The Combination Oral Contraceptive (OC) Pill

What Are They?

Combined oral contraceptive (OC) pills contain two hormones, estrogen and progestin.  They work by stopping ovulation (release of eggs) and by making the lining of the uterus thinner.  Among typical users who start combined pills for the first time, about 5% will experience an accidental pregnancy in the first year.  Often, this occurs because pills are not taken correctly.  If pills are used consistently and correctly, one in 1,000 women will become pregnant.  Use a backup contraceptive for the first seven days of your first pack of pills.
 
Advantages: Disadvantages: Where Can I Get Pills?
In the United States you need a prescription for OCs.  You may see a provider (M.D. or N.P.) by making an appointment for evaluation with Women’s Health at the Campus Health Service (621-9202).  After the evaluation is complete, your provider may prescribe the pill for you based upon your needs and health.  The type of pill prescribed will be based on your discussion and is influenced by your health and personal preferences.  Women that have never used the pill will need to schedule a 3-month follow up visit to Women’s Health to assess their progress and to discuss any concerns they have (no pelvic exam is required during this visit).
 
Transfer Patients
There are a few options to get the pill from Campus Health:

1) Your private physician can call in your birth control pill prescription to the Campus Health Pharmacy, (520) 621-6516.

2) You can make an appointment with Women’s Health for an annual exam and evaluation.  After the appointment the provider can write you a prescription.

3) You can make an appointment with Women’s Health for a consultation and take the following items with you:

What If I Have Sex and Don’t Use Birth Control?
You can take emergency contraceptive pills within 72 hours of unprotected sex to avoid becoming pregnant (effectiveness in preventing pregnancy is up to 75%).  The pills are available at the Campus Health Service Pharmacy and you must have a prescription.  Call Women’s Health to schedule an urgent evaluation by calling 621-7617.
 
Before Starting the Pill:
1)  Read these directions before you start taking your pills or anytime you are not sure what to do.

2)  The right way to take the pill is to take one pill every day at approximately the same time each day.  If you miss pills or start the pack late, you could get pregnant.  The more pills you miss, the more likely you are to get pregnant.

3)  Some women experience spotting/light bleeding and nausea during the first 1-3 pill packs.  If you do have nausea or spotting/light bleeding, do not stop taking the pill.  The problem will usually go away.  If it persists or is severe, consult your provider.

4)  Missing pills can also cause some spotting or light bleeding, even when you make up pills you missed.  On days that you take two pills to make up for the pill that you missed the day before, you may feel a bit nauseated.

5)  If you have vomiting or diarrhea, for any reason, or if you take some medicines (including antibiotics), your pills may not work as well.  Use a backup method (such as condoms, foam, or abstinence) until you check with your provider.

6)  Choose a backup method of birth control to keep available (such as condoms or foam).  Use the method if you:

Starting the Pill:
1)  Decide what time of day you want to take your pill.  It is important to take it at about the same time each day since this will increase its
effectiveness. 2) You may start taking your pills according to one of several different schedules.  You can: 3) Read the pill package insert that came with your pack of pills.

4) Use a backup method:

5) Call Women's Health if you have any questions or concerns, 621-7617.
 
Frequent Concerns / Minor Side Effects:

Spotting / light bleeding:

Light or skipped periods: Nausea:
Nausea is much less common with the combination (low dose) pills.  However, some women have nausea the first month or two they take the pills.  This tends to go away in the next cycle.  To relieve nausea, try taking the pills in the evening or with food.  If nausea continues for more than two cycles or is severe, see your provider.

Breast tenderness:
Some women will notice an increase (or decrease) in breast tenderness.  Often this will disappear or improve over the first few months.  If it is severe, discuss this with your provider at the three-month follow up visit.

Mood changes:
Most women do not notice mood changes when taking oral contraceptives.  Premenstrual Syndrome (PMS) symptoms tend to improve on pills.  However, some women will notice mood changes such as depression, irritability, or increased PMS when starting oral contraceptives.  If the symptoms are severe or persistent, contact your provider.

Weight changes:
Most women do not notice weight changes on combination pills.  As many women lose weight as gain weight on the pill.  If you have concerns regarding weight gain with the pill, talk with your provider.  Sometimes changing to another pill will be helpful.
 
Missed pills:
The following are steps you should take if you miss a pill or pills:

Being “reasonably certain” that you are not pregnant means that you have no pregnancy signs or symptoms (i.e., breast swelling/tenderness, your period stops or becomes very light, nausea or queasiness) and: Danger signs:
Serious complications such as blood clots may occur, but are very rare.  Call Women’s Health (621-7617) or 911 if you have any of the following: Recent studies show that women who smoke fifteen or more cigarettes per day and take birth control pills run a higher risk of heart/circulatory disease.

Fertility and the pill:

The information provided above is for educational purposes only.  Please do not use this information to diagnose yourself.  If you have further questions or concerns about this topic or any others, please contact a Campus Health Service provider, 621-9202.