Top 10 Questions About Hormonal Birth Control

These HBC methods do NOT protect a woman from sexually transmitted infections. Safer sex practices, like using condoms, are recommended even if you are using HBC. The advice given here does not replace the medical advice you receive from your health care provider. Always contact your provider if you have further questions or have problems.

1. How do I start my birth control method? The easiest way is to start the day you get your period. If you do this, your method will work immediately. Some women prefer to start the Sunday after a period begins (so if you period starts on a Wednesday, you start your method 4 days later on Sunday). This is so you won’t get you period on your method over a weekend. If you want to start your method without a period, you should contact your health care provider for further instructions.
2. What do I do if I miss pills/patch falls off/ forget to insert a vaginal ring on time? If you miss one pill, take it as soon as you remember that you forgot, and then take your next pill at the regularly scheduled time. If you miss 2 or more pills, please contact your health care provider for further instructions, or refer to your FDA package insert you received with your pack of pills. If the patch falls off, immediately reapply the same patch (if you have it). If it has been more than 24 hours since your patch was on, or you can’t remember when it fell off, apply a new patch, and use back up birth control, like condoms, for 2 weeks. If you forget to insert a new vaginal ring, as long as you haven’t had any unprotected sex since you were due to inert a new ring, you can go ahead & insert one without your period, and then use back up birth control, like condoms, for 2 weeks.
3. How do I restart my method after being off of it? Just start with your period as described in question 1.
4. Do antibiotics affect my birth control method? At this point, there are no definitive research findings that show that all antibiotics make birth control methods ineffective.  The one which we know absolutely makes HBC methods (pill, patch, and ring) ineffective is called rifampin, which is used to treat tuberculosis.  Further information about antibiotics & oral contraceptives.
5. Are there other drug interactions I should be worried about? See the above link for information about drug interactions. The same information applies to the ring & patch. In addition, using vaginal oil based medications such as yeast infection treatments might increase hormone levels when using the vaginal ring. More information.
6. Are there health benefits to using HBC? Yes. There is research that shows that using HBC can help to reduce the risk of ovarian and endometrial cancer. It can help acne, and decrease the risk of anemia and ectopic pregnancy. Periods are usually lighter, shorter, less crampy, and usually predictable when using HBC.
7. Are there health risks to using HBC? Yes. As with any medication, there are risks. The risk that health care providers worry about the most is cardiovascular risk. When a woman uses HBC, she has a somewhat higher risk for developing a blood clot (this type of clot is not the same as passing a clot with a period). A blood clot can occur in the leg or arm, break off and travel to the heart, lung, or brain, causing a heart attack, a pulmonary embolus, or a stroke. Any of these problems could be fatal. A woman’s risk of having this problem is greater if she smokes. There is NO “safe” amount of smoking on HBC methods. Women who use HBC should not smoke because of this risk. If you want HBC and you smoke, talk about it with your health care provider. The risk of having a blood clot on HBC is half of that when a woman carries a pregnancy to term. Therefore, if a woman wants to prevent pregnancy, the benefit of her using birth control outweighs the risk of pregnancy.
8. Does HBC cause cancer? At this point, there is no direct evidence that HBC causes cancer. However, long term use of Hormone Replacement Therapy (HRT) in older women who have reached menopause has been linked to breast cancer.
9. What if I have nausea on my HBC? Nausea is a common side effect when a woman starts a HBC. It usually goes away within a few weeks. If you are on the pill, take your pill on a full stomach at bedtime. If you use the ring or the patch, have small frequent snacks in between meals, like crackers, fruit, or yogurt to keep your blood sugar steady. If the nausea doesn’t subside after 3-4 weeks, contact your health care provider.
10. What if I have unscheduled bleeding in between my periods on HBC? In the first 3 months of starting your HBC, it is common to have some irregular, unscheduled bleeding in between your periods. It should go away within 3 months. If you forget to take pills or put your patch on, you can have some irregular bleeding as a result. If you are using your HBC correctly, and the bleeding doesn’t go away, you should see your health care provider. Other medical conditions need to be rules out, such as sexually transmitted infections, common vaginal infections, and uterine problems.

If you would like more information and would like to schedule an appointment with our Women’s Health Nurse Practitioner, Katie Wooten-Bielski, CRNP, please call 610-896-1089 for an appointment. Katie is available on Tuesdays & Fridays from 8:30am to 4:30 p.m.