The Pill

Over 100 million women worldwide currently use an oral contraceptive, "the pill," to prevent pregnancy. The pill is also widely used to regulate menstrual periods, reduce menstrual cramps, and treat hormonal imbalances and ovarian cysts. The pill is a combination of estrogen and progestin. These are the same hormones that are naturally produced in the ovaries and are responsible for ovulation and the menstrual cycle. There are a number of different brands available, manufactured by several different companies.

The questions and answers outlined below provide important information to assist you in using the pill in the safest and most effective manner. Be sure to read this information before you start taking birth control pills and refer to it any time that you have a question about them. Please feel free to discuss with your provider any questions or concerns that you may have about taking the pill.

How does the Pill work?

How effective is the Pill?

The pill is 97-99% effective when taken correctly. If you stop taking the pill, you may become pregnant very soon. Start using an alternative method of birth control immediately if birth control pills are discontinued (to avoid an undesired pregnancy).

What are the benefits of the Pill?

Who should or should not take the Pill?

Each person is evaluated on an individual basis. Determining factors include past medical history, family history and findings of a physical exam.

You should NOT take the pill if you have any of the following medical conditions:

Other considerations to discuss with your health care provider before taking oral contraceptives:

What are the risks?

The risks of using birth control pills are low, when compared to the risks of pregnancy and childbirth. Nearly all the risks are associated with the development of blood clots and blockage of blood vessels, which can cause decreased blood flow to vital organs including the brain, lungs, heart or eyes.

Please read the package insert that is included in each pill pack for additional risks associated with oral contraceptive use.

If you experience any of the following symptoms, you should seek medical care right away:

A  - Abdominal pain (severe)

C  - Chest pain, shortness of breath, coughing up blood

H  - Headache (severe), numbness or weakness in arms or legs

E  - Eye problems (vision loss, blurring, flashing lights)

S  - Severe leg pain in calf or thigh

After starting birth control pills, if you experience new onset headaches or you notice a change in the frequency or severity of the headaches, especially if you begin to experience light sensitivity, visual disturbances or nausea you should contact your health care provider immediately.

What about cancer and the Pill?

Since 1960, when birth control pills first became available, important information about pills and cancer has been learned:

What are the side effects?

There is a wide range of common side effects that can be annoying, but usually not harmful. Most people will experience only a few and by the end of the third package of pills, the side effects will have resolved spontaneously. If you continue to experience unpleasant side effects, you should contact the McKinley Dial-a-Nurse or come to the Women's Health Clinic during Walk-In hours. Usually, a switch to a different pill will resolve the problem. Some of the common side effects and suggestions for coping with them are:

These are a list of the most common side effects. There are other side effects which you, as an individual, may experience. If any symptom is severe or persistent after completing three pill cycles, contact the Dial-A-Nurse or come to the Women's Health Department during Walk-In hours and talk with a provider BEFORE discontinuing your birth control pills. We can often change the type of pill you are taking and resolve the problem.

How do I get a prescription for the Pill?

All women taking the pill are encouraged to have an annual health evaluation. This can be done by the providers in Women’s Health or by your home doctor or nurse practitioner.

Women seeing a McKinley provider and starting pills for the first time are required to complete an online birth control education class. If you have taken the pill from another provider previously, you are not required to complete the class, but it is available to all University of Illinois students. Through the class you will have the opportunity to learn about all of the methods of birth control available.

Women seeing their home provider may bring a written prescription to the McKinley Pharmacy or may have it faxed to the pharmacy from the doctor’s office. There is a list of available birth control pills in the McKinley Health Center handout, Transferring Outside Contraceptive Prescriptions to McKinley. You may want to take that handout with you so your provider knows what pills are available at McKinley.

How do I take the Pill?

Taking your birth control pill at the same time every day is important. This provides a steady dose of medication to your body, increasing its effectiveness and reducing the risk of breakthrough bleeding. Missing pills increases the risk of pregnancy and often causes spotting or breakthrough bleeding. Starting a new pill cycle LATE also increases the risk of pregnancy. If you do not start your new pill cycle on the day you are scheduled to do so you must use backup birth control until you have been back on active birth control pills for seven days.

Your pill pack contains 21 active pills and 7 reminder pills. Begin with the first active pill in the cycle, and take an active pill every day. When the active pills are gone, begin the reminder pills. Your period should start and end while taking the reminder pills. When all the pills are gone, open a new package of pills and begin the active pills again. You do not take any days "off."  If you notice that your periods start persistently before you finish the active pills, or that the period lasts into the active pills of the next cycle, notify your provider.

Continuous dosing (taking 2 or 3 months of active pills consecutively, while omitting the “reminder” or inactive pills) is an option to lengthen your period-free weeks and decrease the number or menstrual periods you have per year. It is not recommended that you take more than three cycles of active pills consecutively before having a period. Continuous dosing does increase the incidence of spotting or irregular bleeding and usually works the best if the pills are all one dose throughout the month (referred to as “monophasic” pills). Pill packs that contain different colors or shapes of active pills (triphasic pills) should not be used for continuous dosing. Talk with your provider if you are interested in this method of taking pills.

If you have vomiting or diarrhea, or take antibiotics, your pills may not work as well. Use a backup method of birth control during the illness, or while on the antibiotic, and for seven days afterward. Taking laxatives or the preparations required for certain types of x-rays or diagnostic tests may also interfere with the absorption of the pill. Again, use backup birth control for seven days, after the tests are finished.

Birth control pills may interact with other medications, also. You should inform any health care provider you see, for any reason, that you take birth control pills. Also, review the handout Pill Interactions with Other Drugs.

How do I start the first cycle of Pills?

You have a choice of which day to start your first cycle of pills. Review these instructions and decide which is best for you. Pick a time of day that will be easy to remember.

Day 1 Start

Sunday Start

Quick Start

What do I do if I miss Pills?

See the instructions below for your oral contraceptive dosing schedule. If, for any reason, you are not sure what to do about missed pills or interactions with other medications, continue taking a pill every day, AND use a backup method of birth control, until you can call your provider.

MISSED PILL INSTRUCTIONS: Combined Oral Contraceptives (28 day pill cycle)

Missed 1 ACTIVE PILL and less than 24 hours late — Take 1 Active Pill ASAP and continue as usual.

If you miss taking ONE ACTIVE PILL (in ANY WEEK) at the regular time and less than 24 hours have passed, take the 1 missed active pill ASAP* (as soon as possible) and continue pack as usual.

Missed 1 or more ACTIVE PILL(s) more than 24 hours late

During Week 1:

During Week 2or 3 and missed 1 or 2 pills:

During Week 2 or 3 and missed 3 or more pills:

During Week 4:

MISSED PILL INSTRUCTIONS: Extended Cycling or Continuous Hormonal Contraceptives (For example, 9 weeks of ACTIVE pills)

Missed pills day 1 through 21:  Follow the instructions above

Missed pills after day 21:

When backup birth control is recommended      

Condoms and spermicide are effective and easily obtained birth control options. Condoms are also recommended to decrease exposure to sexually transmitted diseases. Condoms and spermicide are available to Illinois students at the Health Resource Centers:

Main Health Resource Center (HRC) Locations:

McKinley Health Center
Information/HRC Counter (in main lobby)
1109 S Lincoln Ave
Phone: 333-6000

Illini Union
Room 40 (lower level)
1401 W Green St
Phone: 244-5994

Satellite HRC Locations:

(limited hours, only during fall and spring semesters)

African American Cultural Center
708 S Mathews
Phone: 333-2092

La Casa Cultural Latina
1203 W Nevada, 2nd Floor Library
Phone: 333-4950

References

Missed Doses of Hormonal Contraceptive. Pharmacist’s Letter/Prescriber’s Letter 2009; 25(1):250120.
Hatcher, Robert A., et al. Contraceptive Technology. 19th ed. New York: Ardent Media, 2007.
Patient Instruction Sheets enclosed in each package of birth control pills.