Michael Frey, MD

How To Use Birth Control Pills

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Who should NOT use birth control pills? Anyone with the following:

• Less than 6 wks postpartum 

• Smoker over the age of 35 (>15 cigarettes per day)

• Hypertension (systolic > 160mmHg or diastolic > 100mmHg)

• History of venous thromboembolism (VTE)

• History of stroke 

• Heart disease  

• Migraine headache with focal neurological symptoms

• Breast cancer (current)

• Diabetes with retinopathy/nephropathy/neuropathy

• Severe cirrhosis or liver disease

 

When Do I Start My Pills?

You can start your pills on any day of your cycle but here are the options:

1. Start the pill on day 1 of your menstrual period. If you start at this time, you will not need any backup form of birth control (contraception), such as condoms.

2. Start the pill on the first Sunday after your menstrual period or on the day you get your prescription. In these cases, you will need to use backup contraception for the first week.
3. Start the pill at any time of your cycle. If you take the pill within 5 days of the start of your period, you will not need a backup form of contraception. If you start at any other time of your menstrual cycle, you will need to use another form of contraception for 7 days.

 

-No matter which day you start the OCP, you will always start a new pack on that same day of the week. Have an extra pack of OCPs and a backup contraceptive method available in case you miss some pills or lose your OCP pack.

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Will My Pills Work Right Away?

Not always. If you start your pills:

• Within 5 days of the start of your period, you do not need backup birth control.

• After the first 5 days of your period, use backup birth control - like condoms - or don't have sex for 7 days.

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How Do I Take My Birth Control Pills?

It's up to you, depending on whether or not you want to have a period.

 

If you want to have a period every month:

• Swallow one pill every day, the same time every day. Set a daily phone alarm to remind yourself it's time to take your pill.

• Take all the hormone pills, then start a new pack. Taking pills this way will give you a period about every 4 weeks.

• It's okay to skip your reminder pills. There's no hormone in them, so skipping them won't make your pills less effective.

If you want to choose when you have a period:

• Take the first 3 weeks of hormone pills. After taking the last pill, skip the reminder/placebo pills and start a new pack the next day. Continue taking only the hormone pills to avoid having your period.

• Just make sure you are skipping the reminder (placebo) pills. Some pill formulations have only 4 placebo days not 7. Some pills (like Seasonique) have no placebo pills until the third month of use. At the bottom of the pack, when the pill changes color is when the placebo pills kick in. If you have any questions about which are the placebos pills just snap a pic of the pill case and text me. 

• When you're ready to have a period, finish the pack you are using and start taking the reminder/placebo pills again and it will come. 

• If you are skipping, give yourself a period at least every 3 months. 

                

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