The Pill

COMBINATION
These use an estrogen/progestin combo that works with your body to prevent ovulation. A monthly combination pill pack contains 3 consecutive weeks of hormone-based pills and a week of placebos that’ll bring on your period.

PROGESTIN-ONLY
Better known as the mini-pill, these have no estrogen in them and are often prescribed if you’re sensitive to combination pills and having side effects. These release a small amount of progestin every day of the month and don’t give you a period during a set week.

IT TAKES DISCIPLINE
You’ve got to remember to take your pill at the same time every day. Even on weekends. Even on vacation. So, ask yourself: how good are you with stuff like that? There are also apps and tricks like setting an alarm on your phone to help pill users remember.

UNINTERRUPTED SEX
Some pills allow you to skip your period all together. Consider the possibilities!

PREDICTABLE PERIODS
If you’re the type of person who feels comforted by getting their period every month—and by not having random spotting in between—then this might just be the choice for you.

SMOKERS OVER 35, BEWARE
For those over 35 years old, smoking while on the pill increases the risk of certain side effects to your health. And if you’re younger, why not quit smoking now and save yourself the trouble in the future?

THE PREGNANCY QUESTION
You will return to fertility (which just means that you go back to being able to get pregnant) just a few days after stopping the pill. So if you don’t want to get pregnant right away, make sure you start using an alternate method as soon as you stop taking the pill.

IF YOU CAN SWALLOW AN ASPIRIN, YOU CAN TAKE THE PILL.
But here’s the thing: You have to remember to take it every day, at roughly the same time, no matter what.
Some pills come in 21-day packs. Others come in 28-day packs. Some give you a regular period every month. Others let you have your period once every three months. And some even let you skip your period for an entire year. There are so many different pills available that it can be a bit confusing. Talk to your health care provider to learn more and remember, any birth control decision such as the pill should be a fully informed decision free of coercion.

TIPS AND TRICKS
Try taking your pill at the same time you always do something else in your daily routine—like brushing your teeth. Have a box of emergency contraception on hand, just in case you forget your pill sometime during the month and then have sex without a condom or other barrier method.

THERE ARE POSITIVE AND NEGATIVE THINGS TO SAY about each and every method. And everyone’s different—so what you experience may not be the same as what your friend experiences.

THE POSITIVE
Positive “side effects”? You bet. There are actually lots of things about birth control that are good for your body as well as your sex life.

• Easy to use—just swallow with water


• Doesn’t interrupt the heat of the moment


• Might give you lighter periods


• Gives you control over when you have your period


• Some pills clear up acne


• Can reduce menstrual cramps and PMS


• Some pills may offer protection against some health problems, like endometrial and ovarian cancer, iron deficiency anemia, ovarian cysts, and pelvic inflammatory disease

THE NEGATIVE
Everyone worries about negative side effects, but for many people, they’re not a problem. And if you do experience side effects, they’ll probably go away. Remember, you’re introducing hormones into your body, so it can take a few months to adjust. Give it time.
Things that will probably go away after two or three months but if not talk to your healthcare provider about your concerns:

• Bleeding in between periods


• Sore breasts


• Nausea and vomiting

Things that may last longer:
A change in your sex drive If you still feel uncomfortable after three months, talk to your provider about trying different formulations (brands) of pills to try to correct the side effects. If you can’t find a brand you feel good on, switch methods and stay protected. You’re worth it.
*For a very small number of women there are risks of more serious side effects.

WE’RE HERE TO GET THIS METHOD WORKING BETTER FOR YOU.
And if it still doesn’t feel right, we’ve got ideas for other methods. Just remember: If you change methods, make sure you’re protected during your switch.

IT’S HARD TO REMEMBER TO TAKE THE PILL.
Consider setting an alarm on your watch or phone, downloading a reminder app or leave yourself a note. You can also try to get in the habit of grouping your pill taking with another activity, like brushing your teeth.

Still not working?
If you use a reminder system and you’re still having trouble remembering, you might want to consider a method that you don’t have to think about quite so often.
You only have to remember to change the patch once a week and you only have to worry about the ring on a monthly basis.

There are even options you can forget about for years: take a look at the 2 types of IUDs and the implant.

I KEEP BREAKING OUT WITH ACNE.
Most pills actually help with acne, so you could talk to provider to see about switching to another kind of pill.

Still not working?
If you try another type of pill and it doesn’t help, you could also switch to another hormonal method, such as the ring, the shot, the implant, or an IUD. Or you could switch to a non-hormonal method like male condoms or female condoms.

IT MAKES ME NAUSEOUS.
Try this: If you want to stay on your current type of pill, you could try taking it at night. You could also talk to your doctor about getting a pill with less estrogen.

Still not working?
You might want to try another hormonal method that’s not taken by mouth, such as the implant, an IUD,the patch, the ring, or the shot.

I’M BLEEDING IN BETWEEN PERIODS.
Try this: If you just started the pill in the last few months, try to power through. This problem will most likely fix itself. Also, make sure you are taking your pills at the same time each day and not skipping pills and then doubling up. These sorts of things can increase chances of spotting.

Still not working?
If you’ve been on the pill for a while and are taking it correctly, you might consider a new method (like the shot, the patch, or the ring), but also get checked for STIs and pregnancy, just to be sure those aren’t the reason for the bleeding.

I’M TRAVELING TO A DIFFERENT TIME ZONE AND DON’T KNOW WHEN I SHOULD TAKE MY PILL.
Basically you need to figure out what time it is in your home time zone and take it at that time. For example, if you live in Washington, DC, and you travel to Spain, which is 6 hours ahead, you should take your pill 6 hours later in the day than you normally would. So if you take your pill at 9AM in DC, you should take it at 3PM in Spain.

If it’s easier (for example, if your usual pill time falls in the middle of the night wherever you’re visiting), you can change your schedule, as long as you don’t go more than 24 hours without a pill. So, if you live in DC and you go to Spain and want to stay on a 9AM schedule, it’s totally fine to take your next pill at 9AM Spanish time (18 hours after your last East Coast pill).
Also, if you’re traveling long enough that you’ll be starting a new pack of pills while you’re gone don’t forget to stick them in your suitcase.

Still not working?
If you travel a lot and like using a hormonal method, you may want to consider switching to the ring or even the patch so you won’t have to worry so much about keeping track of time zones. If you want to completely forget about time zone calculations, check out the implant or an IUD.

I MISSED A PILL
Take your next pill as soon as you remember, and use a back-up method for 7 days afterward (unless it was a 4th week reminder pill, in which case you can just throw out the reminder pill for that day and get back on schedule).
If you’ve had sex since you got off schedule and that’s within the last five days, you might want to take emergency contraception just in case.

I MISSED MY PILL YESTERDAY AND WANT TO KNOW IF IT’S SAFE TO TAKE TWO PILLS ON THE SAME DAY.
The short answer is yes. If you missed a pill it’s sometimes recommended to take two pills in one day, and if you want to use regular pills for emergency contraception, you might take 2-4 at once. So taking 2 pills at least 10 hours apart shouldn’t be a problem. If the pills are taken close together, it could make you a little nauseous (and puking right after taking your pill is not good). Your best bet is to consult your healthcare provider and use a backup method such as condoms or abstain from sex in the meantime.

I WANT TO START TAKING MY PILL AT A DIFFERENT TIME.
That’s fine—the easiest thing is probably to finish out your current pack on schedule and start the next pack at the time you prefer. In that case you shouldn’t need any backup.
If you can’t wait for your next pack, just make sure you don’t allow more than 24 hours to pass between pills. So, for example, if you want to switch from morning to afternoon, you have to take 2 pills in one day—one at the old time and one at the new time. That’s probably better than waiting 36 hours and worrying about backup for a week! Only catch is you may also have to re-label your pill pack, because if you take the “Wednesday” pill on Tuesday night and forget to change the rest of the pack, confusion may abound.