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Considering the Pill? Here’s What to Discuss With Your Doctor

In the United States, birth control pills have been around since the Food and Drug Administration (FDA) approved them in 1960. They can be a reliable way for women to prevent pregnancy, and in some instances, can even help treat certain health conditions. If you’re considering taking the pill, you might have questions. Amy Snell, a women’s health nurse practitioner with Banner Health Clinic in Page, AZ, has some answers.

How do birth control pills work?

Birth control pills contain hormones that help keep you from getting pregnant. There are two main types of pills. One type contains progesterone only, and the other contains estrogen and progesterone.

Those that contain progesterone:

  • Thicken the mucus in your cervix, which makes it harder for sperm to get to the egg
  • Make the lining of your uterus thin
  • Help prevent ovulation

Pills that contain both estrogen and progesterone completely stop ovulation, in addition to these other changes.

How effective are birth control pills?

Typically, after you’ve been taking them for five to seven days—depending on the kind you are taking and where in your cycle you start using them—they can be 99% effective with perfect use. With typical use—which includes forgetting to take the pill once in a while or taking it inconsistently—they are 92% effective. It’s always important to read the medical insert that comes with your pill pack to make sure you know exactly how to take your pills to ensure maximum effectiveness.

How do I know which type of pill is right for me?

It is always best to discuss the different options with your health care provider, so they can make a recommendation based on your overall health and other medications you are taking. You also want to consider your ability to stay on a strict schedule, which is necessary for some pills.

A common choice is the combination pill, with both estrogen and progesterone. You should take these pills consistently every day, but the timeframe isn’t as strict as it is with progesterone-only pills.

Along with preventing pregnancy, pills that contain estrogen and progesterone can help alleviate heavy, painful periods and even help treat acne. They can also help reduce the risk of uterine, ovarian and colon cancer.

However, talk to your doctor about whether estrogen is right for you. Estrogen is not recommended for:

  • Women who smoke and are 35 or older
  • Women who have just given birth
    • Most women can resume taking combination pills after breastfeeding is established, usually six weeks after delivery
  • Women with a blood-clotting disorder, uncontrolled high blood pressure, certain heart or blood vessel problems, breast cancer, certain liver problems, gallbladder disease, migraines with aura, lupus, prolonged diabetes or complications from diabetes

“Progesterone-only pills (sometimes called the ‘mini-pill’) are a safe and effective option if you cannot or prefer not to take estrogen,” Snell said. You can take them right after you have a baby, and they are safe if you are breastfeeding. But you need to be careful about timing when you take them—you need to take them within a three-hour timeframe consistently.

You should not take birth control pills for male-to-female transgender care—that requires a different type of hormone therapy. Birth control pills are intended for people who are genetically female. However, they can be used to prevent pregnancy in female-to-male transgender care.

Will I still get my period when I’m on the pill?

Yes, though both types of pills should make your period lighter and shorter over time.

Combination pills come in monthly packs with three weeks of active pills. For the fourth week—during the time when you can expect your period—some pill packs have a week of sugar or placebo pills, while others have no pills.

Traditionally, progesterone-only pills have a full month of active pills with no placebo pills. However, there are some newer formulations of progesterone-only pills that include both active and non-active pills. Some women can also take seasonal or extended-cycle pills, so they only have a period every three months.

What side effects could the pill cause?

Both types of pills change the consistency of your vaginal discharge. Discharge can become thicker and whiter, but if you notice an increase in discharge plus itching, that could be a sign of infection, and you should talk to your doctor.

Some women notice irregular vaginal bleeding, spotting, breast tenderness, headache and nausea in the first few months. If you’re experiencing side effects, talk to your doctor. Your doctor can help you manage side effects or possibly recommend a different pill.

“Birth control pills are not one size fits all. If one type of pill does not work, that doesn’t mean that every type will not. You can work with your doctor to figure out what is best,” Snell said.

Rarely, pills can cause blood clots. Stop taking the pill and seek emergency care if you notice significant abdominal pain, chest pain, severe headaches, visual changes, swelling or aching in the legs or thighs.

What if I decide I want to get pregnant?

Your fertility can return within 24 hours of stopping the pill.

Do birth control pills protect against sexually transmitted diseases?

No. You still need barrier protection, such as male or female condoms, with new or untested partners of either sex.

How much does the pill cost?

Your prescription can cost up to $50 per month, but many types of pills come in generic options, which can cost less. And birth control pills are free under many private insurance plans and government programs.

What questions should I ask my doctor?

You’ll want to ask your doctor about the benefits and risks of birth control pills based on your overall health—they aren’t recommended for women with certain medical conditions. Your doctor can explain how the pill works and how you might feel.

If you decide to take the pill, your doctor can tell you how to use it and what to do if you miss a dose. If it’s difficult for you to take medication at the same time every day, another form of birth control might be a better choice.

Your doctor can also talk to you about your other options for contraception. “While the pill might be a great option, it’s not the only one,” Snell said.

Where can I get more information?

Your health care provider is an excellent source of information. If you’re looking to learn more online, it’s important to use reputable sites. Snell recommends the Centers for Disease Control (CDC) for good information about birth control.

The bottom line

Birth control pills are a safe and effective way for a lot of women to prevent pregnancy. They can also help alleviate heavy, painful periods and acne. If you would like to connect with an OB/GYN to talk about your options, reach out to Banner Health.

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