If you’ve ever been curious about birth control pills, one of the most talked-about but often misunderstood topics, this guide is for you. Let’s break down the different types of birth control pills, how they work, and what to keep in mind when using them.
### Types of Birth Control Pills
#### 1. Combination Pills
These are the most common type of birth control pills and include two hormones—progestin and estrogen. They come in 21-day, 28-day, or even 91-day packs, which determine the schedule for taking the pills.
– **28-Day Packs**: With these, you’ll take one pill every day for 28 days. The last week contains reminder or placebo pills without hormones, which help maintain the routine and often include supplements like iron. Your period typically comes during this time.
– **21-Day Packs**: You take one pill daily for 21 days, then skip pills entirely during the fourth week to allow your period to happen. Since there are no placebo pills, you’ll need to set reminders to stay on schedule.
– **91-Day Packs**: These packs provide 12 weeks of hormonal pills followed by a week of placebo pills, which means you’ll only have your period about once every three months.
#### 2. Progestin-Only Pills (Mini-Pills)
Mini-pills contain only progestin, making them an option for people who can’t take estrogen. They require strict timing—you must take them within the same three-hour window each day to remain effective. These come in 28-day packs with no placebo pills, and periods may become irregular, lighter, or stop altogether.
### Using Pills to Skip Periods
If you want to skip your period, it’s as simple as continuously taking active hormonal pills. Options include using pills specifically designed for extended use (like 3-month packs) or skipping the placebo pills in your pack and starting a new one immediately. While you may experience some spotting at first, this usually resolves in a few months. Skipping periods is safe and can be helpful for events or travel plans.
### If You Miss a Pill
Birth control pills work best when taken at the same time daily, but forgetting happens to everyone. If you miss a pill, check the instructions on your packet. As a backup, you may need to use condoms or consider emergency contraception depending on how many pills you missed. Keep a consistent supply of pills and set alarms or use an app for reminders.
### How to Start Birth Control Pills
When starting combination pills, there are three common approaches:
1. **Day 1 Start**: Begin on the first day of your period. You’ll be immediately protected from pregnancy.
2. **Quick Start**: Begin anytime but use backup contraception (like condoms) for the first 7 days.
3. **Sunday Start**: Start on the Sunday after your period begins, even if it starts on the weekend. Use backup methods for the first week.
Mini-pills, however, begin protecting against pregnancy only after 48 hours, so you’ll need backup contraception for the first two days.
### Post-Pregnancy Use
After childbirth, miscarriage, or abortion, it’s important to talk to your doctor about when to start birth control. Progestin-only pills can usually be started right away, while combination pills are often delayed for about 3 weeks. If you’re breastfeeding, keep in mind that traces of hormones can pass into breast milk, though they’re not harmful for most babies.
### Common Side Effects and Considerations
Birth control pills can cause mild side effects like breast tenderness, nausea, spotting, or headaches when you first start taking them. These typically go away within 2-3 months, but if they persist or feel severe, your doctor may recommend switching to a different type or brand. Pills can also affect your period, making it lighter or potentially causing it to stop altogether.
While the pill is highly effective when taken correctly, no method is 100% foolproof. If you miss your period but have been taking your pills as directed, take a pregnancy test to be sure. Birth control pills are also not protective against sexually transmitted infections (STIs) or HIV, so consider using condoms as a backup protection method.
### Is the Pill Safe?
For most people, birth control pills are safe and have been widely used for over 50 years. However, they aren’t suitable for everyone. Combination pills, in particular, are not recommended for smokers over 35 or individuals with specific conditions like blood clots, breast cancer, heart attack, or liver disease. Mini-pills may be a better option for people with certain health concerns, such as high blood pressure or migraines.
While rare, serious complications like blood clots, stroke, and liver tumors are possible. Speak to your doctor if you experience sudden symptoms like severe headaches, chest pain, breathlessness, or yellowing of your skin or eyes. It’s also important to review your entire medical history with your doctor before starting any type of pill.
### Benefits and Risks
Combination pills have the added benefits of reducing menstrual cramps, lightening heavy periods, and lowering the risk of ovarian and endometrial cancers, as well as conditions like pelvic inflammatory disease. However, they can also cause side effects like slight weight gain, mood swings, or changes in libido.
Mini-pills, while easier on those with certain health conditions, come with their own drawbacks—namely, reduced efficacy compared to combination pills and higher chances of irregular bleeding.
### Finding the Right Pill
Choosing the right pill largely depends on your health, menstrual patterns, and personal preference. Some women prefer low-dose pills to minimize hormone exposure, but these may cause occasional spotting. Others may choose extended-cycle pills to reduce the number of periods each year.
### Interactions with Medications
Certain medications, like antibiotics, seizure drugs, HIV treatments, and even herbal supplements like St. John’s Wort, can reduce the effectiveness of birth control pills. Always inform your doctor about any medications or supplements you’re taking before starting the pill.
### Final Thoughts
While birth control pills are a popular and effective way to prevent pregnancy, they aren’t one-size-fits-all. Discuss your options with your doctor to find the pill—or alternative method—that works best for your body and lifestyle. And remember, regular medical check-ups can help ensure you’re using the safest and most effective method of contraception for your needs.