Birth Control Pills

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Oral contraceptive pills, also called ‘the pill’, (Picture 1) are a form of daily birth control that has the hormones estrogen and progestin. These hormones are like the hormones made naturally in your body. Pills prevent pregnancy by stopping the egg from being released from the ovary. Pills also change the mucus at the cervix to help keep sperm from reaching an egg.

Advantages of the Pills

    taking birth control with food
  • 91% effective with typical use
  • lighter menstrual periods
  • regular periods
  • may improve premenstrual syndrome (PMS)
  • can improve acne
  • can decrease risk of uterine and ovarian cancer

Disadvantages of the Pills

  • Side effects include: breast tenderness, nausea, irregular bleeding, headaches, and mood changes. Most of these symptoms improve with time.
  • Birth control pills may interact with certain antibiotics, anti-seizure, and HIV medicines.

How to Use Them

  • It is important to take your pill at the same time every day in the order they are labeled. This is usually: 3 weeks of hormone pills, then 1 week of hormone-free pills, also called the interval week. Hormone-free pills are usually a different color. Some packs may have fewer hormone-free pills.
  • If one hormonal pill is missed in weeks 1, 2, or 3, take the late or missed pill as soon as you can. Take the rest of the pills at the usual time, even if it means taking two pills on the same day.
  • If two hormonal pills are missed during weeks 1 or 2, take the two missed pills as soon as possible. Take the next two hormonal pills on the following day. Use back-up contraception, like condoms and spermicide, or avoid sex for 7 days after missing pills.
  • If two or more hormonal pills are missed during week 3, skip the hormone-free pills by finishing the hormonal pills in the current pack. Then, start a new pack the next day. If you cannot start a new pack right away, use back-up contraception, like condoms and spermicide, or avoid sex for 7 days after missing pills.
  • Consider using emergency contraception (EC) if you do not want to become pregnant, hormonal pills were missed during the first week of a cycle, and unprotected sex happened in the last 5 days.


  • Blood clots: Pills can increase the risk of having a stroke or blood clot. Blood clots can develop in veins (deep vein thrombosis) and in the lungs (pulmonary embolism). These conditions are rare, but can be life‐threatening.
  • High blood pressure: Pills can slightly increase your blood pressure. For most people, this increase is small and does not affect one’s health.
  • Using nicotine products (vape pens, cigarettes, or chewing tobacco) while on the pill can increase your risk for heart attack and stroke. This risk increases as you get older.

Who Cannot Use Them

Birth control pills should not be used by people who have:

  • high blood pressure
  • a blood clotting disorder
  • a history of a blood clot, stroke, or heart disease
  • liver disease
  • certain types of migraine headaches
  • had a baby within the last three weeks
  • had a baby within the past month and are breastfeeding

Tell your health care provider if you have any of these risk factors or conditions, or any other medical concerns.

When to Call the Health Care Provider

Call the doctor or health care provider right away if you:

  • miss a period or are late in starting your period
  • think you are pregnant
  • think you might have a STI
  • have new or worsening headaches
  • have depression or change in mood

When to Call 911

Call 911 or go to the nearest emergency room if any of the following occurs:

  • sudden change in vision
  • severe headache
  • unusual pain in your chest
  • difficulty breathing or speaking
  • weakness or numbness
  • unusual pain or swelling in the legs
  • trouble breathing
  • trouble speaking

Preventing STIs

The pill does not protect against STIs. Condoms are the best way for sexually active people to reduce the risk of infection. Always use a condom when you have sex. Get yearly health check-ups, including testing for STIs.

Birth Control Pills (PDF)

HH-IV-3 ©1977, revised 2022, Nationwide Children’s Hospital