Taking the 28-Day Pill
This handout will explain how to take the 28-day birth control pill. If you have any questions, please ask your health care provider.
How Does the Pill Work?
When taken as advised, the pill:
- Stops the ovary from releasing an egg.
- Thickens cervix mucus to stop the sperm from joining an egg.
- Alters the lining of the uterus.
How Effective is the Pill?
- The pill is 95-99% effective in preventing pregnancy if taken within 2 to 3 hours of the same time every day.
Other Benefits of the Pill
- Periods are less heavy, are shorter in length, and have fewer cramps.
- Risk for ovarian and uterine cancer is decreased.
- Risk of ovary cysts is decreased.
- Acne often improves.
- Risk of benign breast conditions is decreased.
- May protect against osteoporosis, endometriosis, and rheumatoid arthritis.
Instructions for Taking the 28-Day Pill
1. Start taking your pills:
_____ on the Sunday after your period begins
_____ the first day of your period
2. Take one pill each day until you have taken all 28 pills. Take the pill within 2 to 3 hours of the same time each day. The last 7 pills contain no hormones, but help keep you in the habit of taking a pill each day.
3. For the first month only, if you start on the first Sunday of your period, you will not be safe from getting pregnant until you have taken the pills for 7 days. During that time be sure to use a second method of birth control, such as foam or cream and/or a condom. If you start the pill on the first day of your period, you are safe right away and will not need back up birth control methods.
4. After finishing a pack, start a new pack the very next day. There will never be a day when you do not take a pill.
5. Do not skip pills even if you are spotting or bleeding between periods. Spotting may occur for the first 1 to 3 packs, and should go away by the end of the first 3 to 6 months. Call your health care provider if the bleeding becomes heavy or concerns you.
6. Do not skip pills even if you feel nauseous. Try switching your pill to a different time of day, such as bedtime or with a light meal.
What Should I Do if I Forget to Take a Pill?
How late are you in taking your pill?
1. Less than 24 hours
- Take the missed pill as soon as you remember.
- Take your next pill at the normal time.
- A back-up method of birth control is not needed.
2. 24 hours
- Take the missed pill and today’s pill at the same time or you can take them 12 hours apart to avoid nausea.
3. More than 24 hours (You completely missed one pill and are late for or missed a second pill, too.)
- Take the last pill you missed right away.
- Take the next pill on time. This may mean taking 2 pills at one time
- Take the rest of the pills in the package right on time.
- You may have some spotting or breakthrough bleeding.
- You will not be protected against getting pregnant and need to use a back-up birth control method for the rest of this pack if this occurred in the 1st week of pills.
4. If you miss more than 2 pills, call your health care provider for further instructions.
Pills and Your Periods
- Your period usually starts on the second or third day that you start the last row of pills. Your periods may be lighter and not last as long when you did not take the pill.
- If you were bothered by cramps during your periods, this should improve while on the pill.
- Some women have spotting (bleeding) between periods, most often during the first three months of taking the pills. There is no reason to worry if you have been taking the pills within 2 to 3 hours of the same time each day. Keep taking the pills.
- Call your health care provider if bleeding keeps up after the first three months.
- Call if bleeding between periods becomes heavy or lasts longer than normal.
- Sometimes, women will skip a period while on the pill. This is not a concern as long as you have not missed any pills or taken any pills late. If you miss two periods in a row, call your health care provider.
- If you are taking antibiotics while on the pill, you may have breakthrough bleeding. It is generally not necessary to use any form of back-up contraception while on antibiotics, but call your health care provider if any concerns.
- Vomiting and/or diarrhea can also reduce the absorption of the pill. Use a back-up method of contraception for the remainder of the pill pack to avoid getting pregnant.
- The pill does not protect you from sexually transmitted infections, including HIV.
- Report any breakthrough bleeding that occurs after the first three months, unless the bleeding occurred because you forgot to take a pill or have taken one late.
- Take your pill at about the same time every day. Try to match taking the pill with a daily event like brushing your teeth.
- When you are on birth control pills, it is best not to smoke. Research has shown an increased risk of stroke, heart attacks, and blood clotting problems if you smoke on the pill.
- Have a complete physical exam and pap smear each year.
- Tell all of your health care providers that you are taking birth control pills.
- Do not stop your pills without first talking to your health care provider.
Birth control pills are a safe and effective method to avoid getting pregnant. However, there can be rare, serious side effects. You should contact your health care provider or Emergency Room right away if you have:
A Abdominal (stomach) pain—severe or prolonged
C Chest pain or shortness of breath
H Severe headaches
E Eye problems, like blurred vision, flashing lights or blindness
S Severe leg pains (calf or thighs)
After hours and weekends, call your clinic. A nurse or the paging operator will assist you in talking to the clinic doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call 1-800-323-8942.
If you have any questions or concerns, please call:
__________________________________________ at ___________________
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/11/2013
Copyright © 03/11/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4233
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