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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Birth Control Pills (Oral Contraceptives)
What are birth control pills?
Birth control pills (oral contraceptives) are a method of
birth control that uses hormones to prevent pregnancy. The
man-made female hormones in the pills change a woman's
natural hormone levels and prevent her ovaries from
releasing an egg each month. The cervix also produces less
and thicker mucus so that sperm cannot easily enter the
uterus. In addition, the lining of the uterus becomes
thinner, so it would be more difficult for a fertilized egg
to stay in the uterus.
The most commonly used pills are "combined" pills. They
contain man-made forms of 2 hormones: estrogen and
progesterone. There is also a progesterone-only pill (the
mini-pill), but it is not as effective and causes a lot of
blood spotting between menstrual periods.
How are the pills used?
The combined pills usually come in a package of 28 pills.
They are also available in 21-pill packs. You and your
health care provider will decide which type of package is
best for you. Your provider will probably advise you to
start taking the pills on the Sunday after your period has
started or on the first day of your next period, depending
on your preference.
If you are using the 21-pill pack, take 1 pill every day for
3 weeks. Stop taking the pills for 7 days and then start a
new pack.
If you are using the 28-day package, take 1 pill every day
for 4 weeks and then start a new package the next day. The
last 7 pills contain no medication for birth control; they
just keep you in the habit of taking a pill every day. It
is important to try to take the pills at approximately the
same time every day.
Your period will usually occur soon after the last
hormone-containing pill is taken.
Some antibiotics can affect the way birth control pills work
in your body. If you are taking antibiotics, tell your
health care provider. You may need to use an additional
form of birth control while you are taking antibiotics.
What if I forget to take a pill?
If you forget to take some of the pills, you will have
menstrual bleeding at unpredictable times and you may get
pregnant.
If you forget to take a pill, take it as soon as you
remember and take your next pill at the usual time. If you
miss 2 consecutive pills, take 2 pills each day for 2 days
and then go back to your regular schedule.
If you miss 3 or more pills, stop taking the pills and use a
different birth control method until your next menstrual
cycle starts. If your menstrual cycle doesn't start on
schedule, check with your health care provider.
If you have forgotten to take 2 or more pills and you have
missed a period, you might be pregnant. You should stop
taking the pills and use other forms of birth control until
you are sure you are not pregnant.
Do not stop taking the pills if you have taken them
correctly.
When can I start taking oral contraceptives after having a
baby?
If you are breast-feeding your baby, you should not take
oral contraceptives until you have a good milk supply. This
will take about 4 to 6 weeks after the birth. Then, a
low-dose pill or progesterone-only pill may possibly be used.
Talk to your health care provider about when you can start
the pills again. Also, remember that breast-feeding is not
sure protection against pregnancy, so use another form of
birth control before you start taking birth control pills
again.
If you are not breast-feeding your baby, you may be able to
start taking birth control pills 1 to 2 weeks after the
birth or when you begin menstruating again. Use condoms and
spermicides until you start the pills. Be sure to check
with your health care provider before you start taking birth
control pills again.
What are the benefits?
The main benefit of birth control pills is that they are
effective in preventing pregnancy but do not interrupt
lovemaking. On average, no more than 5 of every 100 women
taking birth control pills become pregnant at the end of
1 year.
The pills also may decrease the risk of uterine and ovarian
cancer, ovarian cysts, rheumatoid arthritis, and ectopic
(tubal) pregnancy. Also, when you use birth control pills,
your periods are regular, lighter, and less painful. There
is also a lower incidence of pelvic inflammatory disease
(PID), fibrocystic changes in the breasts, and fibroadenoma
(benign tumors) of the breast.
Generally, women who have no gynecologic problems before
they start taking oral contraceptives have no trouble
becoming pregnant after they stop taking birth control
pills, regardless of how long they have been taking them.
There is no advantage to "taking a break" from birth control
pills unless you have problems specifically related to the
pills. When you want to get pregnant, it is recommended
that you wait until you have had at least 2 normal menstrual
periods after stopping the pills.
What are the disadvantages?
One disadvantage of birth control pills is that you must
remember to take a pill every day.
Problems you may have while you are taking birth control
pills include:
- irregular bleeding for the first few months after you
start birth control pills
- nausea and vomiting
- weight gain
- breast swelling and tenderness
- increased appetite
- depression
- headaches
- scant or missed periods
- high blood pressure
- dizziness.
Women who take birth control pills and smoke, especially
those over 35 years old, have an increased risk of severe
problems such as heart disease and blood clots. The heart
disease could cause a heart attack. The blood clots may
cause leg pain or swelling, chest pain, stroke, or death.
Have your blood pressure checked after you have taken the
pills for 3 months. You should not smoke if you take birth
control pills.
Birth control pills do not protect you from sexually
transmitted diseases such as AIDS. Latex condoms are the
only safe way to protect against AIDS.
When should I call my health care provider?
Call your health care provider if you have:
- leg pain or swelling
- loss of vision or double vision
- bleeding irregularities
- more headaches than usual
- numbness of arms, legs, or any other part of your body.
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