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BirthControlPills(OralContraceptives)
MedicallyreviewedonDec10,2016byL.Anderson,PharmD
Thebirthcontrolpillisapopularandhighlyeffectivemethodofbirthcontroliftakencorrectly.Thepillhasa<1%
failurerate(meaninglessthan1outof100womenunintentionallybecomepregnant)ifusedcorrectly.
However,forwomenwhomisstakingtheirpills,thefailurerategoesuptoroughly8%,or8outof100women
becomepregnantunintentionally.
Ifyouarenotlikelytoremembertotakeapilleachday,youprobablyshouldconsideralongeractingformof
birthcontrol,suchastheinjection,patch,implant,vaginalringorIUD.Roughly85%ofwomenwhodonot
usebirthcontrolandaretryingtogetpregnantwillconceivewithinoneyear.
Currently,birthcontrolpillsarefreewiththeAffordableCareAct,butthatmightchangeinthefuture.Birth
controlpillscanbeaffordable,dependinguponhealthinsurancecoverageandgenericavailability.Manybirth
controlpillsareavailablegenericallyandhavealowerpricediscussgenericavailabilityofbirthcontrolpills
withyourphysicianorpharmacistifcostisaconcern.Also,checkwithyourinsurancecompanybeforegettinga
prescriptiontodeterminewhichbirthcontrolpillsareontheirformulary.Ingeneral,youshouldbeabletoget
birthcontrolpillsfrom$10to$50permonthifyoupaycash,althoughtherearemanymoreexpensivebrands.
Again,ifyouhaveprescriptiondruginsurance,yourbirthcontrolmaybefreeundertheAffordableCareAct.
Advantagestobirthcontrolpilluse:
Lighterperiods,lessfrequentperiods,orpossiblynoperiodsatalldependinguponthetypeofpilltakenand
dosingschedule
Ifthebirthcontrolpillistakencorrectly,ithasahighlevelofeffectivenesstopreventpregnancy.
Thebirthcontrolpillcanlessenheavybleeding,painandseverityofendometriosisandfibroidtumors
Acneorpremenstrualdysphoricdisorder(PMDD)mayimprovewithsomebirthcontrolpills
Theuseofthebirthcontrolpillcanlowertheriskofpelvicinflammatorydisease,uterinecancerandovarian
cancer
Theprogestinonlyformsmaybeusedbywomenwhoarebreastfeedingorcannotuseestrogenforother
reasons
CombinationBirthControlPills
Allbirthcontrolpillsrequireaprescriptionfromahealthcareprovider.Combinationbirthcontrolpillsareavailable
in21daypacks,with21activetablets,or28daypackswith21activetablets,and7inactivetablets.Extended
cyclepillssuchasSeasoniquecontain84activetabletsand7inactivetablets.Theinactivepillsareincludedto
helpthewomanrememberwhensheshouldstartanewpackofpills.Iftheinactivepillsaremissed,thereisno
chancethiswouldresultinapregnancy.However,itisimportanttostartthenewpackandactivepillsonthe
correctday.
Combinationpillscontaintwohormones,progestinandestrogen,whiletheminipillscontainonlyprogestin.
Generally,combinationbirthcontrolpillsareslightlymoreeffectivethanprogestinonlybirthcontrolpills.
Combinationpillsmaycontaindifferentlevelsofhormonesthroughoutthemonth.
Examplesofbrandnamecombinationpillsinclude:Apri,Azurette,Caziant,Kariva,Velivet,Natazia,Gianvi,
Ocella,Yaz,Yasmin,Zarah,Beyaz,Safyral,Kelnor,Zovia1/35,Zovia1/50,Aviane,Levora,Portia,Trivora,
Junel,Microgestin,Necon,Nortrel,OrthoNovum,MonoNessa,Previfem,TriNessa,Cryselle,LowOgestrel,
Ogestrel.Seethechartinthissectionforadditionalbrandnames.
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22/12/2016 BirthControlPills(OralContraceptives)
Amonthlyperiodstilloccurswiththetraditional,combinationbirthcontrolpills.Womenmayalsochoosethe
extendedorcontinuousdosingbirthcontrolpill,inwhichaperiodonlyoccurs4timesayears(e.g.,Seasonique)
oriscompletelyeliminated(e.g.,Lybrel).Itisalsopossibletocompletelyeliminateperiodsbytakingonlythe
activepillscontinuouslyfromacombinationbirthcontrolpillpackage,andskippingtheinactivepills.Askyour
healthcareproviderifthiswouldbeagoodoptionforyou.
ProgestinonlyBirthControlPills(MiniPills)
Theprogestinonlyorminipillscontainonlynorethindroneandeachpillisactive.Whenyoufinishonepackof
progestinonlypills,youstartanotherpackthenextday.Withprogestinonlypillsyouwilleithergetyourperiod
inthefourthweek,getnoperiods,orhavespottingduringthemonth.Yourperiodsmaybeheavierorlighter.Do
notstoptakingyourprogestinonlypills.
Examplesofbrandnameprogestinonlypillsinclude:Camila,Errin,Heather,Jolivette,NoraBE.
WhatshouldIdoifImisstakingoneormorebirthcontrolpills?
Itiseasytoforgettotakeapillortomissapillatonetimeoranother.Butthecombination(estrogenand
progestin)pillsworksbestiftakeneverydayattheaboutthesametime.Theprogestinonlypills(minipills)
MUSTbetakenatthesametimeeachday(nomorethan3hourslate).Ifyoumissapill,youwillincreaseyour
chancesofreleasinganeggthatcouldbefertilized,andgettingpregnant.
Anytimeyoumissapillitisbesttouseabackupmethodofbirthcontrol,suchasacondomordiaphragmwitha
spermicide,oracontraceptivesponge.Yourchancesforgettingpregnantincreasedependinguponwhenyou
missedyourpillduringyourcycle.Checkwithyourhealthcareproviderformoreinformationaboutmissedbirth
controlpills.
Ifyoumissoneortwocombination(estrogenandprogestin)pills,takethemassoonasyouremember.Take
yournextpillattheregulartime.Thismeansifyoumisstwopills,youwouldtakebothmissedpillsatthesame
time,andthentakeyournextpillwheneveritisdue.Takingtwopillsatoncemaymakeyoufeelalittlesickto
yourstomach,butthatwillnotlastlong.Useabackupmethodofbirthcontrol,suchasacondom,spongeor
spermicideuntilyoufinishthepack,unlessyourhealthcareprovideradvisesotherwise.
Ifyoumissthreecombinationpillsinarow,callyourhealthcareprovider.Theymaywantyoutostopusingyour
currentbirthcontrolpackandstartanewpackwhileusingabackupmethodofbirthcontrol.
Youcouldbecomepregnantifyoumisstakingyourprogestinonlypill(minipill)bymorethan3hours.Ifyoumiss
takingoneminipill,takeitassoonasyouremember,andtakethenextpillattheregulartime.Continuetotake
theremainderoftheminipillsontheregularschedule.Useabackupmethodofbirthcontrol,suchasa
condom,spongeorspermicideforthenext48hours.
Ifyouarestillconfusedaboutwhattodoifyouhavemissedanybirthcontrolpills,useabackupmethodofbirth
controleachtimeyouhavevaginalintercourse,andtakeabirthcontrolpilleachdayuntilyoucantalktoyour
healthcareprovider.
WarningsforBirthControlPillUse
BirthcontrolpillsshouldNOTbeusedbywomenwhohaveahistoryofbreastcancer,endometrialcancer,
undiagnosedvaginalbleeding,livertumorsordisease,increasedclottingorstrokerisk,orifpregnant.
Smokingincreasestheriskofseriousheartsideeffectswhenusingacombinedestrogenandprogestinbirth
control,includingtheringorthepatch.CombinationestrogenandprogestinbirthcontrolshouldNOTbeusedin
womenover35yearsofagewhosmokeduetoanincreasedriskofrarebutserioussideeffects,suchasheart
attack,bloodclots,andstroke.
Womenofanyageshouldavoidcombinationhormonalbirthcontroliftheyhaveahistoryofuncontrolledhigh
bloodpressure,chestpain,diabetes,severeheadaches,heartorliverdisease,bloodclotsorstroke.
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22/12/2016 BirthControlPills(OralContraceptives)
Cardiovascularrisksincreasewithage,weight,familyhistoryofheartdisease,andnumberofcigarettessmoked
perday(>15perday).Womenshouldtalktotheirhealthcareprofessionalabouttheirindividualriskprofile
beforedecidingwhichbirthcontrolmethodtouse.
Letyourphysicianknowifyouhavemigraineheadacheswhendiscussingbirthcontroloptions.
Thebirthcontrolpilldoesnotprotectagainstanyformofsexuallytransmitteddisease(STD),includingAIDS/HIV.
Amalelatexorfemalecondomshouldbeusedincombinationwithanyotherformofbirthcontrolifprotection
againstSTDsisneeded.
Breastfeedingmothersshouldavoidtheestrogenincombinedhormonalbirthcontrolasitmayreducemilk
supply.BirthcontroloptionsforbreastfeedingwomenincludeIUDs,progestinonlypills(minipills),theimplant
orthebirthcontrolshot.
CommonSideEffectswithBirthControlPills:
Spottingbetweenperiods
Possibleweightgain
Breastswellingortenderness
Nauseaorupsetstomach
Moodchanges
SeriousSideEffectswithBirthControlPills:
Blurredvision
Severestomachpain
Severeheadache
Swellingorpaininthelegs
Chestpain,heartattack,bloodclots,stroke
Otherwarningsandsideeffectsexistforbirthcontrolpills.Itisimportanttoreviewthespecificconsumer
informationforthebirthcontrolofchoiceanddiscussanyquestionsorconcernswithyourhealthcareprovider.
Tellyourhealthcareprovideraboutallothermedicationsyoutake,includingprescription,overthecounter,
vitaminandherbalsupplements.Certainmedicationsmaymakeyourbirthcontrollesseffective.Besuretohave
completedruginteractionrevieweachtimeyoustartanewmedication.
BirthControlPillOptions
GenericName BrandName(s) Description
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22/12/2016 BirthControlPills(OralContraceptives)
progestincontainingpills.
Womenshouldconsultwith
theirMDpriortousing
drospirenone.Drospirenone
ethinylestradiolisavailable
genericallyforaddedcost
savings.
sametimeeachdayto
preventovulationandbe
mosteffectiveslightlyless
effectivethancombination
hormones.Generic,lower
costversionsof
norethindroneareavailable.
Forotheroptionsandbrandnames,alsosee:OralContraceptives
SeeAlso:
BirthControlPillsBenefitsvsRisks&SideEffects
BirthControlPillsBreakthroughBleeding
BirthControlPillsPeriods
EmergencyContraception
HormonalBirthControl(NonPillOptions)
Missedtakingyourbirthcontrolpill?
NonhormonalBirthControl
PermanentBirthControl
Sources
GiveTeensAccesstoEmergencyContraception,PediatriciansSay.https://www.drugs.com/news/giveteensaccessemergencycontraceptio
npediatricianssay41684.html
FDA.Drugs@FDA:FDAApprovedDrugProducts.AccessedDecember10,2016athttp://www.accessdata.fda.gov/scripts/cder/daf/
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