Birth control information
Hormonal birth control
Hormonal birth control methods -- Oral Contraceptive Pill (OCP), Ring (NuvaRing) and Patch (Ortho Evra) are very effective, reversible methods of birth control and safe for most young, healthy women. Before you start any of these methods, please read the material accompanying your pack.
These methods do not provide protection against sexually transmitted infections (STIs) including HIV infection. Latex condoms used consistently and correctly reduce your risk of becoming infected with a STI. Latex condoms are free to any UK student and are available in the health educator's office, University Health Service room 246. For information on lambskin condoms, polyurethane condoms, or female condoms, call the health and wellness nurse at 323-5823, ext. 83264.
Contraceptive action
Combination hormonal methods contain the hormones estrogen and progestin, much like those produced by a woman's body. They work primarily by suppressing ovulation. Other actions include altering cervical mucus making it hostile to sperm penetration and altering the uterine lining preventing implantation of a fertilized egg.
Benefits
- Very effective method of birth control if used consistently and correctly
- Regular periods, lighter flow, less menstrual cramping
- Improvement of acne (with some)
- Reduction of excessive facial or body hair (hirsutism)
- Reduced risk of noncancerous lumps or cysts in the breasts
- Reduced risk of cancer of the ovary and cancer of the endometrium (lining of the uterus)
- Reduced risk of ectopic pregnancy (pregnancy that occurs outside of the uterus)
- Reduction in iron deficiency anemia due to less bleeding with periods
- Reduced risk of pelvic inflammatory disease, a major cause of female infertility
- Reduced risk of functional ovarian cysts
Side effects
Minor side effects may occur during the first two or three cycles but usually resolve spontaneously. See your health care provider if any of the symptoms persist after three months of use.
- Nausea. Try taking your pill with food or at bedtime. Avoid skipping meals. Eating small amounts of healthy food more frequently during the day may also help.
- Spotting or light bleeding between periods. Take your pill at the same time every day. See your clinician if bleeding is heavier than a period or if severe cramping or abnormal discharge accompanies bleeding.
- Weight gain. With a healthy diet and appropriate exercise, it is unlikely that you will gain weight.
- Breast tenderness. Wear a bra that provides good support.
- Hormonal methods may increase sensitivity to the sun in some women, increasing the risk of sunburn. Increase your time in the sun slowly and follow usual skin and sun precautions, such as a good sunscreen with an SPF of at least 15. If you use a tanning bed (never a good idea), build up your time slowly for the same reason.
- Some women notice increased skin pigmentation (darkening of the skin) on the upper lip, under the eyes, and on the forehead. Sun exposure can increase the risk of pigmentation in susceptible women. This is not dangerous and is not an indication to stop hormonal methods, but may be slow to fade when they are stopped. Increased pigmentation may even be permanent in some women.
Major risks
Although the risk of serious, life-threatening complications is small, users of hormonal birth control have a slightly greater risk of certain cardiovascular problems than nonusers. The most serious is the possibility of blood clots in the legs, lungs, heart, or brain.
Smoking places a woman using hormonal methods of birth control at greater risk for cardiovascular problems. You are strongly encouraged to stop smoking if you are using these methods. For information on smoking cessation or for assistance in becoming smoke free, please call 323-APPT to make an appointment with our health educator.
The majority of studies have found no overall increase in the risk of breast cancer in hormonal birth control users.
If you develop any of these symptoms, seek prompt medical attention.
- Severe headaches
- Numbness or weakness of one side of body
- Eye problems such as blurred or double vision, loss of vision, or other unusual visual symptoms
- Sudden shortness of breath or coughing up blood
- Sudden or constant pain or redness and swelling in your leg
- Worsening or severe depression
- Yellowing of the skin or eyes (jaundice)
- Breast lump
Starting oral contraceptive pills:
University Health Service clinicians usually prescribe a "28 day pill pack." The first 21 pills of each pack are your "hormone" or "active" pills. In most brands the last 7 pills of each pack are "blanks" or "inactive" pills, placed in the pack to keep you on a daily pill schedule and you should have a period during this week.
There are three options for starting the first pack of OCPs:
- First day start. Take your first active pill on the first day of your period.
- Sunday start. Take your first active pill on the Sunday immediately following the first day of your period (for example, if your period starts on Monday, Tuesday, Wednesday, Thursday, Friday, or Saturday, take your first pill that Sunday. If your period starts on Sunday, take your first pill that same day.)
- Quick Start. Take your first active pill in the provider's office during your appointment or when you pick up your pill pack from the pharmacy. Never start your pills if there is a possibility that you could be pregnant.
Take one pill every day until you finish the entire pack. Your pills are most effective if you take a pill about the same time each day (within one or two hours of the same time every day).
Your period will occur sometime during that last week of each pill pack. Take all of the "blank/inactive" pills even if your period does not last the entire week. You will always start a new pack of pills on the same day of the week. If you started your first pill pack on Sunday, you will always start a new pack on Sunday. If you started your first pill pack on the first day of your period (e.g. Wednesday) you will always start a new pack on Wednesday.
When you have taken all of the pills in your pack, start the first pill of your new pack. Do not skip any pills, and do not skip any days between packs.
When backup contraception may be needed:
Abstain from intercourse or use an additional method of birth control such as a male condom and/or vaginal spermicide if you have any intercourse during the first seven days of initially starting your hormonal contraceptive method. Hormonal contraception may not fully protect you from pregnancy during this first week of use.
Missed or late pill. If you forget one hormone pill, take the missed pill as soon as you remember. Take your next pill at the regular time. Taking a pill as much as 12 hours late may decrease your protection against pregnancy. Use a back-up method of contraception for 7 days or abstain from sex for 7 days. If you miss more than one pill, refer to the more detailed information provided in the insert with each pill pack. The risk of pregnancy is greatest if you are late starting a new pack of pills. Use back-up contraception or abstain from sex until you are back on pills for seven consecutive days.
Diarrhea or vomiting. Use an additional method of contraception along with your current hormonal contraceptive method beginning on the first day of any vomiting or diarrhea, and contact the Health Service Phone Information Nurse or your health care provider for additional instructions.
Back-up contraception such as a male condom may also be needed if you are on certain medications such as antibiotics or anti-seizure medications. Consult with your health care provider.
Important note: refer to the package insert for problems or questions about use of the birth control pill.
Menstrual suppression (extended cycle)
Menstrual suppression or purposefully delaying your menstrual cycle is safe and effective, especially for those who have heavy periods or migraines related to their period. Some pill packs already come in a 91 day regime, i.e., Seasonale and Seasonique. These can be very expensive. Certain monthly (28 day) pill packs, the Ortho Evra Patch, and the NuvaRing can also be used if you desire menstrual suppression. Please make an appointment or contact your clinician for further instructions on how to use this method and to assure that you are on the correct type of birth control pill.
Ring
The ring prevents pregnancy by transferring hormones into your body through the surface of the vagina. This method uses a 28-day cycle. A ring is inserted and left in the vagina for 3 weeks (21 days). The ring is removed after 21 days and your period should start during this ring-free week.
There are three options for starting the Ring:
- First day start. Place your ring on the first day of your period.
- Sunday start. Place your ring on the Sunday immediately following the first day of your period (for example, if your period starts on Monday, Tuesday, Wednesday, Thursday, Friday, or Saturday, place your ring that Sunday. If your period starts on Sunday, place your ring that same day.
- Quick Start. Place your ring in the provider's office during your appointment or when you pick it up from the pharmacy. Never place your ring if there is a possibility that you could be pregnant. Insert ring as directed; you may or may not be bleeding.
Remove the ring three weeks after insertion on the same day of the week it was inserted, about the same time of day. Remove the ring by hooking the ring with your index finger and pulling it out.
After a one-week ring-free break, insert a new ring on the same day of the week it was inserted in the last cycle. For example, when the ring is inserted at 10 p.m. on Sunday it should be removed on the Sunday 3 weeks later at 10 p.m. Do not leave the ring out longer than 7 days. It is a good idea to check ring placement every day to be sure it has not slipped out.
When back-up contraception may be needed:
- Abstain from intercourse or use an additional method of birth control such as a male condom if you have intercourse during the first 7 days of this cycle.
- Back-up contraception such as a male condom may be needed if you are on certain medications such as antibiotics or anti-seizure medications.
- If your ring is ever out for 3 or more hours, abstain from intercourse or use back-up contraception for 7 consecutive days.
Patch
The birth control patch prevents pregnancy by transferring hormones to your body through your skin. This method uses a 28-cycle. You apply a new patch each week for 3 weeks (21 total days). No patch is applied the 4th week and your period should start during this patch-free week.
There are three options for starting your first cycle of the patch:
- First day start. Apply 1st patch on the 1st day of your period.
- Sunday start. Apply the 1st patch on the first Sunday after your period starts (for example, if your period starts on Monday, Tuesday, Wednesday, Thursday, Friday, or Saturday, put patch on that Sunday. If your period starts on Sunday, apply the first patch that day.
- Quick Start. Place your patch in the provider's office during your appointment or when you pick it up from the pharmacy. Never place your patch if there is a possibility that you could be pregnant.
Wear the patch for 7 days. On day 8 apply a new patch for Week 2 and on Day 15 apply a new patch for Week 3. Do not wear a patch during week 4 and your period should start during this week. Every new patch should be applied on the same day of the week. Patches can be put on your buttock, abdomen, upper outer arm, or upper torso in a place where it won't be rubbed by tight clothing. Never place a patch on your breast(s). Do not leave patch off more than 7 days.
When back-up contraception may be needed:
- Abstain from intercourse or use an additional method of birth control such as a male condom if you have intercourse during the first 7 days of this cycle.
- Back-up contraception such as a male condom may be needed if you are on certain medications such as antibiotics or anti-seizure medications. Consult with your health care provider.
- An additional method of birth control is required for 7 consecutive days any time the patch is off more than 24 hours other than patch free week.
Important note: refer to the package insert for problems or questions about use of the patch, such as a patch falling off or forgetting to apply a patch at the proper time.
- Tell your health care provider that you are using a hormonal method of birth control prior to any scheduled surgery.
- Tell your health care provider that you are using a hormonal method of birth control if another medication is prescribed for any reason, as some prescription medications, especially antibiotics and anti-seizure medications, these may decrease their effectiveness and require use of back-up contraception.
- If, for any reason, you are going to discontinue your method of birth control, please contact us first. It may be that you are having a problem that would be quite simple to work out. Rest periods off these methods are not necessary.
Please contact University Health Service if you have any questions:
Appointments 323-APPT (2778)
Health & Wellness Nurse 323-5823, ext. 83264
Phone Information Nurse 323-INFO (4636)
Health Education Specialist 323-5823, ext. 83258