Frequently Asked Questions (FAQ)

For more information on "POPs" or "the minipill", click here.

Oral contraceptives are used to prevent pregnancy and are more effective than any non-surgical methods of birth control. When they are taken correctly, without missing any pills, the chance of becoming pregnant is less than 1% (1 pregnancy per 1000 women per year of use). Typical failure rates are actually 5% per year when women who have missed pills are included. The chance of becoming pregnant increases with each missed pill during a menstrual cycle.

In comparison, typical failure rates for other non-surgical methods of birth control during the first year of use are as follows**:

Implant: < 1%
Injection: < 1%
IUD: 0.1% to 2%
Diaphragm with spermicides: 20%
Spermicides alone: 26%
Vaginal sponge: 20% to 40%
Cervical cap: 20% to 40%
Condom alone (male): 14%
Condom alone (female): 21%
Periodic abstinence: 25%
No methods: 85%

**Adapted from Hatcher, R.A. Trussell, J. Stewart, F., et al. Contraceptive Technology: Seventeenth Revised Edition, New York, NY, 1998.

If you become pregnant while taking the pill, please consult your doctor.

For more information on "POPs" or "the minipill", click here.

Some women should not use the pill. For example, you should not take the pill if you are pregnant or think you may be pregnant.

You should also not use the pill if you have any of the following conditions:

• A history of heart attack or stroke
• Blood clots in the legs (thrombophlebitis), lungs (pulmonary embolism), or eyes
• A history of blood clots in the deep veins of your legs
• Chest pain (angina pectoris)
• Known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina
• Unexplained vaginal bleeding (until a diagnosis is reached by your doctor)
• Yellowing of the whites of the eyes or of the skin (jaundice) during pregnancy or during previous use of the pill
• Liver tumor (benign or cancerous)
• Known or suspected pregnancy

Tell your health care provider if you have ever had any of these conditions. Your health care provider can recommend an alternative method of birth control.

OTHER CONSIDERATIONS BEFORE TAKING ORAL CONTRACEPTIVES

Consult with your health care provider if you have or have had:

• Breast nodules, fibrocystic disease of the breast, an abnormal breast x-ray or mammogram
• Diabetes
• Elevated cholesterol or triglycerides
• High blood pressure
• Migraine or other headaches or epilepsy
• Mental depression
• Gallbladder, heart or kidney disease
• History of abnormal or irregular menstrual periods

Women with any of these conditions should be examined often by their health care provider if they choose to use OCs. Also, be sure to inform your doctor or health care provider if you smoke or are on any medications.

For the majority of women, oral contraceptives can be taken safely. But there are some women who are at high risk of developing certain serious diseases that can be fatal or may cause temporary or permanent disability. The risks associated with taking oral contraceptives increase significantly if you:

• smoke
• have high blood pressure, diabetes, high cholesterol
• have or have had clotting disorders, heart attack, stroke, angina pectoris, cancer of the breast or sex organs, jaundice or malignant or benign liver tumors

Although cardiovascular disease risks may be increased with oral contraceptive use after age 40 in healthy, non-smoking women (even with the newer low-dose formulations), there are also greater potential health risks associated with pregnancy in older women.

You should not take the pill if you suspect you are pregnant or have unexplained vaginal bleeding.

RISKS OF TAKING ORAL CONTRACEPTIVES

1. Risk of developing blood clots
Blood clots and blockage of blood vessels are one of the most serious side effects of taking oral contraceptives and can cause death or serious disability. In particular, a clot in the legs can cause thrombophlebitis and a clot that travels to the lungs can cause a sudden blocking of the vessel carrying blood to the lungs. Rarely, clots occur in the blood vessels of the eye and may cause blindness, double vision, or impaired vision.

If you take oral contraceptives and need elective surgery, need to stay in bed for a prolonged illness or have recently delivered a baby, you may be at risk of developing blood clots. You should consult your doctor about stopping oral contraceptives three to four weeks before surgery and not taking oral contraceptives for two weeks after surgery or during bed rest. You should also not take oral contraceptives soon after delivery of a baby. It is advisable to wait for at least four weeks after delivery if you are not breast feeding or four weeks after a second trimester abortion. If you are breast feeding, you should wait until you have weaned your child before using combination OCs. (Please refer to the leaflet included with your pack of pills for more information.)

The risk of circulatory disease in oral contraceptive users may be higher in users of high-dose pills and may be greater with longer duration of oral contraceptive use. In addition, some of these increased risks may continue for a number of years after stopping oral contraceptives. The risk of abnormal blood clotting increases with age in both users and nonusers of oral contraceptives, but the increased risk from the oral contraceptive appears to be present at all ages. For women aged 20 to 44, it is estimated that about 1 in 2,000 using oral contraceptives will be hospitalized each year because of abnormal clotting. Among nonusers in the same age group, about 1 in 20,000 would be hospitalized each year. For oral contraceptive users in general, it has been estimated that in women between the ages of 15 and 34 the risk of death due to a circulatory disorder is about 1 in 12,000 per year, whereas for nonusers the rate is about 1 in 50,000 per year. In the age group 35 to 44, the risk is estimated to be about 1 in 2,500 per year for oral contraceptive users and about 1 in 10,000 per year for nonusers.

2. Heart attacks and strokes
Oral contraceptives may increase the tendency to develop strokes (stoppage or rupture of blood vessels in the brain) and angina pectoris and heart attacks (blockage of blood vessels in the heart). Any of these conditions can cause death or serious disability.

Smoking greatly increases the possibility of suffering heart attacks and strokes. Furthermore, smoking and the use of oral contraceptives greatly increases the chances of developing and dying of heart disease.

3. Gallbladder disease
Oral contraceptive users probably have a greater risk than nonusers of having gallbladder disease, although this risk may be related to pills containing high doses of estrogens.

4. Liver tumors
In rare cases, oral contraceptives can cause benign but dangerous liver tumors. These benign liver tumors can rupture and cause fatal internal bleeding. In addition, a possible but not definite association has been found with the pill and liver cancers in two studies, in which a few women who developed these very rare cancers were found to have used oral contraceptives for long periods. However, liver cancers are rare.

5. Cancer of the reproductive organs and breasts
There is conflict among studies regarding breast cancer and oral contraceptive use. Some studies have reported an increase in the risk of developing breast cancer, particularly at a younger age. This increased risk appears to be related to duration of use. The majority of studies have found no overall increase in the risk of developing breast cancer. Some studies have found an increase in the incidence of cancer of the cervix in women who use oral contraceptives. However, this finding may be related to factors other than the use of oral contraceptives. There is insufficient evidence to rule out the possibility that pills may cause such cancers.

ESTIMATED RISK OF DEATH FROM A BIRTH CONTROL METHOD OR PREGNANCY
All methods of birth control and pregnancy are associated with a risk of developing certain diseases that may lead to disability or death. An estimate of the number of deaths associated with different methods of birth control and pregnancy has been calculated and is shown in the following table.

In the above table, the risk of death from any birth control method is less than the risk of childbirth, except for oral contraceptive users over the age of 35 who smoke and pill users over the age of 40 even if they do not smoke. It can be seen in the table that for women aged 15 to 39, the risk of death was highest with pregnancy (7-26 deaths per 100,000 women, depending on age). Among pill users who do not smoke, the risk of death was always lower than that associated with pregnancy for any age group, although over the age of 40, the risk increases to 32 deaths per 100,000 women, compared to 28 associated with pregnancy at that age. However, for pill users who smoke and are over the age of 35, the estimated number of deaths exceeds those for other methods of birth control. If an OC user is over the age of 40 and smokes, her estimated risk of death is four times higher (117/100,000 women) than the estimated risk associated with pregnancy (28/100,000) in that age group.

The suggestion that women over 40 who do not smoke should not take oral contraceptives is based on information from older, higher dose pills. An Advisory Committee of the FDA discussed this issue in 1989 and recommended that the benefits of lowdose oral contraceptive use by healthy, non-smoking women over 40 years of age may outweigh the possible risks.

In addition to preventing pregnancy, use of combination oral contraceptives may provide the following certain benefits:

• menstrual cycles may become more regular
• blood flow during menstruation may be lighter and less iron may be lost
• pain or other symptoms during menstruation may be encountered less frequently
• ectopic (tubal) pregnancy may occur less frequently
• noncancerous cysts or lumps in the breast may occur less frequently
• acute pelvic inflammatory disease may occur less frequently
• oral contraceptive use may provide some protection against developing two forms of cancer: cancer of the ovaries and cancer of the lining of the uterus

If any of these adverse effects occur while you are taking oral contraceptives, call your doctor immediately:

• Sharp chest pain, coughing of blood, or sudden shortness of breath (indicating a possible clot in the lung)
• Pain in the calf (indicating a possible clot in the leg)
• Crushing chest pain or heaviness in the chest (indicating a possible heart attack)
• Sudden severe headache or vomiting, dizziness or fainting, disturbances of vision or speech, weakness, or numbness in an arm or leg (indicating a possible stroke)
• Sudden partial or complete loss of vision (indicating a possible clot in the eye)
• Breast lumps (indicating possible breast cancer or fibrocystic disease of the breast; ask your doctor or health care provider to show you how to examine your breasts)
• Severe pain or tenderness in the stomach area (indicating a possible ruptured liver tumor)
• Difficulty in sleeping, weakness, lack of energy, fatigue, or change in mood (possibly indicating severe depression)
• Jaundice or a yellowing of the skin or eyeballs, accompanied frequently by fever, fatigue, loss of appetite, dark-colored urine, or light-colored bowel movements (indicating possible liver problems)

For more information on "POPs" or "the minipill", click here.

For most women oral contraceptives are free of serious or unpleasant side effects. The following are some common side effects from oral contraceptive use:

1. Vaginal bleeding
Irregular vaginal bleeding or spotting may occur while you are taking the pill. Irregular bleeding may vary from slight staining between menstrual periods to breakthrough bleeding which is a flow much like a regular period. Irregular bleeding occurs most often during the first few months of oral contraceptive use, but may also occur after you have been taking the pill for some time. Such bleeding may be temporary and usually does not indicate any serious problems. It is important to continue taking your pills on schedule. If the bleeding occurs in more than one cycle or lasts for more than a few days, talk to your doctor or health care provider.

2. Contact lenses
If you wear contact lenses and notice a change in vision or an inability to wear you lenses, contact your doctor or health care provider.

3. Fluid retention
Oral contraceptives may cause edema (fluid retention) with swelling of the fingers or ankles and may raise your blood pressure. If you experience fluid retention, contact your doctor or health care provider.

4. Melasma
A spotty darkening of the skin is possible, particularly of the face, which may persist.

5. Other side effects
Other side effects may include nausea and vomiting, change in appetite, headache, nervousness, depression, dizziness, loss of scalp hair, rash, and vaginal infections.

If any of these side effects bother you, call your doctor or health care provider.

There may be times when you may not menstruate regularly after you have completed taking a cycle of pills. If you have taken your pills regularly and miss one menstrual period, continue taking your pills for the next cycle but be sure to inform your health care provider before doing so. If you have not taken the pills daily as instructed and missed a menstrual period, you may be pregnant. If you missed two consecutive menstrual periods and it is 45 days or more from the start of your last menstrual period, you may be pregnant. Check with your health care provider immediately to determine whether you are pregnant. Do not continue to take oral contraceptives until you are sure you are not pregnant, but continue to use another method of contraception.

There is no conclusive evidence that oral contraceptive use is associated with an increase in birth defects, when taken inadvertently during early pregnancy. Previously, a few studies had reported that oral contraceptives might be associated with birth defects, but these findings have not been seen in more recent studies. Nevertheless, oral contraceptives or any other drugs should not be used during pregnancy unless clearly necessary and prescribed by your doctor. You should check with your doctor about risks to your unborn child of any medication taken during pregnancy.

If you are scheduled for any laboratory tests, tell your doctor you are taking birth control pills. Certain blood tests may be affected by birth control pills.

Certain drugs may interact with birth control pills to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include rifampin; drugs used for epilepsy such as barbiturates (for example, phenobarbital), anticonvulsants such as carbamazepine (Tegretol is one brand of this drug), and phenytoin (Dilantin is one brand of this drug); phenylbutazone (Butazolidin is one brand), and possibly certain antibiotics. You may need to use additional contraception when you take drugs that can make oral contraceptives less effective.

It is important to always let your health care professional know that you are taking oral contraceptives so they can appropriately instruct you.

Many women have spotting or light bleeding, or may feel sick to their stomach during the first pack of pills.

Missing pills can also cause spotting or light bleeding, even when you make up these missed pills.

If spotting or light bleeding should occur, continue taking the pill according to the schedule. Should spotting or light bleeding persist, you should notify your doctor or clinic.

If you are scheduled for surgery or you need to stay in bed for a long period of time you should tell your doctor that you are on the pill. You should stop taking the pill for weeks before your operation to avoid an increased risk of blood clots. Talk to your doctor about when you may start taking the pill again.

There are no reports of serious illness or side effects in young children who have swallowed a large number of pills. In adults, overdosage may cause nausea and/or bleeding in females. In case of overdosage, contact your doctor, clinic, or pharmacist.

It's hard to say since every woman reacts to different pills in different ways. Some women will have more side effects and others will have less. It depends on the triphasic OC that you're switching to and your individual response to it. Check the package insert that comes with the triphasic pill you are switching to. It will tell you what side effects are usually associated with it. But you can be sure that the triphasic pill is as effective as the monophasic pill.

No, it may not be as effective, so it is a good idea to quit smoking if you want to continue on the pill. Smoking can increase the risk of serious cardiovascular side effects (like heart attack and stroke) that are associated with OC use. Also you might have less annoying side effects like breakthrough bleeding if you stop smoking.

The pill is a convenient and highly effective form of birth control. But remember, it is meant to prevent pregnancy. It does not protect you from contracting sexually transmitted diseases. To protect yourself fully from these diseases, including AIDS, use a condom when you have sex. OC use is not without risks. OC users have an increased risk for cardiovascular disease and blood clots.

No method of birth control is foolproof except abstinence! However, when used correctly the pill is more than 99% effective, which means that 1 pregnancy will occur for every 1000 women per year of OC use.

This is not a good idea. The choice of an OC should be made after a careful physical examination is performed and a medical history is obtained. A good pill for you may not be a good pill for her. Advise her to use a backup method of birth control until she gets her prescription refilled. Remember it's against the law to give your prescription medicine, even the pill, to anyone else.

Many plans do not cover the cost of oral contraceptives. Ask your pharmacist if he/she can substitute with a generic. This can usually reduce the cost considerably. Many of the leading OCs have generic equivalents that are just as effective and a lot cheaper.

Most chain pharmacies will have your prescription information in their computer database so you should be able to transfer your prescription and get it filled at your vacation destination.

The pill has several noncontraception-related health benefits. Click here to learn more about noncontraception-related health benefits.

For more information on "POPs" or "the minipill", click here.

Some important points you should remember before you start taking oral contraceptives include:

1. BE SURE TO READ THE LEAFLET ENCLOSED WITH YOUR PACK OF PILLS

• Before you start taking your pills
• Anytime you are not sure what to do

2. THE RIGHT WAY TO TAKE THE PILL IS TO TAKE ONE PILL EVERY DAY AT THE SAME TIME.

• If you miss pills you could get pregnant. This includes starting the dispenser late. The more pills you miss, the more likely you are to get pregnant.

3. MANY WOMEN HAVE SPOTTING OR LIGHT BLEEDING, OR MAY FEEL SICK TO THEIR STOMACH DURING THE FIRST 1-3 DISPENSERS OF PILLS.

• If you feel sick to your stomach, do not stop taking the pill. The problem will usually go away. If it doesn't go away, check with your doctor or clinic.

4. MISSING PILLS CAN ALSO CAUSE SPOTTING OR LIGHT BLEEDING, even when you make up these missed pills.

• On the days you take 2 pills to make up for missed pills, you could also feel a little sick to your stomach.

5. IF YOU HAVE VOMITING OR DIARRHEA, for any reason, or IF YOU TAKE SOME MEDICINES, including some antibiotics, your pills may not work as well. Use a back-up method (such as condoms, foam, or sponge) until you check with your doctor or clinic.

6. IF YOU HAVE TROUBLE REMEMBERING TO TAKE THE PILL, talk to your doctor or clinic about how to make pill-taking easier or about using another method of birth control.

7. IF YOU HAVE ANY QUESTIONS OR ARE UNSURE ABOUT THE INFORMATION HERE, OR IN YOUR LEAFLET INCLUDED WITH YOUR PACK OF PILLS, call your doctor or clinic.

For more information on "POPs" or "the minipill", click here.

Before you start taking your pills you should:

1. DECIDE WHAT TIME OF DAY TO TAKE YOUR PILL. It is important to take it about the same time every day.

2. LOOK AT YOUR PILL DISPENSER TO SEE IF IT HAS 21 OR 28 PILLS.

• The 21-pill dispenser has 21 "active" pills (with hormones) to take for 3 weeks. This is followed by 1 week without pills.
• The 28-pill dispenser has 21 pills (with hormones) to take for 3 weeks. This is followed by 1 week of reminder pills (without hormones).

3. ALSO FIND:

• Where on the dispenser to start taking the pills
• In what order to take the pills
  CHECK ADDITIONAL INSTRUCTIONS FOR USING THE DISPENSER IN THE BRIEF SUMMARY PATIENT PACKAGE INSERT INCLUDED WITH YOUR PACK OF PILLS

4. BE SURE YOU HAVE READY AT ALL TIMES:

• ANOTHER KIND OF BIRTH CONTROL (such as condoms, foam, or sponge) to use as backup in case you miss pills
• AN EXTRA, FULL PILL DISPENSER

For more information on "POPs" or "the minipill", click here.

You have a choice of which day to start taking your first dispenser of pills. Decide with your doctor which is the best day for you. Pick a time of day which will be easy to remember.

SUNDAY START: Most people choose a Sunday start. For a Sunday start, you would take the first "active" pill of the dispenser on the Sunday after your period starts, even if you are still bleeding. If your period begins on Sunday, you would start the dispenser the same day. It is important to USE ANOTHER METHOD OF BIRTH CONTROL as back-up method if you have sex anytime from the Sunday you start your FIRST dispenser until the next Sunday (7 days). Condoms, foam or the sponge are good back-up methods of birth control.

DAY 1 START: Take the first "active" pill of the first dispenser during the first 24 hours of your period. You will not need to use a back-up method of birth control, since you are starting the pill at the beginning of your period.

TAKE ONE PILL AT THE SAME TIME EVERY DAY UNTIL THE DISPENSER IS EMPTY.

• Do not skip pills even if you are spotting or bleeding between monthly periods or feel sick to your stomach (nausea).
• Do not skip pills even if you do not have sex very often.

For more information on "POPs" or "the minipill", click here.

WHEN YOU FINISH A DISPENSER OR SWITCH YOUR BRAND OF PILLS:

• 21 pills: Wait 7 days to start the next dispenser. You will probably have your period during that week. Be sure that no more than 7 days pass between 21-day dispensers.
• 28 pills: Start the next dispenser on the day after your last "reminder" pills. Do not wait any days between dispensers.

Progestin pill (POP) users:

• Take it as soon as you can. Then go back to taking your pills at your regular time.
• You will also need to use a backup method of contraception each time you have sex for the next 48 hours. Remember that progestin-only pills especially have to be taken at the same time each day. Even taking the progestin-only pill late by 3 hours can decrease its effectiveness.
• If you miss more than 1 pill, call your doctor.

Combination pill users:

If you MISS 1 "active" pill (with hormones):

• Take it as soon as your remember. Take the next pill at your regular time. This means you may have to take 2 pills in 1 day.
• You do not need to use a back-up birth control method if you have sex.

If you MISS 2 "active" pills (with hormones):

Monophasic and Biphasic pill users:

• Take 2 pills on the day your remember and 2 pills on the next day.
• Then take 1 pill a day until you finish the dispenser.
• You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.

  Triphasic pill users:

  It depends on which pill you missed. Were the pills in week 1, week 2, or week 3 of your pack?

  Week 1 or 2

• Take 2 pills on the day your remember and 2 pills on the next day.
• Then take 1 pill a day until you finish the dispenser.
• You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.

Week 3

Did you start your pill pack on the day your period started (Day 1 start) or on the first Sunday after your period (Sunday start)?

• Day 1: If you miss 2 or more pills during week 3, throw out the rest of the pack and start a new pack of pills today. You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.
• Sunday: If you miss 2 or more pills during week 3, then keep taking 1 pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack of pills that day. You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.

If you MISS 3 OR MORE "active" pills:

Did you start your pill pack on the day your period started (Day 1 start) or on the first Sunday after you period (Sunday start)?

• Day 1: If you miss 3 or more pills, throw out the rest of the pack and start a new pack of pills today. You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.
• Sunday: If you miss 3 or more pills, then keep taking 1 pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack of pills that day. You MAY BECOME PREGNANT if you have sex in the 7 days after you miss pills. You MUST use another birth control method (such as condoms, foam, or sponge) as back-up method for those 7 days.

I missed 3 "active" pills and had unprotected sex. Is it too late to do anything?

No, it may not be too late. Consult your doctor about what to do.

I missed a couple of pills in Week 4 of my 28-day pack. What should I do?

• Combination pill users: This probably won't matter since the pills in Week 4 of most OCs are just sugar or iron pills. Just throw the pills away and take the remaining pills as you normally would. You don't need a backup method of contraception on these days.
• Progestin-only pill users: You have missed active pills. You should call your doctor.

I'm finding it really hard to remember to take my pill at the same time each day. Any suggestions?

It's a good idea to connect taking the pill with an activity that you do at the same time each day, such as brushing your teeth or eating breakfast. You can try setting an alarm or placing a calendar on your bathroom mirror. Also check your pack of pills each morning to make sure you took your pill the day before.

Breakthrough bleeding is a very common side effect of oral contraceptives in the first 3 or 4 cycles. If the bleeding has persisted for more than 3 months, your doctor may be able to switch you to a pill that causes less breakthrough bleeding. The best thing you can do to relieve breakthrough bleeding is to take the pill at the same time each day and avoid missing pills. If you smoke, try to quit. Smokers have a higher incidence of breakthrough bleeding. Taking medicines like ibuprofen may also increase bleeding.

Estrogens do help relieve acne to some degree, but combination pills contain progestins as well which have the opposite effect on acne. The key is to have a pill with the right combination of estrogen and progestin and to have the right type of progestin. If you want your pill to work against your acne, ask your doctor about switching to an OC that can best do this. Two OCs are currently approved by the FDA for the treatment of acne. You should discuss these options with your doctor.

It might and it might not. OCs cause fluctuations in weight because of their effect on appetite and fluid retention and have different effects on different women. You should consider other possible causes for your weight gain. If you think the weight gain is definitely related to the OC, then ask your doctor about switching you to another pill.

You need to contact your doctor immediately. These are signs of blood clots that may be aggravated by pill use.

No. You need to discontinue pill use and see your doctor immediately. If birth control is a concern, use an alternative form. Persistent headaches may be a sign of a blood clot, which can be aggravated by pill use.

Has it lasted more than 3 months?

No: Nausea is a pretty common side effect of the pill in the first 3 cycles. It's a good idea to take the pill with food or at bedtime. Taking the pill on an empty stomach may aggravate the nausea.

Yes: It's important that you see your doctor. Your doctor may switch you to a pill that doesn't cause as much nausea.

Yes. When you're on the pill, your periods tend to be short with little or no bleeding. This is because the pill suppresses the formation of uterine tissue so there is very little tissue to slough.

It has been reported that some OC users have a decreased sex drive. If this is a problem for you, you may want to talk to your doctor. Your doctor may switch you to an OC that has less risk of this side effect.

This is most likely due to the progestin part of the pill this is the same hormone that causes these symptoms in pregnancy. But it could also be due to other factors including generally poor health, poor nutrition from "fad" diets, anemia, low blood sugar, or vitamin B6 deficiency. If it is a problem and definitely related to your pill use, then your doctor may switch you to another OC.

It probably will not work as well. Use a backup method (eg, condoms, foam, sponge) until you check with your doctor about what you should do.

Because OCs change the hormone levels in your system, these changes may lead to mood swings. If it becomes a problem, your doctor may switch you to another OC.

If you think you may be pregnant for any reason, check with your healthcare provider immediately to determine if you are pregnant. Do not continue to take oral contraceptives until you are sure that you are not pregnant, but continue to use another form of birth control.

There is no conclusive evidence that oral contraceptive use is associated with an increase in birth defects when taken inadvertently during early pregnancy. Previously, a few studies had reported that oral contraceptives might be associated with birth defects but these studies have not been confirmed. Nevertheless, oral contraceptives or any other drugs should not be used during pregnancy unless clearly necessary and prescribed by your doctor. You should check with your doctor about risks to your unborn child from any medication taken during pregnancy.

If you are breast feeding, consult your doctor before starting oral contraceptives. You can discuss the option of a progestin-only pill, sometimes referred to as "POPs" or "the minipill". If you are breastfeeding, POPs will not affect the quality of amount of your breastmilk or the health of your nursing baby.

Caution should be used if considering the use of combination oral contraceptives. Some of the drug will be passed on to the child in the milk. A few adverse effects on the child have been reported, including yellowing of the skin (jaundice) and breast enlargement. In addition, combination oral contraceptives may decrease the amount and quality of your milk. If possible, do not use oral contraceptives and use another method of contraception while breast feeding. You should consider starting combination oral contraceptives only after you have weaned your child completely.

After you have a baby it is advisable to wait 4-6 weeks before starting to take the pill. Talk to your doctor about when you may start taking the pill after pregnancy.

There may be some delay in becoming pregnant after you stop taking the pill, especially if you had irregular menstrual periods before you started using the pill. Your doctor may recommend that you delay becoming pregnant until you have had one or more regular periods.

There does not appear to be any birth defects in newborn babies when pregnancy occurs soon after stopping the pill.

Click here to learn more birth control pills that contain one hormone, a progestin.

Probably not. There is no conclusive evidence that OC use while pregnant is associated with an increase in birth defects. But you should consult with your doctor about the risks to your unborn child from taking OCs.

Yes. The pill is a reversible form of contraception so if you want to get pregnant, just stop taking the pills. You do not have to finish the pack that you're currently taking. There may be a delay in becoming pregnant after you stop taking the pill, especially if you had irregular periods before you started using the pill. Your doctor may recommend that you delay becoming pregnant until you have had one or more regular periods.

With the progestin-only pill, irregular bleeding is more common than with combination OCs. Women who use POPs also may have a higher incidence of headaches, breast tenderness, nausea, and dizziness. And remember, it is very important that you take the POP at the same time every day. A delay of even a few hours can affect the efficacy of the POP.

With the progestin-only pill, it is absolutely essential that you take it at the same time each day. Whenever you take the pill 3 or more hours late, you need to use a backup method such as a condom or spermicide every time you have sex for the next 48 hours. If it is too difficult to take the pills on time, you may want to consider another form of birth control.

Yes, in that they prevent ovulation and thicken the cervical mucus, making it difficult for the sperm to get to the egg. But combination pills are only taken 3 out of 4 weeks in the cycle. With POPs, you're taking an active pill every day of the cycle.