Keeping It Sexy & Safe

When used perfectly, the pill is 99% effective. But when it comes to real life, the pill is about 91% effective because it can be hard to be perfect. So in reality, 9 out of 100 pill users get pregnant each year.

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The better you are about taking your pill every day and starting your pill packs on time, the better it will work. But there's a very small chance that you could still get pregnant, even if you always take your pills correctly.

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If effectiveness is the most important thing to you when picking what birth control to use, you might want to check out IUDs and the implant. They're the most effective kinds of birth control. But if you decide the pill is right for you, make sure you take them on time for the best effectiveness.
 

How long do birth control pills take to work?

 

It depends on when you start taking them. You can take your first birth control pill any day of the month, but you may need a backup birth control method (like condoms) for the first 7 days.

Combination Pills (COCs)

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• If you start combination pills within 5 days after your period starts, you'll be protected from pregnancy right away. For example, if you get your period Monday morning, you can start the pill anytime until Saturday morning and be protected from pregnancy right away.

• If you start combination pills any other time, you'll be protected from pregnancy after 7 days of taking the pill. Use another method of birth control — like a condom or female condom — if you have vaginal sex during the first week you're on the pill.

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Progestin-Only Pills (Mini Pills)

You can start progestin-only pills at any time. You'll be protected from pregnancy after 48 hours (2 days). So use another method of birth control (like condoms) if you have vaginal sex during the first 48 hours.

Your nurse or doctor can help you figure out the best time to start your birth control pills, and when they'll start working for you.
 

What lowers the pill's effectiveness?

 

The main thing that makes the pill not work is not taking it every day. But other things, like having vomiting or diarrhea for more than 48 hours may reduce how well the pill prevents pregnancy. The pill may be a little less effective for very overweight women. Some medicines or supplements can also make it not work as well:

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• The antibiotic Rifampin (other antibiotics do not make the pill less effective)

• The antifungal Griseofulvin (other antifungals do not make the pill less effective

• Certain HIV medicines

• Certain anti-seizure medicines

• The herb St. John's Wort

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If you're taking any of these, use condoms as a backup method. Switch to a different method of birth control if you'll be on them for a long time.

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Your nurse or doctor can help you decide if there's any reason the birth control pill won't work well for you.

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How safe are oral contraceptives?

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Chances are the pill will be totally safe for you — most people can take it with no problems. It's been around for more than 50 years, and millions of people have used it safely.
 

Can I take the birth control pill?

 

Like with all medications, the pill isn't for everyone.

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If you're over 35 and a smoker, you shouldn't use the pill or any other kind of birth control that contains the hormone estrogen. You can use progestin only pills (mini pills) if you're a smoker.

Also avoid using combination pills if you've had any of these health problems:

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• blood clots, an inherited blood-clotting disorder, or vein inflammation

• breast cancer

• heart attack, stroke, angina, or other serious heart problems

• migraine headaches with aura (seeing flashing, zigzag lines)

• uncontrolled high blood pressure

• very bad diabetes or liver disease

 

Talk with your doctor or nurse about your risks and health problems. It will help you decide if the pill is right for you.
 

What are the risks of birth control pills?

 

Even though birth control pills are very safe, using the combination pill can slightly increase your risk of health problems. Complications aren't common, but can be serious. These include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death. For the most part, progestin-only pills (aka mini pills) don't have these risks.

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When talking with your doctor about birth control, tell them about any medications you're taking and any health problems you've had.

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There's a very slight chance that you can get pregnant even if you always take the pill as directed. But accidentally taking the pill during early pregnancy won't increase the risk of birth defects.

It's important to remember that for most people, the chance of having any of these problems while taking birth control pills is really, really low. In fact, pregnancy is more likely to cause serious health problems than the pill. Your doctor or nurse can help you figure out which birth control method will be safest for you.
 

What warning signs should I know about?

 

Most people on the pill won't have any problems at all. But just in case, it's good to know what the signs of a serious issue are.

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See a doctor or nurse right away if you have:

• sudden back/jaw pain along with nausea, sweating, or trouble breathing

• chest pain or discomfort

• achy soreness in your leg

• trouble breathing

• severe pain in your belly or stomach

• sudden, very bad headache

• headaches that are different, worse, or happen more often than usual

• aura — (seeing flashing, zigzag lines)

• yellowing of your skin or eyes

 

You can always call a nurse, doctor, or your local Planned Parenthood health center if you have questions or you're worried about any health issues.
 

Is it safe to take the pill while breastfeeding?

 

Progestin-only pills will not affect your milk while nursing, so they're perfectly fine to use.

Combination pills may reduce the amount and quality of your breast milk in the first 6 weeks of breastfeeding. If you're nursing, wait at least 6 weeks after giving birth to start using combination pills.

Your breast milk will contain traces of the pill's hormones, but it's unlikely that these hormones will have any effect on your baby. Talk with your nurse or doctor about any concerns you may have about breastfeeding and birth control.