Oral Contraceptive Information

Most birth control pills consist of a combination of synthetic hormones – estrogen and progesterone. Birth control pills primarily prevent pregnancy by inhibiting egg production. With no egg to be fertilized by sperm, pregnancy cannot occur. It is very important to recognize that “The Pill” helps protect you from pregnancy but offers no protection against sexually transmitted infections.


ACTUAL USE EFFECTIVENESS is approximately 96-99%. Incorrect use, such as skipping a pill or taking one late may increase your chance of getting pregnant on the birth control pill.

Please contact our office for refills on your birth control within 72 hours of running out to ensure there is not a lapse in medication coverage. 


How to Use

For Sunday Start Pill: Start your first pack on the first Sunday after your period begins. If you period begins on Sunday, start the pill that day. You will always start your pill pack on Sunday.


For First day Start Pills: Find the day label strip that starts with the day of the week your period begins. The first day of your period is the day you begin bleeding or spotting (even if it is almost midnight when bleeding begins). Peel the label strip and place it on top of the pill pack card where it says, “Place Day Label Here”. Make sure each day of the week is above a row of pills. Throw away the strips you are not using.


28 Day Regimen: You take 21 hormone pills followed by 7 different colored “reminder” or placebo pills. Your period will come during the time you are taking the reminder pills because these pills contain no drugs. You start your next pack the day after you finish the reminders (Sunday). This eliminates the on-and-off schedule of the 21 day regimen; there is no medical difference.


Helpful Hints

Birth control pills do not protect you for the first month; therefore, a second form of birth control (back up method) must be used during that entire first package of pills. Choose a backup method of birth control (such as condoms and foam) to use with your first package of pills or if the following occurs:

  • Run out of pills

  • Forget pills

  • Experience pill danger signs and stop taking the pill

  • Are sick and vomit your pills

  • Have to take medicine which may alter the pill’s effectiveness. (see below list for examples)


Use of condoms and foam with the birth control pills will help to protect you for sexually transmitted infections. Please consider a condom whenever there are questions about your partner’s sexual activity, past or present.

Pills must be taken every day at the same time (i.e. within one-half hour of the same time) in order to maintain a specific hormone level in your body which prevents egg productions. Each time you miss a pill or take it at a different time you increase your chance of becoming pregnant. To help your memory, associate taking your pills with one of your daily activities such as brushing your teeth or eating dinner.


If you miss 1 pill, take it as soon as you remember it. You are not protected; therefore, use your backup method of birth control for the rest of that package. You may have bleeding or spotting until your next package of pills is started.


If you miss 2 pills, take 2 pills as soon as you remember and 2 pills the next day. You are not protected; therefore, use your backup method of birth control for the rest of that package. You may have bleeding or spotting until your next package of pills is started.


If you miss 3 or more pills, stop pills and use another form of birth control until your period starts. Restart your birth control pills as described on the first page.


Periods may be shorter and scant on the pill. You may have no fresh blood at all. If you only have a drop of blood or a brown smudge on the tampon or pad, that counts as a period.


If you have missed one period but have not missed any pills and have no signs of pregnancy, then you should continue the pills. If you are worried about pregnancy, call the office. If you miss one or more pills in a cycle and then miss your period, you should stop the pills, use your backup method of birth control and call the office.


If you miss 2 periods in a row, call to set up a pregnancy test, even if you have taken your pill every day.


If you decide you want to get pregnant, stop your pills at the end of the package and use your backup method of birth control until you have at least 1 normal menstrual period off the pill. This is to allow for accurate calculation of your due date.


Always tell your health care provider that you are on birth control pills, especially if you are admitted to a hospital of need surgery.


If mood changes, depression, irritability or change in sex drive continue for three months or more on the pill, please let us know. Switching to another brand of pill may help.


If you smoke more than 14 cigarettes per day, you should watch carefully for pill danger signs and stop taking the pill at age 35. We highly recommend you not smoke at all while taking the pill. We offer Smoking Cessation Classes if you desire. Please ask us about these classes.


Learn the pill danger signs: any one of these could mean a serious problem.


Abdominal pain (severe)

Chest pain (severe), cough, shortness of breath

Headache (severe), dizziness, weakness, numbness

Eye problems (vision loss or blurring), speech problems

Severe leg pain or swelling (calf or thigh)


See your health care provider if you have these problems or if you develop depression, yellow jaundice or a breast lump.

Certain medications may decrease the effectiveness of birth control pills. If you use them, you should discuss this with your health care provider.


The following medications can decrease the efficacy of your birth control:

Antibiotics: Most antibiotics are now safe to take with OCP’s. However, the antibiotic Rifampin has known to interfere with birth control and a back up method should be used.

Antacids: There are some antacids that can decrease the effectiveness of your birth control pill. If you are taking an antacid regularly please let our office now and we can check for a conflict.

Anti-HIV Medications: There are certain types of antivirals that can interfere with birth control, please make sure to make sure we have all of your medications on file in order to properly identify an interaction.

Anti-fungal Medication: The two main ones to watch out for are griseofulvin (Gris-PEG) and ketoconazole (Extina, Nizoral, Xolegel). Scientists have shown that the risk of anti-fungal meds interfering with your birth control is relatively low, and should you start a new medication please contact our office.

Anti-Seizure Medication: Some of these medications increase the breakdown of the hormones in birth control pills. That could make them less effective. These medications include: Carbamazepine (Carbatrol, Epitol, Tegretol), Felbamate, Oxcarbazepine (Trileptal), Phenobarbital (Luminal), Phenytoin (Dilantin, Phenytek), Primidone (Mysoline), Topiramate (Topamax). You may want to consider an alternative birth control option such as IUD or condoms if you take any of these medications. The birth control pills will not interfere with the efficacy of your seizure medication.

Modafinil (Provigil): This medication is a stimulant that is used to treat certain sleep disorders like narcolepsy or sleep apnea. Studies have shown that is can decrease the effectiveness of your birth control and you should use a back up birth control method while on it and for 1 full month after stopping the medication.

Herbal Remedies: St. John’s Wort, Saw Palmetto, Alfalfa, Garlic Pills, and Flaxseed. These are just a some of the herbal remedies that have been known to decrease the effects of your birth control. Please make sure you advise our office of all supplements you are taking as well.

It is important to remember to keep your medication list up to date with our office to avoid any possible interactions