THE PILL

Ah, the pill. For adolescent girls, the pill is kind of like a gateway drug to other forms of hormonal contraceptives. For most uterus owners trying not to get pregnant, the pill is usually the first hormonal contraceptive option you’ll be prescribed before you begin to explore other options. Some people like the pill so much, they never stray from it. There are a variety of different brands that you can use, each with different dosages of hormones, but they all work much the same in theory.

How does the pill work?

There are two major types of oral contraceptives: combined oral contraceptives and progestin-only pills. These are differentiated based on the types of hormones they release. As their names suggest, combined oral contraceptives release a combination of hormones, whereas progestin-only pills release, you guessed it, progestin only.

Combined Oral Contraceptives

These pills releases the hormones estrogen and progestin, which are absorbed into your body.  These hormones prevent ovulation, meaning your ovaries don’t release any eggs.  If there are no eggs chilling in your uterus, there’s nothing for sperm to fertilize. In addition, these hormones thicken your cervical mucous, making it more difficult for sperm to access your uterus in the first place.  Lastly, the hormones alter the lining of your uterus, making it difficult for a fertilized egg to implant, even if that egg were able to be released and fertilized.

Progestin-Only Pills

These pills release the hormone progestin only. Like combined oral contraceptives, progestin-only pills prevent ovulation, thicken cervical mucous, and alter the lining of your uterus. The main difference is that progestin-only pills contain a lower dose of hormones, so they must be taken on a much more rigid schedule. As in, they must be taken at the exact same time every day.

How do you use the pill?

For both kinds of hormonal contraceptives, you just pop them down your gullet like any other pill! They do work on slightly different schedules though.

Combined Oral Contraceptives

With these babies, you get a pack of twenty-eight pills—that’s one pill per day for exactly four weeks. Twenty-one of these pills (that’s three week’s worth) are active pills, meaning they contain hormones. Seven of these pills (that’s one week’s worth) are sugar pills, meaning they don’t contain any hormones or medical ingredients at all.  The purpose of the sugar pills is to keep you on track while stopping the hormones so that your body can begin menstruation normally.

It’s worth noting that some brands of birth control pills will work on different schedules. Some might contain three or six straight month’s worth of active pills before there’s a week of sugar pills. This means that you would only get your period every three or six months, depending on which variety you are using. In addition, some doctors will prescribe you different schedules for your pill intake depending on your personal preferences. My first doctor told me to take the active pills straight through and discard the sugar pills, so that I would never have a period. This didn’t work super well for my body, and I had enough breakthrough bleeding that I eventually got sick of it and switched to a different birth control method. However, another friend of mine swears by this method, and she hasn’t had a period in years. If you’re someone who would like to reduce or eliminate your periods, discuss these options with your doctor. But do not alter the schedule of your birth control without consulting your doctor first.

Progestin-Only Pills

These little follows also come in packs of twenty-eight pills, but there are no sugar pills. You take one active pill every single for four weeks until your pack is up, and then you start another. No breaks, no sugar pills. Timing is important here: you must take your pills at the exact same time every day for maximum effectiveness.

How do you start taking the pills?

The process for starting up is the same for both kinds of pills. There are a couple ways you can go about this:

  1. Begin a new pack of pills by taking an active pill on the first day of your period. Continue to take one pill every day, and start up a new pack as soon as the old one is finished. With this method, you don’t need to use any form of backup protection because the pill will be effective immediately.
  2. Start a new pack by taking an active pill on any day, regardless of where you’re at in your body’s menstrual cycle. With this method, you’ll need to use a non-hormonal form of backup protection (like condoms) for at least seven days.

How much does the pill cost?

On average, birth control pills cost between $0 and $50, depending on the type of pill and your insurance provider. A good way to reduce the cost of your birth control is to ask your doctor or pharmacist for a generic version. They’re exactly the same as the brand name versions, but at a reduced cost. Most doctors and pharmacists will give you a generic version automatically. If you’re really strapped for cash, try going to a non-profit sexual health clinic—they might have options for subsidizing your birth control. The pill does require a prescription, so if you’re in a place where you don’t have access to universal health care, you might have to pay for your visit to the doctor.

How effective is the pill?

If used correctly, birth control pills are very effective at preventing pregnancy. According to Options for Sexual Health, with perfect use you’re looking at 99.7% effective at preventing pregnancy. With typical, imperfect use, that figure drops down to 92% effective at preventing pregnancy. These numbers are the same for combined oral contraceptives and progestin-only pills.

Pros

  • Very effective at preventing pregnancy.
  • Easily reversible.
  • May lighten periods and some hormone-related symptoms like acne.

Cons

  • Do not protect against STIs.
  • Must be taken daily, at or around the same time each time.
  • It’s easy to forget to take them, and it’s easy to lose them.
  • Require a prescription.
  • Like all hormonal birth controls, they may come with some side effects such as depression, mood swings, headaches, weight gain, bloating, etc.  Talk to your doctor for a full list of potential side effects.
  • If you suffer from migraines and have a family history of strokes, taking combinated oral contraceptives can increase your risk of suffering a stroke. If you fall into both of these categories, tell you doctor so they can prescribe a birth control method that will be safer for you.

 

References: “Birth Control Pill,” PlannedParenthood.org, Planned Parenthood, https://www.plannedparenthood.org/learn/birth-control/birth-control-pill; Gupta, Rupal Christine, MD, “About Birth Control: The Birth Control Pill,” KidsHealth.org, KidsHealth, Jan. 2017, http://m.kidshealth.org/en/parents/bcpills.html; “Progestin-Only Hormonal Birth Control: Pill and Injection,” ACOG.org, American Congress of Obstetricians and Gynecologists, Jul. 2014, https://www.acog.org/Patients/FAQs/Progestin-Only-Hormonal-Birth-Control-Pill-and-Injection, “Progestin-Only Pills (POPs)”, OptionsforSexualHealth.org, Options for Sexual Health, Mar. 2009, https://www.optionsforsexualhealth.org/birth-control-pregnancy/birth-control-options/hormonal-methods/progestin-only-pill; “Relative Effectiveness of Birth Control Methods,” OptionsforSexualHealth.org, Options for Sexual Health, Mar. 2009, https://www.optionsforsexualhealth.org/birth-control-pregnancy/birth-control-options/effectiveness; “Using the Pill (Combined Oral Contraceptives),” OptionsforSexualHealth.org, Options for Sexual Health, https://www.optionsforsexualhealth.org/birth-control-pregnancy/birth-control-options/hormonal-methods/combined-hormonal-contraceptives/using-pill.
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