Birth Control Pills

Birth control pills or “oral contraceptives” were the first hormonal birth control method available to women. “The Pill” has been available since the 1960s, and millions of women use it to prevent unintended pregnancy.


Birth control pills contain hormones that are naturally produced in a woman’s body. Most birth control pills contain the hormones estrogen and progestin, although there are some pills that contain progesterone only. The hormones in the pills prevent pregnancy by stopping ovulation (the release of the egg), and thickening the cervical mucus (so the sperm can’t get through).

Some women find it helpful to imagine that birth control pills ‘trick’ their body into thinking it’s pregnant; typically, when a woman is pregnant, she does not ovulate.

Birth control pills require a prescription. A woman who is interested in using them should contact her health care provider or local reproductive health clinic. Most clinicians require that a woman have a full physical exam (including a pelvic exam and a Pap test) before starting on birth control pills.

In order for birth control pills to work as well as possible, the woman using them must taking one pill a day, at the same time each day. The specific time that she sets to take the pill doesn’t matter, as long as she can take her pill at about that time EVERY day.

The woman should start taking her pills on the designated day and continue taking one pill a day until all the pills in the pack are gone. Most pill packs clearly indicate the pill that starts the pack, which is where the woman should begin taking them. If the pills that a woman is using contain 21 hormone pills and 7 non-hormone (or spacer pills), she should start the pack by taking the hormone pills for 21 days, and then take the non-hormone pills for 7 days. At some point while she is taking the spacer pills, she will likely have a period. After 7 days of spacer pills, she should begin a new pack of pills. If her period hasn’t stopped already, it will shortly thereafter.

If a woman misses one or more pills in her cycle, she should read the patient information that came with the pills or contact her health care provider for instructions on how to make up the pills that she’s missed.

Also, if a woman is taking any other medications (like antibiotics), she should let her health care provider know, as they can decrease the effectiveness of oral contraceptives.

Most women on birth control pills find that their menstrual periods are lighter, shorter, more regular, and less uncomfortable than their natural periods. Some women also find that their facial complexion improves.

Some women using birth control pills experience slightly uncomfortable nuisance side effects:

o Breakthrough bleeding
o Nausea (upset stomach)
o Headaches
o Breast tenderness
o Moodiness
o Appetite changes
o Weight gain (though some women lose weight)

Generally, these side effects are mild and tend to go away after the first few months of pill use. If a woman feels that her side effects are moderate or severe, her clinician may allow her to switch pill brands, which can help reduce side effects for some women.

It is important for women to know that there are some potentially serious side effects that can occur as a result of taking birth control pills, like heart attack, stroke, and blood clots. These side effects are uncommon, and are more likely to occur in women who are over 35 years old and who smoke 20 (a pack) or more cigarettes a day. Although these things are rare, it is important for all women to be aware of the symptoms of serious side effects:

o Pain or swelling in the legs
o Vision problems (like blurriness)
o Sudden pain in the abdomen/chest/arm
o Worsening of depression
o Jaundice (yellowing of the skin or eyes)

If a woman is taking birth control pills and she experiences any of these symptoms, she should contact a health care provider immediately.

For a woman who takes her pills perfectly, they are 99.7% effective in the prevention of pregnancy. However, very few people take their pills perfectly. The rate of effectiveness for the typical user is about 95%. Birth control pills do not provide any protection against Sexually Transmitted Infections (STIs) or HIV.

o Excellent protection against unintended pregnancy
o More comfortable periods
o Some health benefits including treatment and prevention of a number of health problems [like Polycystic Ovary Syndrome (PCOS)]

o Requires a woman to remember to take a pill every day
o Requires a woman to take a pill every day
o Possible unpleasant side effects
o Women that have sex infrequently might not feel that having to take a pill every day is worth it
o No protection against STI/HIV

The cost of the exam that may be required before a woman starts on birth control pills varies by provider. Some women may be able to get their exams for free, while others pay $20 to $150 or more, depending on their insurance coverage, if any.

How much someone pays for the pills themselves depends on where she gets them. Women who come to the Family Planning Association for birth control pills are asked to pay $7 per pack (a 28-day supply) or less, depending on what they can afford. A woman who gets her pills from a pharmacy should expect to pay $20-$35 per pack (a 28-day supply), depending on the brand and the store. Some health insurance companies will pay for birth control pills, and some will not.