- The pill has been around for 50 years. They are easy to swallow and can have positive side effects
- Effectiveness: the pill is really effective when taken perfectly, but most women do not take it perfectly. With a perfect use 99 in every 100 women will manage to prevent pregnancy.
- Side effects: the most common are sore breasts, nausea, spotting, and decreased sex drive
- Effort: high. You need to take a pill at the same time every single day
- Doesn’t protect against sexually transmitted infections (STIs).
“The Pill” is a small tablet that comes packaged for each month. Some people call it “oral contraception.” You take it once a day, at the same time every day. There are many different kinds of pills available, and new options are available often. Most work by releasing hormones that keep your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place.
Types of pills:
Combination. Combination pills use two types of hormones –estrogen and progestin- to prevent ovulation. A monthly combination pill pack contains 3 weeks of hormone-based pills and a week of hormone-free pills. You will take the hormone-free pills while you wait for your period each month.
Progestin-only. These have no estrogen in them and are often recommended if you are sensitive to combination pills. They are also recommended if you have side effects from a combination pill. They release a small amount of progestin every day of the month and do not give you a period during a set week.
The pill takes discipline. You need to remember to take your pill at the same time every day. If you do not take it at the same time every day, then it will not work as well.
You want predictable periods. If you like getting your period every month, with no spotting, then the pill may be a good choice.
You can skip your period. Some pills allow you to skip your period altogether, which is 100% safe.
Smokers over 35 years old, be careful. For women over 35 years old, smoking while using the pill increases the risk of certain side effects.
You want to stop using a contraceptive method and get pregnant quickly. You will be able to get pregnant a few days after stopping the pill. If you stop using the pills and do not feel ready to get pregnant, use another method.
Availability. Would you like to use this method? Check out the “Methods in my country” section to learn what is available
How To Use
If you can swallow an aspirin, you can take the pill. But the important thing: you have to remember to take it every day, at the same time, no matter what.
Some pills come in 21-day packs. Others come in 28-day packs. Some give you a regular period every month. Others let you have your period once every three months. And some let you skip your period for an entire year. There are many different pills available, and it can be a bit confusing. A health provider or trained community health worker can help you figure out which pill is right for you.
Everyone is different. What you experience may not be the same thing as another person.
The Positive: there are lots of things about the pill that are good for your body as well as your sex life.
- The pill is easy to use – just swallow it with water
- You do not need to interrupt sex to use it
- Might give you lighter periods
- Gives you control over when you have your period
- Some pills clear up acne
- Can reduce menstrual cramps and premenstrual syndrome (PMS) symptoms
- Some pills offer protection against some health problems: like endometrial and ovarian cancer; iron deficiency anemia; ovarian cysts; and pelvic inflammatory disease
The Negative: Everyone worries about negative side effects, but for many women, they are not a problem. And if you do experience side effects, they will probably go away. Remember, you are introducing hormones into your body, so it can take a few months to adjust. Give it time.
Things that will probably go away after two or three months:
- Sore breasts
- Nausea and vomiting
Things that may last longer:
- A change in your sex drive
If you feel the side effects are more than you can accept after 3 months, switch methods and stay protected. Condoms offer good protection while you find a method that suits your needs. Remember, there is a method for everyone, everywhere!
* For a very small number of women, there are risks of serious side effects.
- We are here to help you. If it still does not feel right, we have ideas for other methods. Just remember: If you decide to change methods, make sure to stay protected while you switch. Condoms offer good protection while you find a method that suits your needs.Should I be worried about spotting?
- Spotting can happen with a bunch of different methods. You do not lose that much blood with spotting, even though it might seem like it.
- Still not working? You may have more luck on a pill with a slightly higher dose of estrogen, or one that provides estrogen during a different part of your cycle.
- Try a different method: IUD
Will the pill give me cancer?
- The pill does not give you cancer. In some very rare cases, women may get a blood clot. The risk of getting a blood clot while taking the pill is lower than the risk of getting a clot while pregnant. Some women have medical problems that mean they should not use the pill.
- If you are healthy, contraceptive pills are very safe. They can help you with some problems now (like anemia from heavy periods) as well as later in life (they may protect you against some kinds of cancer).
What if I have problems remembering to take the pill?
- Try setting a daily reminder on your mobile device.
- Still not working? If you use a reminder system and you are still having trouble remembering, you might want to consider a method that you do not have to think about quite so often.
- Try a different method: implant; IUD ; patch ; ring
Is it normal to get acne?
- Most pills help with acne. If you think the pill is causing the acne, consider switching to another kind of pill.
- Still not working? If you try another type of pill and it does not help, you could also switch to another hormonal method. Consider ring, The Injectable, implant;, or an IUD . Or, you could switch to a non-hormonal method like external condoms (male).
- Try a different method: internal condom (female); implant; IUD ; condom; ring,; The Injectable
Why does the pill make me nauseous?
- Try this: if you want to stay on your current type of pill, try taking it at night. You can also think about getting a pill with less estrogen.
- Still not working? You might want to try another hormonal method that is not taken by mouth, such as implant; an IUD; patch; ring; injectable
- Try a different method: implant; IUD; patch; ring; injectable
Why am I bleeding between periods?
- If you just started the pill in the last few months, try to power through – this problem will most likely fix itself. Make sure you are taking your pills at the same time each day and not skipping pills and then taking two at once. Skipping pills or taking two at once can increase chances of spotting.
- Still not working? If you have been on the pill for a few months, are taking it correctly, and still spotting, then consider a new method. You should also get checked for STIs and pregnancy, just to be sure those are not the reason for the bleeding.
- Try a different method: patch; ring; injectable
What if I travel to a different time zone? Do I have to adjust when I take my pill?
There are different options:
Option 1: Keeping the time of your home country
- You need to figure out what time it is in your home time zone and take it at that time. For example, if you live in Mexico City and you travel to Morocco, which is 6 hours ahead, you should take your pill 6 hours later in the day than you normally would. So if you take your pill at 9 am in Mexico, you should take it at 3 pm in Morocco.
- If you remember your pill by setting the alarm on your phone, make sure to adjust it as needed when you are on the road.
Option 2: Adjusting to the new time zone
- If it is easier, or if you are moving to a new place for a long period, you can change your schedule, as long as you do not go more than 24 hours without a pill. So if you live in Mexico City and you go to Morocco and want to stay on a 9 am schedule, it is totally fine to take your next pill at 9 am Moroccan time (18 hours after your last Mexico pill).
If you are travelling long enough that you will be starting a new pack of pills while you are gone, do not forget to pack them in your bag. If you are forced to suddenly travel, and you didn’t have the opportunity to pack your pills (e.g. you are in a disaster area), then try to find a local health provider or community health provider as soon as possible in your new location. Use natural methods in the meantime if you can’t access other options, like condoms.
Still not working? If you travel a lot and like using a hormonal method, you may want to consider switching to ring or even patch so you will not have to worry so much about keeping track of time zones. If you want to completely forget about time zone calculations, check out the implant or an IUD.
I missed a pill, or I took my pill late. What do I do?
- Take your next pill as soon as you remember, and use a back-up method for 7 days afterwards. If it was a placebo pill during the 4th week, throw out the placebo for that day and get back on schedule the next day.
- If you have had sex since you got off schedule and that is within the last five days, you might want to take emergency contraception just in case.
I missed my pill yesterday. Is it safe to take two pills on the same day?
- If you missed a pill then sometimes it is recommended to take two pills in one day. Taking the two pills at least 10 hours apart should not be a problem. Taking them closer together could make you a little nauseous, and you do not want to throw up after taking the pills.
- If you want to take regular contraceptive pills as emergency contraception, you might take 2-4 at once.
- If it has been more than 24 hours since your last pill, use a second method, like a condom or internal condom (female) anytime you have sex for the next 7 days.
What if I want to start taking my pill at a different time each day?
- That is fine. The easiest way to do that is to start your next pack of pills at the time you prefer. You will not need a backup that way.
- If you cannot wait for the next pack, just make sure you do not wait more than 24 hours between pills.
Is the pill bad for the environment?
- Any method is better than no method when it comes to the environment.
- Some of the hormones from the pill will enter the environment through a woman’s urine. But it is smaller than other sources of estrogen in the environment.
- Estrogen from industrial and manufacturing processes, fertilizers and pesticides, and the drugs given to animals all enter the environment in larger amounts than the estrogen in a woman’s urine from the pill.
- If you do not want to add hormones to the environment or your body, there are options for you. Natural latex condoms and the copper IUD are both good options. Whatever you decide, pick a method and keep using it.
- Still not working? If would like to use a very effective method without any hormones, try the non-hormonal IUD.
- Try a different method: IUD
Does the pill prevent pregnancy if I am taking antibiotics?
- Rifampin is the only antibiotic that has been shown to lessen the effectiveness of the pill. It is usually used to treat tuberculosis.
- If you need to take rifampin, talk with your provider about what method is best.
What if I threw up after taking my pill?
- If you throw up within two hours of taking your pill, treat it as a missed pill. Take the next pill in your pack right away.
- Use a second method, like or internal condoms (female), for the next seven days to be on the safe side.
What if I had diarrhea after taking my pill?
- Having diarrhea sometimes will probably not affect how well your pill works.
- Severe diarrhea (several times in one day) might affect how well your pill works.
- You should use a second method (like a condom) if you have severe diarrhea. You should use the back-up method every time you have sex while sick, and for the 7 days after you recover.
- Still not working? Forgetting to take a pill, throwing up right after one, or having severe diarrhea are reasons why the pill has a 9% failure rate. If that it is too risky for you, use a back-up method. Another option is to switch to a method that requires less effort.
- Try a different method: condom; implant; IUD ; ring
Is it safe to take the pill for years without a break?
- If you want to get pregnant, then you should just stop taking the pill. Research about contraceptive pills over the years indicates that using the pill for years does not affect your ability to get pregnant once you stop taking the pill.
- If you experience spotting, taking a break sometimes may help manage it. If you want to take a break, stop using the pill for 3-7 days. Use a second method, like a condom, every time you have sex during the break and for the first seven days after you start taking the pill again.
- Still not working? If you smoke or have a medical condition that makes the pill risky for you, consider trying a progestin-only method instead.
- Try a different method: implant; IUD; injectable