How to Use Combination Birth Control Pills

Woman holding birth control pills, mid section
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Combination birth control pills are oral contraceptives that combine estrogens and progestins, similar to the natural sex hormones produced in a woman's body.

When using combination birth control pills, you should make sure that your health care provider has fully explained how to start taking the pill and what to do if you accidentally forget to take a pill.

How Combination Birth Control Pills Should Be Used

Tips for Using Combination Birth Control Pills

The following tips are meant to be general guidelines.

  1. You should pick a time of day to take the pill that is easy to remember. Taking the pill at the same time each day makes it more effective.
  2. Take the first active pill in the pack within five days after the start of one's period. If you start your pack on the first Sunday after her period begins, it will result in her period almost always beginning on a Tuesday or Wednesday every 4 weeks. If the pill pack is started during your  period, she will be protected against pregnancy immediately and will not need to use a backup method of birth control.
  3. You can decide to take the first active pill in the pack at any time during your cycle. However, if the pill pack is started during any other time during the menstrual cycle (and not during her period), protection will begin after seven days. You should use an additional method of birth control if having sexual intercourse during the first week of combination pill use.
  1. Take the pill at the same time, every day, for the first 3 weeks of each pill pack. It may be helpful to check the pack of pills each morning to make sure that yesterday's pill was taken.
  2. You can choose whether or not to take the "reminder" pills during week 4. The hormones contained in the active pills (during weeks 1 to 3) prevent pregnancy throughout the month, so even during the fourth week (regardless if you are taking reminder pills or no pills at all), a you are protected against becoming pregnant.
  1. Continue to take one pill a day until the pack is finished.
    • If you are using a 28-day pack, you should begin a new pack immediately and not skip any days between packages.
    • If you are using a 21-day pack, you should stop taking pills for 1 week and then start your next pack.
  2. Be sure to read and follow the instructions inside the pill package.
  3. If you want to become pregnant (or do not want to use the pill anymore), you can just stop taking it. It typically can take anywhere from one to three months for your period to return to the cycle you had before starting the pill. However, you can still become pregnant during this time.
  4. You can also choose to skip your withdrawal bleed (period) by using the pill. This is extremely easy and safe to do. Follow steps 1 to 4, above. Instead of taking week 4's pills, begin your next pack. See: How to Skip Your Period Using the Pill (for more specific directions).
  5. If pills are missed, the best thing to do is to refer to the particular pill’s package insert because the instructions can be more complicated with the newer, lower dose and extended regimen pills
  6. You should always keep one copy of your package insert in a place where you can find it easily.

Tips for Taking Combination Birth Control Pills

It is super important that you remember to take your combination birth control pill at the same time every day.

Luckily, there are some tricks to help do this. For example, make your combination pill a regular part of your evening routine (after you finish checking your email for the night or after brushing your teeth). How come? You have a better chance of remembering to take your pill when you pair its use with something you do each day. Guess what? There are also birth control apps! Try using a birth control app or alarm to remind you to take your pill. Finally, make sure to keep your pill pack in a place where you are guaranteed to see it every day, like next to your toothbrush or cell phone.

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