If anything is confusing, call your healthcare provider and go over the directions so you'll know exactly how to proceed. Make sure you always have an extra pack of pills on hand so you won't have a problem if your pharmacy is closed or out of your brand of pills when you need to start a new pack. You'll also need to keep condoms around to use for backup contraception when you take the minipill for the first time, any time you take one more than three hours late or miss a pill, or if you're at risk for sexually transmitted infections.
Finally, consider emergency contraception pills so you'll have them on hand in case you need them. See the note on emergency contraception at the end of the article. It's extremely important that you take your pill at the same time each day and never miss a pill. The minipill is a very low dose contraceptive and is unforgiving of mistakes, particularly if you're not exclusively breastfeeding.
If you take your pill just three hours late, you'll need to abstain from sex or use a backup method during the next 48 hours. Also, the minipill's contraceptive effect on cervical mucus is greatest between four and 22 hours after you take it. So if you usually have sex at bedtime, it's best to establish a regular pill-taking time that's earlier in the day.
Set your watch or cell phone alarm as a reminder.
Information from Your Family Doctor
When you've taken all the pills in the pack, you start a new pack of pills on the very next day. Unlike combination birth control pills, each minipill contains hormones and you need to take one every single day without a break. You may not get your period when you're taking the minipill or you may have irregular bleeding or spotting, but you still take a pill every day, whether you're bleeding or not.
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And even if you're not having sex very often, you still need to take a pill daily — otherwise you won't be protected when you do have sex. Finally, if you or your partner is having sex with anyone else or using illicit IV drugs, you'll need to make sure your partner uses a latex condom or a polyurethane male or female condom , if either of you is allergic to latex every time you have sex. Birth control pills won't protect you from HIV , gonorrhea , chlamydia , or any other sexually transmitted infections.
If you miss one or more pills by three hours or more, take one pill as soon as you remember: This may mean taking two pills on the same day. Then keep taking one pill each day as usual. You'll need to abstain from sex or use a backup method of contraception for the next 48 hours after you take the missed pill unless you fulfill the criteria for LAM, as mentioned above.
If you feel at all confused about what to do, don't hesitate to call your healthcare provider or the clinic that prescribed your pills. In the meantime, continue taking a pill each day and use backup contraception as well.
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If you suspect that you're pregnant, call your provider. Note: If you had unprotected sex before you were back on the minipill for 48 hours, using emergency contraception will reduce your risk of becoming pregnant. It can be used up to hours five days after unprotected sex, but it's most effective if used in the first 12 hours. Unless you already have emergency contraceptive pills on hand, go to a pharmacy without delay — you can get these pills without a prescription if you're 17 or older. If you're younger than 17, call your caregiver.
You may be able to use the birth control pills you have on hand for emergency contraception, but you'll need to check with a medical professional to see whether your brand of pills is suitable, if you have enough of them, and how to take them. If you vomit more than two hours after taking your pill, you should be fine. If you vomit sooner, take another pill. If you vomit repeatedly and can't keep your pill down or have diarrhea for more than 24 hours, follow the instructions above for missed pills.
Progestin-Only Birth Control Pills
If you continue to be ill, call your caregiver for specific instructions. In the meantime, keep taking your pills. And if you have sex while you're ill or for 48 hours after, use a backup method. While you were sick, your body might not have absorbed enough hormones from the pill to prevent pregnancy. Some medications and herbal preparations can affect the way birth control pills work, and vice versa: The minipill can make some other drugs more or less potent. So be sure to tell any healthcare provider you're seeing that you're taking the minipill.
Also tell the provider who's prescribing the minipill about every other medication you take, including herbal supplements. Substances that are known or strongly suspected to reduce the effectiveness of oral contraceptives include the herb St.
Why it's done
John's Wort Hypericum perforatum , the antibiotic rifampin, an antifungal drug called griseofulvin, barbiturates, some HIV drugs, and a number of antiseizure medications. If you need to take a medicine that interferes with the contraceptive action of the minipill and you'll be taking it for a long time, talk to your provider about other contraceptive methods. If you'll only be taking it for a short time, you can continue on the minipill but you'll need to use backup contraception at the same time and for 48 hours after the drug is cleared from your body.
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Because some medications take longer to leave your body, you may need to use a backup method for more than two days after you stop taking the drug. Ask your provider for specific guidance about any prescription you're given.
Contraception - the mini pill
The most common side effect of the minipill is unpredictable light vaginal bleeding or spotting. This is even more common if you miss a pill or take your pills late. You may continue to have your period at regular intervals, but it's likely to be lighter and might last longer than usual. Your periods could also become irregular or stop altogether. A small percentage of women on the minipill have prolonged or heavy menstrual bleeding.
Breastfeeding women are less likely to have frequent or prolonged bleeding on the minipill. If you're breastfeeding, you're not likely to have regular periods for many months after giving birth. And taking the minipill might delay the return of your period even longer. Less commonly, the minipill can cause headaches, breast tenderness, and nausea. More rare side effects include weight gain, mood changes, acne, and extra face and body hair. And, of course, call your healthcare provider if you think you might be pregnant.
As long as you've been taking your pills consistently and correctly, it's unlikely that a missed period means you're pregnant. But if you miss a period after several months of regular menstrual cycles, call your provider. Switching birth control methods can be tricky. You don't need to finish your current pack of pills or wait until the beginning of a menstrual cycle to start a new method. Taking a break between methods is not recommended either. In fact, you may need to start your new method a week before you stop using the old method.
Progestogen-Only Contraceptive Pill - Family Planning
The Reproductive Health Access Project has posted a chart that explains how to switch contraceptives while minimizing the risk of pregnancy. It can be found at www. Women who are at least 17 years old can now buy emergency contraception pills from a pharmacy without a prescription.
Younger women still need a prescription in most states. Because of the age requirement, you'll have to ask for the pills at the pharmacy counter and show proof of age. Not all pharmacies carry them, so call first. And make sure a pharmacist will be on duty when you get there, because only a pharmacist can dispense emergency contraception. By the way, although the pills are only for women, men who meet the age requirement can buy them for their female friends.
This article was reviewed by Andrew M.