Why am I having irregular bleeding on the pill?
It can take 3–6 months for your body to adjust to the hormones when first starting on an OCP or when switching from one pill to another. Your body can have irregular bleeding or “breakthrough bleeding” during that adjustment time. This can be alarming to many patients, but it is considered a normal side effect of the OCP. Taking your pill at the same time every day and making sure not to miss any pills can decrease the incidence of this. If the breakthrough bleeding persists into the fourth or fifth pack of pills or if you experience any heavy bleeding (soaking super pads/tampons every hour for more than 2 consecutive hours) you should call the office and speak to a Nurse Practitioner or Physician Assistant.

When will my pill be effective?
Chicago Women’s Health Group recommends patients use a backup form of birth control (ex: condoms) for the first pack of pills (28 days) when first starting a pill or when switching from one pill to another.

Oral Contraceptive Use Instructions

How do I start my pills?
Take your first pill on the Sunday after your next normal period starts. If your period starts on a Sunday, take the first pill on that day. Most pill packs have 21 or 24 “active” pills with hormones, and 4–7 “reminder” pills without hormones. If you take one pill each day, you will always be on a 28-day cycle, and you will always start a new pack of pills on Sunday.

How do I take my pills?
Take one pill daily about the same time every day until the pack is empty. Do not skip pills for any reason. If you feel sick or have bleeding or spotting, still take your daily pill. At the end of the pack of pills (including the “reminder” pills), start a new one, without skipping any days.

What if I miss a period?
As long as you have taken your pills correctly, the chance of being pregnant is very small. If you have skipped any pills during the month and then miss a period, you should take a home pregnancy test and/or call the office. If you have taken your pills correctly but miss two periods in a row, call the office. Remember, while taking the pill, your periods may be much lighter and shorter than they were before.

Do I have to take the seven “reminder” pills?

If you choose not to take the reminder pills, just take the active hormone pills and take those days off before starting a new pill pack. You will still be protected from pregnancy during the days off, as long as you start the next pack of pills at the right time.
Note: There is one type of pill which has some active hormone pills in the 4th week. There is also a type of pill which contains iron in the “reminder” pills to help with iron loss during your period. Your provider will give you specific instructions if you have been prescribed either of these types.

What should I do if I forget to take a pill?
Missing pills can cause spotting or light bleeding, even if you make up the missed pills. You might be somewhat nauseous on the days you take extra pills to make up for missed ones.

If you miss one pill: Take it as soon as you remember and take the next pill at the usual time. This means you may take 2 pills in one day. You do not need to use an additional backup form of birth control.

If you miss two pills in a row in week 1 or 2 of your pills: Take two pills on the day you remember, then two the next day. Finish the remainder of the pill pack as usual. Use backup birth control until you have taken 7 pills in a row correctly.

If you miss two pills in a row in week 3 of your pills or three pills at any time during the month: Immediately start a new pack without having a pill-free interval. Use a backup method for 7 days.

What if I have bleeding between my periods?
In the first few months of taking the pill, breakthrough bleeding or spotting is very common. It can also happen if you don’t take your pill at the same time each day. Do not stop taking your pill! Continue taking the pills as instructed. If the bleeding is heavy or lasts past the first 2 or 3 cycles, call the office to discuss this with the nurse practitioner or physician assistant.

Is it all right to take other medication(s) while I am on the pill?
There are some drugs which may interfere with the effectiveness of your birth control pills. If you are on the pill, ask your provider or a pharmacist if the medicine that has been prescribed will interfere with the pill’s effectiveness.

What if I run out of pills?
Try not to! When you open a new pack of pills, check that your prescription is current and mark your calendar to pick up your next pack. If your prescription expires before your next appointment to get pills, call the office so arrangements can be made for you to remain on the pill.

What if I want to stop taking the pill?
It is best to finish a whole pack before you stop. Any time you stop taking the pills you’re no longer protected from becoming pregnant. Your first period after stopping the pill may be on time or it may be late. Call the office with any specific questions.