Possible Side Effects

The Pill is a safe and effective method of birth control. Most young women who take the Pill have none to very few side effects.
Smoking cigarettes and using the Pill can increase a girl's risk of certain side effects, which is why health professionals advise girls who use the Pill not to smoke. Side effects that some women have while on the Pill include:

• irregular menstrual bleeding
• nausea, headaches, dizziness, and breast tenderness
• mood changes
• blood clots (rare in women under 35 who do not smoke)

Some of these side effects improve over the first 3 months on the Pill. When a girl has side effects, a doctor will sometimes prescribe a different brand of the Pill.
The Pill also has some side effects that many young women enjoy. It usually makes periods lighter, reduces cramps, and is often prescribed for women who have menstrual problems. Taking the Pill can improve acne, and some doctors prescribe it for this purpose. Birth control pills have also been found to protect against some forms of breast disease, anemia, ovarian cysts, and ovarian and endometrial cancers.

How Does the Birth Control Pill Work?

Question: How Does the Birth Control Pill Work?

 

Answer: Birth control pills, or oral contraceptives, contain hormones that suppress ovulation. During ovulation an egg is released from the ovaries, without ovulation there is no egg to be fertilized and pregnancy cannot occur. There are 2 types of birth control pills -- the combined pill and the Minipill. The combined pill contains both estrogen and progestin, while the Minipill contains only progestin.The progestin in the Minipill may prevent ovulation; however it may not do this reliably each month. The Minipill works further by thickening the mucous around the cervix and preventing sperm from entering the uterus. The lining of the uterus is also affected in a way that prevents fertilized eggs from implanting into the wall of the uterus. The Minipill is taken every day. You may not have a period while taking the Minipill, if you do have periods that means you are still ovulating and your risk for pregnancy occuring is greater.
Combination birth control pills come in either 21 or 28-day packs. You take one pill each day at the same time for 21 days. If you have a 21-day pack, you stop taking birth control pills for 7 days at the end of the pack. If you are taking a 28-day pack, you continue taking pills every day, the last 7 non-hormonal pills serve as a reminder to help you remember to take your pill at the same time every day. Your period will occur during the week you take the 7 reminder pills.

Birth Control Pills Affect Women's Taste in Men

This year 2.25 million Americans will get married—and a million will get divorced. Could birth control be to blame for some of these breakups? Recent research suggests that the contraceptive pill—which prevents women from ovulating by fooling their body into believing it is pregnant—could affect which types of men women desire. Going on or off the pill during a relationship, therefore, may tempt a woman away from her man.
It’s all about scent. Hidden in a man’s smell are clues about his major histocompatibility complex (MHC) genes, which play an important role in immune system surveillance. Studies suggest that females prefer the scent of males whose MHC genes differ from their own, a preference that has probably evolved because it helps offspring survive: couples with different MHC genes are less likely to be related to each other than couples with similar genes are, and their children are born with more varied MHC profiles and thus more robust immune systems.
A study published in August in the Proceedings of the Royal Society B, however, suggests that women on the pill undergo a shift in preference toward men who share similar MHC genes. The female subjects were more likely to rate these genetically similar men’s scents (via a T-shirt the men had worn for two nights) as pleasant and desirable after they went on the pill as compared with before. Although no one knows why the pill affects attraction, some scientists believe that pregnancy—or in this case, the hormonal changes that mimic pregnancy—draws women toward nurturing relatives.
Women who start or stop taking the pill, then, may be in for some relationship problems. A study published last year in Psychological Science found that women paired with MHC-similar men are less sexually satisfied and more likely to cheat on their partners than women paired with MHC-dissimilar men. So a woman on the pill, for example, might be more likely to start dating a MHC-similar man, but he could ultimately leave her less sexually satisfied. Then if she goes off the pill during the relationship, the accompanying hormonal changes will draw her even more strongly toward more MHC-dissimilar men. These immune genes may have a “powerful effect in terms of how well relationships are cemented,” says University of Liverpool psychologist Craig Roberts, co-author of the August paper.
Note: This article was originally published with the title, "A Tough Pill to Swallow".

Can you have a pill withdrawal period and be pregnant?

I know that when you're on the pill, the bleeding you have during your placebo week is in fact withdrawal bleeding and not a "true" period, of course, the blood is real, but there is some difference.

Since this is true, is it also correct that if one became pregnant while on the pill, they would not have withdrawal bleeding at all during their placebo week, or it would be very spotty/light? (assuming that no pills were missed). I have heard that this withdrawal bleeding each month, when it is on time, normal, etc. is "proof" that the woman is not pregnant and the pills are working correctly--is this correct?

If you were to become pregnant on birth control pills, a normal withdrawal period would not occur because progesterone production from the corpus luteum gland on the ovary overrides the drop in progesterone from finishing the active pills. Occasionally a woman could have some spotting while pregnant but usually it isn't a full period.

Switching pills and switching back - Will they work the same?

I am switching from Loestrin 1.5/30® to Levlen® to try and lessen the amount of bleeding on the first day of my period, and also, to help some with the cramps. I will be starting these new pills this week. I am still a little leery about switching pills thinking I may end up worse off than I am now, but I am willing to give it a shot. My main concern is that if I take these new pills and I am not happy with the results the first month for some reason, will I be able to go back to taking the LoEstrin® and have it work exactly like it was working before I made the switch, or will it be like starting a whole new pill in that there may be breakthrough bleeding, spotting, and I may not get it on the exact same day as I used to (it was always 3 days after my last hormone pill). I am just asking this as I know that with other meds I've taken (like anti-depressants...I suffer from panic/anxiety disorder and depression) that you may take them once and have no side effects and they may work fairly well, but then if you stop that med for whatever reason and try and re- start it maybe a month or several months later, your body chemicals have now changed and the med either no longer works on you or you experience side effects this time around.

What do you think the chances are of me being able to re-start the LoEstrin® after being off of it for one month and having it work exactly like it used to?

80-90% - pure guess

I am sure there is always a risk that it will not work the same, but how large is that risk?? I have taken LoEstrin® for about 2 years. Does the risk increase the longer I am off of it?

Not over the course of less than a year, but after that I would think the chance is more that there might be change. Again pure guess -- no scientific studies I know of.

Pill potency to decrease flow on pills even more

Two and a half years ago, I started using Desogen®. I used the Sunday start method and tho I would not spot or have any breakthrough bleeding during the month, when I did get my period during the week of taking the "reminder" pills, it would start anywhere from a Tuesday one month, to a Saturday the next or anywhere in between. My periods had always been irregular so this was one of the reasons I decided to try the pill. Also, I knew they usually lessened the bleeding which was fairly heavy and also helped with cramps. Besides not getting my period on at least approximately the same day each month, they kept getting heavier and heavier each month, and the PMS also increased from one week in advance to having it the entire month. The pill did nothing to help with the cramps, either. I told my gyn and she switched me to LoEstrin 1.5/30® the following year. I also switched the pills to a Friday start so I would get my periods on Sundays.

At first, this pill worked great as far as the bleeding. It lessened it and also shortened the length of time it lasted. I also got it the exact same day (Sunday) each month, which I found very convenient. Unfortunately, it did nothing to help with the cramps and I usually had to take about 24 Advil® within a 24 hour time period for a day or two. Eventually, the Advil® wasn't helping and I switched to using Ultram® which helped much more. But, I noticed a few months after switching pain killers, that the first day of my period became quite heavy---heavier than it even was before I took any BC Pills---and also contained many more clots. For about 12-18 hours on the first day I will bleed very heavily, then it will lessen to average and then go to barely nothing for the next 2-3 days and end. I have since read that using Ibuprofen can lessen the flow and I think that's what happened with me---I stopped taking the Advil® and that's when the periods became heavier. I have become fed up with how heavy it is the first day and have recently asked my doctor what to do.

She suggested using Levlen® instead because it is a stronger pill than both Desogen® and LoEstrin 1.5/30® were. I am just wondering if you think this will help lessen the bleeding or make things worse like the Desogen® did because my understanding is that Desogen® is a stronger pill than LoEstrin®, yet it caused heavier bleeding. From what my pharmacist said, according to her chart, LoEstrin® is considered a "lower level" pill and Desogen® is an "intermediate level" pill. So, I'm thinking that because Desogen® caused me to bleed heavier and it was a higher level pill than the LoEstrin® (which lessened the bleeding in comparison to the two), then is Levlen® (which is a higher level than both of them) what I need or will it, too, cause heavier bleeding as the Desogen® did? Should I be going to a pill that's even lower than LoEstrin®? I guess I don't understand how you figure which way to switch someone's pills. My gyn said that you can't really compare two pills like Desogen® and LoEstrin 1.5/30® because the types of progestin in the two are completely different. I've read that if you have heavy periods that you want to increase the progestin level, but it seems like going from Desogen® to LoEstrin® was a decrease (at least according to the pharmacist's chart), but it did work in lessening the amount of bleeding compared to what I had on the Desogen®. So, now I'm completely confused whether to try this pill or not. I'm not as concerned with the cramps as I am with the bleeding and I'm hoping that my doctor is basing her choice of new pills on the bleeding factor more than the pain factor, which I tried to stress to her. She said she thinks this will help more with both, but I am still leery because, well, I have to worry about everything!!

Is there more progestin in Levlen® than the other two pills, and do you think it sounds like the right choice---or at least a choice that shouldn't make things worse even if it doesn't make things better?? I believe that the levels of progestin in each are:Desogen®---desogestrel 0.15mg LoEstrin®----1.5mg Norethindrone Acetate Levlen®-----0.15mg Levonorgestrel Is it true that you should increase the progestin level for heavy bleeding?? And, according to you, which is the weakest and strongest of all these pills? They all have the same dose of 30mcg of estrogen (the estradiol kind). I've heard that you can use two tampons at once---do you place them next to each other?? Does this really work?? Sorry this letter is so long, but I'm starting college in June and my period is, of course, due that week and I guess I'm looking for some reassurance that I won't be hemorrhaging at the time like with the Desogen®!! Should I give this pill a try--do you agree with her choice and that a stronger pill is what I need in spite of the bleeding, etc. that the Desogen® caused? Also, will I notice any change the first month or will it take a few? If the bleeding gets heavier on this pill in the first month, then I would think that it's not the right choice and change back or try another new one. If it doesn't get less, but stays the same, then I should try it for a few months, anyway. Does this sound correct? I am hoping that this pill will work like the others in that I will get my period the same day each month---do most pills work like that? Besides my Desogen® experience!! Again, sorry that this letter is so long, but for some reason, this is a big issue with me---what I'd really like is a hysterectomy so I won't have to deal with it anymore, but....

Keep in mind that what follows about pill potency is controversial. Some very prominent experts in the field feel that since there is so much individual variability in how any woman's specific tissue reacts to any specific hormone, you can't assign biologic potencies accurately enough to clinically prescribe different formulations according to different symptoms. That being said, pills are assigned biologic potencies as a combination of both the estrogen and the progestin. Since almost all pills have the same estrogen (ethinyl estradiol), the estrogen potency only varies from a few pills at the 20 ug level (Loestrin 1/20® and Allesse®) to the majority at 30 and 35 ug. In this respect Loestrin 1/20® would be considered -low- but actually Loestrin 1.5/30® I wouldn't consider low. The other component is the progestin. Progestin potency has in the past been measured by a "delay of menses" index, i.e., how well a hormone keeps the endometrium from sloughing. The higher the progestin potency (and it doesn't go mg per mg across different formulations) the more likely to stop heavy bleeding. For example Levlen® (levonorgestrel) mg for mg is more potent than many other progestins such as the one in Desogen® which is actually a very mild progestin. Higher progestin potency also tends to decrease cramps more. To complicate matters more, sometimes a higher estrogen potency (dose) is needed to "stabilize" the endometrium if if the progestin makes the endometrium too atrophic. You went from Desogen®, a low potency progestin, to Loestrin®, an intermediate potency progestin and your doctor has now suggested a higher potency progestin in Levlen. It seems like it would be worth a try. Another slightly higher progestin potency pill would be Demulen® 1/35. You may also need to get a thyroid check and a bleeding time check to rule out other causes of heavy bleeding.

How do I take birth control pills?

The most common pill packs come with 21 active hormone pills and seven placebo pills, but some packs have 23, 24, or even 28 active pills. The example shown below is for a 28–day pill pack in which you take 21 active hormone pills, and then seven placebo pills that contain no active hormones. These last seven pills are just "reminder" pills in most pill brands. They are taken during the fourth week, including during your period. With packages that have 24 active pills, the last 4 are "reminder" pills. There are also pill packages that have 84 active pills for continuous hormones and 7 "reminder" pills. Your health care provider will tell you whether you will be taking the active pills continuously or in cycles as illustrated below.

 

1. To take the Pill, follow the instructions on the package. Your health care provider will explain how to use your pill pack. You will be told to start taking the oral contraceptive pill on a Sunday, on the first day of your menstrual period, or the day you are seen by your health care provider.
2. You should take one Pill each day, at the same time of day until you finish the pack. Take the Pill at the same time as something that you do regularly so you don't forget. For example, you could keep them near your toothbrush, or set your cell phone alarm as a reminder. The best time is ½ an hour after a complete meal such as dinner or at bedtime. You may have slight nausea the first month, but this usually goes away with time. Some young women who take the Pill first thing in the morning find that they are more likely to have nausea, especially if they skip breakfast, so taking the pill at dinnertime may cure this symptom.
3. After completing a 28–day pack, you should immediately start a new packet of pills the next day. During your fourth week on the pill cycle, you should get your menstrual period. Your menstrual period should stop once you begin the new packet of pills.