Contraception – Oral Contraceptives


The goal of contraception (or birth control) is to prevent an unplanned pregnancy. The majority of methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
Oral contraceptives prevent ovulation (release of a ripened egg from the ovary) and therefore make pregnancy unlikely or impossible. There are three types of contraceptive pills: combination, sequential, and daily progestogen.

The combination type, combing both estrogen and a synthetic progestogen, are the most popular and the most effective. At present, oral contraceptives other than the combination type are infrequently prescribed and then only for special reasons.


  • Effective, with lower failure rate of any nonpermanent method-less than 0.1 pregnancy per 100 women per year, if all pill are taken as prescribed.
  • Freedom from fear of pregnancy.
  • Spontaneity of sexual experiences.
  • Regulation and less painful menstrual periods.
  • Decrease in the amount of menstrual bleeding in most women.
  • No increase in risk of breast cancer and decrease in risk of initiating benign breast disease.
  • Less likelihood of anemia or arthritis.
  • Decrease in incidence of pelvic inflammatory disease.
  • Decrease in thickness of the lining of the uterus.


  • There are many conditions that might prevent your taking the pill. Your doctor will take a thorough medical history and perform a physical examination prior to prescribing oral contraceptives. If any of the conditions are present that prelude prescribing the pill, another form of birth control will be recommended.
  • There may be other side effects from the pill. Many of these occur rarely and, even when the do, will frequently decrease in severity with passage of time. Most patients experience no side effects at all. Side effect may include-enlargement of fibroid tumors (leiomyomas); breast fullness or tenderness; increase of serum copper and iron levels; alteration of thyroid tests as if you were pregnant; fluid retention; missed periods; acne; mild headache; high blood pressure (hypertension); thrombophlebitis-less likely with pills with minimum estrogen content and in non-smokers; impairment of glucose tolerance; weight gain; nausea; vomiting; diarrhea; stroke (rare); depression or easy mood shifts; change in sex drive (may be more or less); decrease of levels of some vitamins and minerals (as in pregnancy); elevation of triglycerides and cholesterol; increase in incidence of gallstones; depigmentation of areas of the skin, made worse by sun exposure; increased likelihood of vaginal yeast infection, with itching and discharge.
  • Will not protect against sexually transmitted disease (STDs). A form of barrier protection will need to be used.


Note: Use a second contraceptive method during your first cycle of pills – otherwise you will be inadequately protected.

Combination pills:

  • Count the first sign of your menstrual cycle as day 1.
  • On day 5, begin taking 1 pill each day. Pick a time that suits you and stick to it as your routine.
  • Continue taking the pills for 21 days.
  • Begin taking pills again for the next cycle after these 7 days, no matter when menstrual bleeding begin or ends.
  • If you forget a combination pill take it as soon as you remember. Take the next pill at the regular time (with very low dose of pills, another form of contraception should be used for the remainder of the cycle).
  • If you forget 2 days in a row, take 2 pills as soon as you remember and 2 pills the next day. Also, for the remainder of this cycle, use an additional form of contraception: condom, foam, jellies, diaphragms, and so on.
  • If you forget for 3 days or more days, stop taking any pills, wait for 7 days, then start on a brand new packet. Use another form of contraception for a month.

Note: Some packets come with 28 pills. Follow instructions on the package.


Note: Use a second method of contraception during your first complete cycle-otherwise you will be inadequately protected.

  • Start on day 5 as explained above, but continue to take a pill every day without interruption.
  • If you forget a mini pill, take 2 as soon as you remember, but use an additional contraception method for 3 or 4 weeks.


Do not use any medicines, even those you buy without prescription, before discussing them with your doctor. Carefully follows the instructions on any prescription.