Learning About the Birth Control Pill
What is the birth control pill (the pill)?
The pill is taken every day to prevent pregnancy. It contains hormones (estrogen and progestin) that mimic natural hormones. They stop the ovaries from releasing an egg. You can’t get pregnant if you don’t release an egg.
How well does the pill work?
- With typical use (not following the exact directions) the pill is 91% effective.
- With perfect use (you follow the exact directions all the time) the pill is 99.7% effective.
- Most pregnancies happen because people forget to take their pills.
- The pill doesn’t protect you from sexually transmitted infections (STIs) or HIV.
How do I start taking the pill?
You need a prescription from your healthcare provider. Many sexual health clinics offer some types of birth control for free or for low cost for people who qualify.
If you start the first hormone pill on:
- day 1 of your period, it works right away to prevent pregnancy
- any other day, use an extra method of birth control (like condoms) or don’t have vaginal sex for 7 days
How do I use the pill?
To use a 28-day pack:
Take 1 pill each day at the same time. There are different types of 28-day packages:
- first 21 pills have hormones and the last 7 pills are hormone free
- first 24 pills have hormones and the last 4 pills are hormone free
- first 26 pills have hormones and the last 2 pills are hormone free
You’ll usually get your period 2 to 3 days after starting the hormone-free pills. You’re still protected from pregnancy during this time.
When the pack is done, start a new pack the next day. Always start your new pack of pills on time, even if your period hasn’t ended. Your period should stop in a few days.
If you don’t get a period, start your new pill pack and see your healthcare provider.
To use a 21-day pack:
- Take 1 pill each day at the same time for 21 days.
- When the pack is done, wait 7 days before you start a new pack. You’ll get your period when you aren’t taking pills (hormone-free days). You’re still protected from pregnancy during this time.
- The hormone-free days must not be longer than 7 days. At the end of the hormone-free days, start a new pack. Always start your new pack of pills on time, even if your period hasn’t ended. Your period should stop in a few days.
- If you don’t get a period, start your new pill pack and see your healthcare provider.
What are the benefits of the pill?
- Your period may be more regular, lighter, or shorter with less cramping.
- The pill may lower your risk of ovarian and endometrial cancer.
- The pill may help with acne and painful periods (dysmenorrhea).
- It’s safe to use the pill for many years. There is no need to “take a break” from the pill.
- You can get pregnant as soon as you stop using the pill.
What are the side effects of the pill?
There’s a chance (more likely in the first 3 months) that you might have:
- headaches
- breast or chest tenderness
- bloating
- upset stomach (nausea)
- moodiness
- spotting or bleeding between periods
If you have any side effects, don’t stop taking the pill. Talk to your healthcare provider. Most side effects get better within 3 months.
Can the pill cause blood clots?
When taking the pill, there’s a small risk of blood clots in the legs, lungs, heart, or the head.
The risk is higher depending on your:
- age
- weight
- history (or family history) of blood clots, heart attack, or stroke
- history of smoking or vaping nicotine (especially people older than 35 who smoke)
- history of migraines with aura or other nervous system problems affecting speech, vision, movement, or sensations
- risk factors for heart disease (like high blood pressure, diabetes, or high cholesterol)
- history of other medical problems (ask your healthcare provider about this)
The risk of getting a blood clot is higher during pregnancy and right after having a baby than when taking the pill. The risk for blood clots might be different depending on the type of progestin in your pill.
Blood clots are very serious. Go to the nearest emergency department or call 911 if you have:
- trouble breathing or it hurts to breathe
- a very bad headache
- sudden numbness in the face, arms, or legs (often only on one side of the body)
- very bad pain in your abdomen, chest, or legs
- eye problems (like sudden blurry vision or loss of vision)
- sudden problems with walking or balance
- sudden confusion or trouble understanding what people say to you
What if I forget to take my pills?
Missing any pills can increase your risk of pregnancy. Your risk is increased if you miss a pill right at the start or the end of your pack. If you need help deciding what to do, talk to your healthcare provider, read the chart below, or use the Sex & U – Stay on Schedule tool. There are also apps you can use on your phone to help you remember to take your pill.
If you forgot a pill but took one less than 48 hours ago:
- take it as soon as you remember (this might mean you take 2 pills on the same day)
- continue taking 1 pill every day at the same time
- you’re protected from pregnancy
If you took your last pill more than 48 hours ago:
| Week 1 | Week 2 or 3 |
| Forgot 1 or more | Forgot 1 or 2 pills | Forgot 3 or more pills |
- Take 1 pill right away (this might mean you take 2 pills on the same day).
- Continue to take 1 pill every day until the end of the pack.
- Use an extra method of birth control (like condoms) or don’t have vaginal sex for 7 days.
- Get emergency contraception as soon as possible if your extra method of birth control fails (like if the condom breaks) or if you’ve had vaginal sex without a condom in the last 5 days.
| - Take 1 pill right away (this might mean you take 2 pills on the same day).
- Continue to take 1 pill every day until you finish your hormone pills.
- Don’t take hormone-free days and start a new pack right away.
- You might have spotting or miss your period this month. Don’t stop taking your pills.
- You’re protected from pregnancy.
| - Take 1 pill right away (this might mean you take 2 pills on the same day).
- Continue to take 1 pill every day until the end of your hormone pills.
- Don’t take hormone-free days and start a new pack right away.
- Use an extra method of birth control (like condoms) or don’t have vaginal sex for 7 days.
- Get emergency contraception as soon as possible if your extra method of birth control fails (like if the condom breaks) or if you’ve had vaginal sex without a condom in the last 5 days.
- You might have spotting or miss your period this month. Don’t stop taking your pills.
|
If you vomit within 1 hour of taking the pill, take the next pill in your package. This means you’ll start your next pack of pills 1 day early.
What else is important to know about consent, sexual activity, and birth control?
- You have the right to decide to have sex or not. Talk with your partner or partners about consent.
- There’s an 85% chance of becoming pregnant within one year, if no birth control is used for vaginal sex.
- Use a condom or barrier every time you have sex (oral, vaginal, anal). Condoms help prevent pregnancy, STIs, and HIV.
- You can lower your risk of HIV by taking an HIV medicine every day. Many Albertans can get it for free. Visit HIV PrEP to find out more.
- Transgender and gender diverse people who have a uterus can use hormonal birth control. It can help prevent pregnancy and make periods lighter and less painful.
Where can I find more information?
If you have questions, need to find a sexual health clinic near you, or want more information, call Health Link at 811 anytime, day or night, to talk to a registered nurse.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_birth_control_pill_inst.
Related to Sexual and Reproductive Health
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: February 12, 2024
Author: Sexual and Reproductive Health, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
