Center for Health & Wellness

Birth Control Information And Options

Female Contraceptive Information

Birth Control Pills

What are birth control pills?

Birth control pills (oral contraceptives) are a method of birth control that uses hormones to prevent pregnancy. The man-made female hormones in the pills change a woman’s natural hormone levels and prevent ovulation, which means to prevent her ovaries from releasing an egg each month. A woman cannot get pregnant if she doesn’t ovulate because there is no egg to be fertilized.The hormones also help prevent pregnancy in two other ways: they cause a thickening of the mucus on the cervix and they change the lining of the uterus. The thickened mucus on the cervix makes it hard for sperm to enter the uterus. The change in the lining of the uterus helps to prevent a fertilized egg from attaching to the uterus.

The most commonly used pills are "combined" pills. They contain man-made forms of two hormones: estrogen and progesterone. There is also a progesterone-only pill (the mini-pill).

Birth control pills do not protect you from sexually transmitted diseases such as HIV. Latex or polyurethane condoms are the only safe way to protect against HIV.

What are the benefits?

  • Birth control pills are over 99% effective in preventing pregnancy if taken as directed.
  • You do not have to interrupt sex to use a birth control device or spermicide.
  • Periods become regular and usually lighter. Menstrual cramps may become less severe.
  • Long-term use lowers the risk of ovarian, endometrial and colorectal cancer.
  • Birth control pills may reduce symptoms of premenstrual syndrome (PMS).
  • May improve acne.

How are the pills used?

The combined pills usually come in a package of 28 pills. They are also available in 21-pill or 91-pill packs. You and your healthcare provider will decide which type of package is best for you. Your provider may advise you to start taking the pills on the Sunday after your period has started or on the first day of your next period, depending on your preference.

  • Take your pill at the same time every day. This will keep hormone levels steady and help to avoid break through bleeding.
  • The pill will be effective immediately as birth control if started on the first day of your period, or after 2 weeks of taking the pill as directed. Use a back up method of birth control until one of these two guidelines is met.
  • Use condoms for protection against sexually transmitted disease.
  • If you have bleeding between periods for 2 or more cycles you may need a different pill. Call your healthcare provider for an appointment.
  • When you see a medical provider, be sure to mention that you are taking birth control pills. This is particularly important if you are admitted to the hospital or having surgery.

28-day pill pack

If you are using the 28-day package, take 1 pill every day for 4 weeks and then start a new package the next day. Your period should come during the week that you are taking the last 7 pills.

91-day pill pack

If you are using the 91-day pill pack, take 1 pill of active medicine every day for 12 weeks (84 days). Then you take 1 inactive pill every day for 1 week (7 days). You will have your period while you are taking the inactive pills. This means that you have a period just once every 3 months.

Frequently Asked Questions

What if I forget to take a pill?

Your risk of pregnancy increases when you miss any pills. You may have spotting or break through bleeding.

**If you forget 1 pill, take it as soon as you remember, even if it is the next day. Take the next pill on time.

**If you miss 2 or more doses in a row, follow the information sheet that comes in the medicine package or ask your healthcare provider what to do. Use a back up method of birth control, such as condoms, at least until your next period starts.

Who should not take birth control pills?

Some women with chronic diseases or other problems should not use birth control pills. For example, women who have had blood clots, high blood pressure, certain cancers, heart attack, or stroke should not use the pills. You should also not take birth control pills if you think you may be pregnant. Your healthcare provider will discuss your medical history with you.

What are the potential side effects?

The pills often have no side effects, but sometimes they may cause side effects such as:

  • irregular menstrual bleeding or spotting for the first few months after you start the pill
  • nausea and vomiting
  • breast swelling or tenderness
  • swelling of your hands or ankles
  • mood changes or irritability
  • headaches
  • vaginal infection (usually yeast)
  • amenorrhea (absence of menstrual period)
  • increased appetite
  • acne

Additional Important Information

What else should I know when taking birth control?

You should not smoke. Smoking increases the risk of serious side effects, such as heart attack, stroke, and blood clots. This is especially true if you are over 35 years old and smoke 15 or more cigarettes a day.

Other risks of taking birth control pills include cataracts, gallstones, and non-cancerous liver tumors.

Some medicines can affect the way birth control pills work in your body. Birth control pills may not keep protecting you against pregnancy if you are taking certain antibiotics or medicines for seizures or fungal infections. Tell your healthcare provider about all medicines or natural remedies you are taking. You may need to use an additional form of birth control while you are taking these medicines.

When should I call my healthcare provider?

Call during office hours if you have any of the following:

  • problems with your menstrual periods, such as bleeding between periods lasting longer than 2 months, prolonged periods, or if you think you are pregnant
  • more headaches than you used to have
  • severe mood changes
  • vaginal discharge with itching

Get medical assistance right away if you have any of the following symptoms:

  • chest pain, sudden shortness of breath, or are coughing up blood
  • sudden severe headache, vomiting, dizziness, fainting, or problems with vision or speech
  • sudden partial or complete loss of vision
  • yellowing of the skin or whites of the eyes (jaundice), especially with fever, tiredness, loss of appetite, dark urine, or light-colored bowel movements
  • unexplained pain, weakness, redness, swelling or numbness in one or both of your legs
  • severe pain, swelling, or tenderness in the abdomen

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Current Birth Control Options


What is it?

How does it work?

How effective is it?

STI or HIV protection?

Additional Information

Abstinence Not having sexual intercourse. No contact between penis and vagina. 100% No risk for STI’s. This is the only way to completely avoid risk of pregnancy and STI’s/HIV.
Withdrawal (coitus interruptus) This is when the male partner withdraws his penis from his partner’s vagina prior to ejaculation. Prevents fertilization by preventing contact between sperm and egg. Unreliable No Unreliable method as sperm is in pre-ejaculate.
Condoms (male and female) Thin rubber device that provides a barrier between the penis and vagina. Prevents the exchange of fluids between penis and vagina. Female condoms: 79-95%; Male condoms: 85-98% Yes Inexpensive and easy to obtain. Discard after use.
Diaphragm/Cervical Cap Dome shaped rubber devices that are used with spermicide and inserted inside the vagina to cover the area around the cervix. Require an office visit for fitting and positioning. Physical barrier to prevent sperm from reaching the cervix. Spermicide is used to kill any additional sperm that may get by. Must be inserted 30 minutes prior to intercourse and needs to stay in place at least 8 hours after ejaculation has occurred. 80-94% Minimal Requires visit to a provider for fitting and prescription. May need practice to insert. Need to inspect for holes. May need to be refitted if weight change or pregnancy. Cannot be used during your period.
Spermicide (foam, gel, suppositories, & film) OTC agent that contains chemicals that kill sperm. Also serves as a barrier and to immobilize sperm. Must be inserted into vagina at least 15-30 minutes prior to intercourse. Foam and gel are applied with applicator. Suppositories and film are manually inserted into the vagina. 71-85% **most effective when used with a condom or diaphragm No Obtain at the drugstore. Acts as a lubricant. Need to use before each act of intercourse. Some people are allergic to spermicide and develop irritation. If irritation occurs, this can increase STI/HIV risk.

Oral Contraceptives

("Birth Control Pill")

A pill taken at the same time each day that contains either the hormones estrogen and progestin, or simply progestin only. Stops ovulation (release of eggs), thickens cervical mucus, and thins the lining of the uterus. 99% when used as directed To achieve maximum contraceptive benefits, pills must be taken at the same each day. No Additional benefits may include decreased menstrual cramps, lighter periods, and decreased risk of ovarian cancer. Risks may include nausea and spotting during the first 1-3 months on the medication.
NuvaRing A flexible ring, about 2 inches in size, that is inserted by a woman into the vagina and releases estrogen and progestin. 21-days after insertion, ring is removed and replaced with a new NuvaRing after 1 week ring-free. Stops ovulation (release of eggs), thickens cervical mucus, and thins the lining of the uterus. 98-99% No Similar risks as oral contraceptives. Potential side effects include vaginal infections and irritations, headache, weight gain, and nausea.
Ortho Evra Patch A skin patch that releases the hormones estrogen and progestin. A new patch is applied once a week for 3 weeks. Week-4 is patch-free. 4 discrete locations to place the patch. Stops ovulation (release of eggs), thickens cervical mucus, and thins the lining of the uterus. 99% No Patch stays on at all times, including during bathing. Replace the patch if it becomes loose or falls off. Similar side effects to the pill.
Contraceptive Injections There are 2 options currently available: a monthly injection and an injection that is given every 3 months. Stops ovulation (release of eggs), thickens cervical mucus, and thins the lining of the uterus. Greater than 99%. No Many women stop having their periods completely. May cause slight weight gain. Spotting is common during the first few months.
Implanon Progestin only subdermal implant that is placed just under the skin of your arm by a healthcare provider. It can remain in place for up to 3 years. Stops ovulation (release of eggs), thickens cervical mucus, and thins the lining of the uterus. Greater than 99%. No Can be removed at any time by a medical provider. Similar side effects to the pill.
Intrauterine Device (IUD) A T shaped device is inserted into the uterus by a healthcare provider. The Copper-T IUD can stay in place up to 10 years and does not release any hormones. The Mirena IUD releases progestin and can stay in place up to 5 years. Interferes with fertilization and implantation. Mirena also releases hormone to thicken cervical mucus and thin the uterine lining. Greater than 99%. No Inserted and removed by a clinician. Recommended for mutually monogamous relationships due to increased risk of pelvic infections if exposed to STI's.

Emergency Contraception

("Morning after pill")

Birth control you can take up to 5 days (120 hours) after unprotected sex. Stops ovulation (release of eggs) and thickens cervical mucus. The mucus blocks the sperm and keeps it from joining with an egg. The sooner it is started, the better! Effectiveness depends on the type and how soon it is taken, but can be up to 95% effective if certain brands are taken within the first 24 hours after intercourse. No Available at local drug stores. Costs vary from $10-70. Does NOT cause abortion. Nausea, vomiting, and breast tenderness are the most common potential side effects.