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Birth control pills - overview

Birth control pills (BCPs) contain man-made forms of two hormones called estrogen and progestin. These hormones are made naturally in a woman's ovaries. Birth control pills can contain both of these hormones, or have progestin only.

Both hormones prevent a woman's ovary from releasing an egg during her menstrual cycle (called ovulation). They do this by changing the levels of the natural hormones the body makes.

Progestins also make the mucus around a woman's cervix thick and sticky. This helps prevent sperm from entering the uterus.

Alternative Names

Contraception - pills - hormonal methods; Hormonal birth control methods; Birth control pills; Contraceptive pills; BCP; OCP

Information

Birth control pills are also called oral contraceptives or just "the pill." A health care provider must prescribe birth control pills.

  • The most common type of birth control pill combines the hormones estrogen and progestin . There are many different forms of this type of pill.
  • The "mini-pill" is a type of birth control pill that contains only progestin, no estrogen. These pills are an option for women who do not like the side effects of estrogen or who cannot take estrogen for medical reasons.
  • They can also be used after delivery in women who are breast-feeding.

All women who take birth control pills need a check-up at least once a year. Women should also have their blood pressure checked 3 months after they begin to take the pill.

Birth control pills only work well if the woman remembers to take her pill daily without missing a day. Only 2 or 3 women out of 100 who take birth control pills correctly for a year will get pregnant.

Birth control pills may cause many side effects. These include:

  • Changes in menstrual cycles, no menstrual cycles, extra bleeding
  • Nausea, mood changes, worsening of migraines (mostly due to estrogens)
  • Breast tenderness and weight gain

Rare but dangerous risks from taking birth control pills include:

  • Blood clots
  • Heart attack
  • High blood pressure
  • Stroke

Birth control pills without estrogen are much less likely to cause these problems. The risk is higher for women who smoke or have a history of high blood pressure, clotting disorders, or unhealthy cholesterol levels. However, the risk of these complications are much lower with either type of pill than with pregnancy.

Regular menstrual cycles will return within 3 to 6 months after a woman stops using most hormonal birth control methods.

References

Carter C, Baxley G. Postpartum biomedical concerns: Breastfeeding. In: Ratcliffe SD, Baxley EG, Cline MK, Sakornbut EL, eds. Family Medicine Obstetrics. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 20.

Jensen JT, Mishell DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 13.

Linares AC, Schutt-Aine AI. Contraception. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 26.

Spencer AL, Bonnema R, McNamara MC. Helping women choose appropriate hormonal contraception: update on risks, benefits, and indications. Am J Med. 2009;122:497-506.

Amy JJ, Tripathi V. Contraception for women: an evidence based overview. BMJ. 2009;339:b2895.doi:10.1136/bmj.b2895.

Mørch LS, Løkkegaard E, Andreasen AH, Krüger-Kjaer L, Lidegaard O. Hormone therapy and ovarian cancer. JAMA. 2009;302:298-305.

Updated: 3/11/2014

Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, WA; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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