About the Birth Control Pill

Talking to your kids about sex can be a challenge. But discussing things like abstinence, sexually transmitted diseases (STDs), and birth control can help lower teens' risk of an unintended pregnancy or getting an STD.

Discussing these issues like any other health topics — not as something dirty or embarrassing — makes it more likely that your kids will come to you with any questions and problems. As awkward as it can be, answer questions honestly. And if you don't know something, it's OK to say so, then find out and report back.

If you have questions about how to talk with your kids about sex, ask your doctor. Lots of parents find this tough to tackle, and a doctor may offer some helpful advice.

What Are Birth Control Pills?

The birth control pill (also called "the Pill") is a daily pill that usually contains the hormones estrogen and progesterone, and is taken to prevent pregnancy.

How Does the Pill Work?

Most birth control pills are "combination pills" with a mix of the hormones estrogen and progesterone to prevent ovulation (the release of an egg during the monthly cycle). A female cannot get pregnant if she doesn't ovulate because there is no egg to be fertilized.

The Pill also works by thickening the mucus around the cervix, which makes it difficult for sperm to enter the uterus and reach any eggs that may have been released. The hormones in the Pill can also sometimes affect the lining of the uterus, making it difficult for an egg to attach to the wall of the uterus.

How Is the Pill Taken?

Most combination pills come in either a 21-day pack or a 28-day pack. One hormone pill is taken each day at about the same time for 21 days. Depending on the pack, the birth control pills are either stopped for 7 days or a pill that contains no hormones is taken for 7 days. During the week that a woman is taking no pills or pills that don't contain hormones, she has her period. Some women prefer the schedule in which pills are taken every day of the month because it helps keep them in the habit of taking a pill every day.

Also available is a combination pill that reduces the frequency of a woman's period by supplying a hormone pill for 12 weeks and then inactive pills for 7 days. This reduces the number of periods to one every 3 months instead of one every month.

Another kind of pill that may change the number of monthly periods is the low-dose progesterone pill, sometimes called the mini-pill. This differs from other birth control pills in that it only contains one type of hormone — progesterone — rather than a combination of estrogen and progesterone. It changes the cervical mucus and the lining of the uterus, and sometimes by affects ovulation. It may be slightly less effective than the combination pills at preventing pregnancy.

The mini-pill is taken every day without a break. A girl who is taking the mini-pill may have no period at all or she may have irregular periods. For the mini-pill to work, it must be taken at the same time every day, without missing any doses.

Every type of birth control pill works best when it is taken every single day at the same time of day, regardless of whether a female is going to have sex. This is especially important with progesterone-only pills. It's very important that your daughter not take anyone else's pills. If pills are skipped or forgotten, she is not protected against pregnancy and she will need a backup form of birth control, such as condoms, or she will need to stop having sex for a while.

For the first 7 days of taking the Pill, a girl should use a second form of contraception, such as condoms, to prevent pregnancy. After 7 days, the Pill should work alone to prevent pregnancy. This timing can vary based on the type of Pill and when a girl starts taking it — your daughter should talk about it with her doctor. Also, it's important to continue using condoms to protect against STDs.

How Well Does the Pill Work?

Over the course of a year, about 8 out of 100 typical couples who rely on the Pill to prevent pregnancy will have an accidental pregnancy. The Pill is an effective form of birth control, but even missing 1 day increases the chance of pregnancy.

In general, how well each type of birth control method works depends on many things. These include whether a woman has any health conditions or is taking any medicines or herbal supplements that might interfere with its use (for example, an herb like St. John's wort can affect how well the Pill works).

Protection Against STDs

The birth control pill does not protect against STDs. Couples having sex must always use condoms along with the Pill to protect against STDs.

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

The Pill is a safe and effective method of birth control. Most young women who take the Pill have none to very few side effects.

Smoking cigarettes and using the Pill can increase a girl's risk of certain side effects, which is why health professionals advise girls who use the Pill not to smoke. Side effects that some women have while on the Pill include:

• irregular menstrual bleeding (more common with the mini-pill)
• nausea, headaches, dizziness, and breast tenderness
• mood changes
• blood clots (rare in women under 35 who do not smoke)

Some of these side effects improve over the first 3 months on the Pill. When a girl has side effects that are bothersome or don't get better, a doctor may prescribe a different brand of the Pill.

The Pill also has some side effects that many young women enjoy. It usually makes periods lighter, reduces cramps, and is often prescribed for women who have menstrual problems. Taking the combination Pill can improve acne, and some doctors prescribe it for this purpose. Combination birth control pills have also been found to protect against some forms of breast disease, anemia, ovarian cysts, and ovarian and endometrial cancers.

Who Uses Birth Control Pills?

Young women who can remember to take a pill each day and who want excellent protection from pregnancy can use birth control pills.

Not all girls can — or should — use the birth control pill. In some cases, other medical conditions make the use of the Pill less effective or more risky. For example, it is not recommended for those who have had blood clots, certain types of cancers, or some kinds of migraine headaches.

If a girl has high blood pressure that's under control, she can sometimes use the Pill under a doctor's supervision. Girls who have had unexplained vaginal bleeding (bleeding that is not during their periods) or who think they may be pregnant should talk to their doctor.

Where Are Birth Control Pills Available?

A doctor or a nurse practitioner (NP) must prescribe the Pill. He or she will ask about a girl's health and family medical history, and will do a complete physical exam, which may include a pelvic exam. If the doctor or NP prescribes birth control pills, he or she will explain when to begin taking it and what to do if pills are missed.

When your daughter returns to the doctor in a few months, her blood pressure will be checked and she'll be asked about any problems. After that, girls who are having sex should get routine exams every 6 months to a year, or as recommended.

How Much Do Birth Control Pills Cost?

The Pill usually costs between $0–$50 a month, depending on the type. Many health and family planning clinics (such as Planned Parenthood) sell birth control pills for less. And birth control pills and doctor visits are covered by many health insurance plans.