How it works
Minor Side Effects
Major Side Effects
Who can’t take the pill?
How to take the pill
Important Notes
Late or Missed Pills
Missed Periods

How it works:

  • Suppresses ovulation (egg production)
  • Changes the endometrium (lining of the uterus) to make it unreceptive to implantation
  • Produces thickened cervical mucus


  • 99.6% effective when taken at the same time everyday
  • Regulates menstrual flow
  • Lighter flow and less cramping
  • Can decrease the incidence of uterine and ovarian cancers
  • Relieves symptoms associated with peri-menopause


  • Minor Side Effects:
    • Nausea (take with food or a bedtime to help; Use condoms if you vomit within 1 hour of taking the pill)
    • Spotting
    • Increase in vaginal discharge
    • Depression or mood changes
    • Acne
    • Mild Headaches
    • Lighter menstrual flow, maybe missed periods
  • Major Side Effects:
    • Blood clots
    • Hypertension (high blood pressure)
    • Gallbladder disease
    • Heart attack (smokers 35 and older)
    • Smoking doubles risk factor associated with pill use

    Minor side effects usually go away after the first three months or changing to a different pill or discontinuing pill use.
    Major side effects are rare in women under 35 who are non-smokers.

These side effects are characterized by the following danger signals.
If they occur, go to the Emergency Room.

  • Abdominal pain (severe)
  • Chest pain (severe) or shortness of breath
  • Headaches (severe)
  • Eye problems such as blurred vision or loss of vision
  • Severe pain, redness, or swelling in calf or thigh

Contraindications: (reasons you may not be able to take the pill)

  • History of thromboembolic disorders (blood clots)
  • Impaired liver function at present time (Hepatitis, mono, tumor)
  • Cancer of the breast or reproductive system (current or past history)
  • Hypertension (high blood pressure)
  • History of coronary artery disease
  • Hyperlipidemia (high cholesterol)
  • History of a stroke
  • Sickle Cell Disease
  • 40 years of age or older accompanied by a second risk factor
  • 35 years or older and currently a smoker
  • Pregnant
  • Undiagnosed vaginal bleeding

How to Take the Pill:

  • Start taking your first package of pills as directed by your healthcare provider
  • Usually, pills are started the Sunday after the first day of your period even if you are still bleeding; if your period begins on a Sunday, begin the pills on that day
  • Swallow one pill at the SAME TIME EVERY DAY
  • A second form of contraception is recommended for the first cycle

Important notes:

  • Some medications can decrease the effectiveness or cause other pill-related problems (ie, spotting) Always mention to your health care provider that you are on oral contraceptives prior to starting any other medication. Also let them know of any changes in medication while you are on oral contraceptives. Use a back-up method of birth control if you have any doubts about the possibility of a drug interaction or call health services for assistance.
  • Antibiotics decrease the effectiveness of oral contraceptives. Use a back-up method (condoms or abstinence) while on the antibiotic and for 7 days. after completing the antibiotic.
  • If you experience vomiting and/or diarrhea, use a back-up method of birth control (rest of cycle) since the pill may not have been absorbed properly.
  • Breakthrough bleeding (spotting) is common in the first three months, don’t be alarmed if you experience this.
  • If you begin having spotting after several months of pill use with no problems, make sure you are taking your pill at the same time everyday. If you are taking your pill properly and having spotting, get evaluated by your health care provider.

Missed Pills:

Read the package insert for the specific pill you are on in case there is a subtle difference.

More than 6 hours late
Take the pill when you remember it and use a back-up method for the next 7 days.

Miss one pill
Take the missed pill when you remember it and take the scheduled pill at the regular time (if you notice when you are taking your pill that you missed the previous day’s, take the missed one and today’s together). Use a back-up method for the next 7 days.

Miss 2 pills in first 2 weeks of pack
Take 2 pills at the regular time and then 2 pills at the regular time the next day. Use back-up method for the next 7 days.

Miss 2 pills in week 3 or miss 3 or more at any time
Sunday starter: Take 1 pill each day until Sunday, then throw out the rest of the pack and begin a new pack immediately, omitting the hormone-free week. Use back-up method for full cycle.

First Day starter: Throw away the rest of the pack and begin a new pack that day. Use back-up method for full cycle.

If 1 or more pills are missed with no back-up method, Emergency Contraception is available. It is most effective if used in the first 72 hours of unprotected intercourse. If 1 or more pills are missed, and then a period is missed, a pregnancy test should be done.

If you are not sure what to do about missed pills, use a back-up method any time you have sex and keep taking the birth control pill each day until you can talk with your Health Care Provider.

Missed period:

  • Have not been late with pills or missed any pills, continue with next pill cycle until you miss 2 periods, then see your health care professional, but keep taking your pills unless told to do otherwise.
  • Late or missed pills, no back-up method, see you health care provider. Keep taking pills until told otherwise.

UHWCS logo