day of your cycle, there is a small chance of pregnancy, in which case it will take some time to use additional contraceptive measures or abstain from vaginal sex.
   • In order to ensure reliable contraception during the first month of taking oral contraceptives, it is recommended to use additional methods of preventing pregnancy.
   • If you start taking drugs without taking into account the onset of the menstrual cycle, it will take a whole month before hormonal components provide reliable protection against pregnancy.
   • If you do not have time to start taking the pills within the first five days of your cycle, you will have to take additional contraception until the end of the cycle or until you run out of packaging.

Part 3 of 4: How to take oral contraceptives

1. 1 Take your pills at the same time every day. You can take a pill in the morning or, conversely, before going to bed. Most often, women choose the evening time, since many have a constant ritual of going to bed, and the morning hours are more hectic and unpredictable. If you can't stick to a stable pill schedule, the likelihood of spotting spotting increases. In addition, irregular use of contraceptives negatively affects their effectiveness.
   • If you are taking one-way contraceptives (mini-pills), you must take the pill at the same time every day, and the permissible deviation from this time does not exceed three hours. If you do not meet this time frame, consider using an additional method of contraception for the next 48 hours. For example, if you always take a pill at 8 p.m., but today only remember about it at midnight, take the pill immediately. If you plan on having sex in the next 48 hours, be sure to take additional precautions against pregnancy, such as using condoms.
   • If you can't boast of a good memory, set an alarm on your mobile phone or put a pack of pills next to your toothbrush - so you will definitely remember them.
   • Several mobile applications have been developed, such as myPill and Lady Pill Reminder, which send a daily reminder to the phone to take a pill.
   • Take the drug half an hour after meals to avoid nausea.
2. 2 Make sure you know what type of birth control pill you are taking. The modern pharmaceutical industry produces monophasic, two-phase and three-phase combined contraceptives. In the last two groups of drugs, the amount of hormones in the tablets varies depending on the phase of the menstrual cycle. If you are taking two- or three-phase drugs, your doctor will likely give you additional instructions in case you miss a pill. The specific algorithm of actions is individual for each drug.
   • In monophasic combination contraceptives, the percentages of estrogen and progestin remain the same in each tablet. If you forget to take such a pill, take it as soon as you remember. The next day, take another pill at your usual time. The most common drugs in this group are Logest, Mercilon and Jess.
   • Biphasic contraceptives contain two types of pills that differ from each other in the percentage of progestin. These drugs include, for example, Femoston and Anteovin.
   • In three-phase contraceptives, the percentage of hormones changes every seven days, which corresponds to the first three weeks of the cycle. The most common drugs in this group are Tri-regol, Tri merci and Triziston.
   • Four-phase contraceptives, in which the percentage of hormones changes four times during a cycle, have only recently appeared on the market. In Russia, this group is represented by only one drug, which is called Klayra.
3. 3 Take combined contraceptives according to the chosen scheme. As you remember, these drugs are divided into two large groups: traditional pills and drugs that lengthen the menstrual cycle. Some combination contraceptives consist of pills of different compositions that must be taken at certain times of the menstrual cycle. Carefully read the instructions for your drug.
   • If the pack contains 21 tablets, you need to take one tablet at the same time every day. When the tablets run out, you take a break for 7 days (these days you will most likely have your period), after which you start a new pack of the drug.
   • If the pack contains 28 tablets, you need to take one tablet at the same time every day. Some of these pills do not contain hormones or contain only estrogen. When you take the "blank" tablets, your period occurs and lasts four to seven days.
   • If you are taking three-month combination drugs, you need to take one tablet at the same time every day for 84 days. After that, you need to take one pill that does not contain hormones or contains only estrogen for seven days. Thus, menstrual bleeding will last for seven days at a frequency of once every three months.
   • If you are taking the one-year combination drug, you need to take one tablet every day at the same time throughout the year. During this time, you may have your period with minor bleeding; in some women, while taking these contraceptives, menstruation stops completely.
4. 4 Wait for your body to get used to the hormones. Note that during the first month, you may experience pregnancy symptoms (breast swelling, nipple tenderness, mild bleeding, and nausea) as your body adapts to the hormones. Some types of contraceptives cause menstruation to stop, so be sure to ask your doctor what symptoms to expect while taking your medication.
   • If you suspect you are pregnant, use a home pregnancy test. The results of this test are reliable, and the use of oral contraceptives does not affect the accuracy of this method.
5. 5 Pay attention to spotting spotting. Spotting spotting in the middle of the menstrual cycle is quite common in women taking oral contraceptives, which reduce the frequency of menstruation. Even if your pills do not affect your cycle length and your period occurs every month, you may notice slight spotting in the middle of your cycle. This is completely normal during the period of time your body is getting used to the effects of birth control pills. Usually this symptom disappears in the first three months of taking the drug, but in some cases you have to wait about six months.
   • Mid-cycle bleeding is usually associated with low-dose combination contraceptives.
   • In addition, spotting can occur if you missed a pill or take pills irregularly, without being tied to a specific time of day.
6. 6 Make sure you have the next pack of the drug in stock. Oral contraceptives are not strictly prescription drugs (you just need to get a prescription from a doctor, after which you can buy the drug at the pharmacy an unlimited number of times), so you don't have to go to the doctor every time you run out of another pack. However, it is better to take care of contraceptives in advance and buy packaging in reserve. You don't want to find out late at night that the pills have run out and all the pharmacies in the area are already closed.
7. 7 Try other methods of contraception if the drug for some reason does not suit you. If contraceptives prescribed by your doctor are not suitable for you, try a different brand of drug or choose a different method of protection against pregnancy for yourself. If certain contraceptives significantly impair your quality of life (exacerbate PMS or cause other side effects), ask your doctor to choose a different type or brand of contraceptive for you. In the arsenal of modern medicine there are many methods of protection against unwanted pregnancy, and some of them are no less effective than oral contraceptives, but more convenient.
   • Hormonal methods of contraception also include patches or vaginal rings that contain a combination of estrogens and progestins.
   • In addition, there are other long-term, highly effective methods of protecting against unwanted pregnancies, such as intrauterine devices, contraceptive injections and progestin-containing implants.
8. 8 Pay attention to possible negative reactions of the body to the components of contraceptives. Stop taking this medicine if you have chest or abdominal pain, yellow skin, severe leg pain, headache, or vision problems. Be especially careful about how you feel if you smoke. It is best if you get rid of this bad habit while taking birth control pills. Smoking significantly increases the risk of developing serious side effects of contraceptives, including the likelihood of blood clots.
9. 9 Know when to see a doctor. As mentioned, taking oral contraceptives does increase your risk of developing certain medical conditions. See your doctor immediately if you develop any of the following symptoms:
   • persistent severe headaches;
   • change or deterioration in vision;
   • aura (you see bright, pulsating lines);
   • violation of skin sensitivity;
   • severe pain in the chest area;
   • labored breathing;
   • coughing up blood;
   • dizziness and fainting;
   • severe pain in the muscles of the thighs or calves;
   • yellowing of the skin and sclera of the eyes.

Part 4 of 4: If you forget to take a pill

1. 1 Try to always take your pills on time. If for some reason you missed the next dose of the drug, you need to compensate for this.If you forget about a pill, take it as soon as you remember, and the next day, take the pill at your usual time. For some types of combined contraceptives (especially multiphasic drugs), there are special instructions that you need to follow if you forget to take a pill.
   • For most birth control pills, there is a general rule: if you forget to take a pill, take two pills the next day.
   • If you miss two days, take two tablets the day you remember, and two more the next day.
   • If you forget to take a pill on any day of your cycle, you will need to use an additional method of contraception (such as condoms) until you run out of contraceptive packaging.
   • If you forget to take your first week pill and have had unprotected sex, you may need to use emergency contraception.
   • If you are taking a single-dose progestin-only contraceptive, you need to take the pill at a specific time, the same on all days of your cycle. Even a few hours late can result in an unexpected pregnancy.
2. 2 See your gynecologist. If you forget to take a pill and do not know how to properly compensate for the missed dose of the drug, or are in doubt whether you should use emergency contraception, consult your gynecologist. Tell us in detail what exactly happened (how many pills you missed, on which days of the cycle it was, and the like).
   • The actions to be taken depend on what kind of contraceptive you are taking, so it is always best to consult a specialist.
3. 3 Consider alternative contraceptive measures if you get sick. Use other methods of contraception if you have vomiting and diarrhea (in this case, the pill cannot be completely absorbed in the digestive tract, which reduces the protection against pregnancy).
   • If a woman has vomiting or loose stools within four hours of taking the pill, the contraceptive will be less effective. In this case, it is necessary to resort to an additional method of contraception, just as in the case of a missed pill.
   • If you have an eating disorder, vomit, or are taking laxatives, oral contraception will not work for you. If this is the case, consider other methods of preventing pregnancy. See a therapist or mental health professional to get the help you need.

Tips

• If you go to your doctor about health problems, be sure to tell him that you are taking oral contraceptives or had to use emergency contraceptive drugs. This rule applies to any type of medical care, even if it seems to you that the doctor will not need this information (this also applies to dentists).
• Be open-minded about hormonal contraception. The possible side effects are not as dangerous to the body as an unwanted pregnancy.
• It is not uncommon for women to refuse hormonal contraception because they are afraid of gaining excess weight. Studies have shown that during the first year of using oral contraceptives, body weight increases by about half a kilogram, but then the woman returns to her previous weight. Thus, pills alone do not induce weight gain, although some women tend to gain weight from hormonal drugs, especially progesterone, which increases appetite.

A warning

• If for some reason you do not take the pill on time, contact your doctor right away. You can get pregnant if you don't follow the directions for your medication exactly.