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How to Use Contraceptive Pills After Giving Birth or for the First Time

Women should know how to use contraceptive pills especially when it comes to their reproductive health.

How to use contraceptive pills is knowledge all women need to know. It is a mistake to think it's only taken or used to prevent pregnancy. Contraception can help regulate menstruation for those who have irregular periods, ease menstrual pain, and even help treat conditions such as acne and endometriosis, a disorder that causes infertility. In fact, "The Pill" was a major breakthrough in medicine.

How do contraceptive pills work

Contraceptive pills contain synthetic hormones that help trigger changes in your body to prevent you from getting pregnant or alter your menstrual cycle (regulate it or help ease period cramps).

"Combination pills" contain the hormones estrogen and progestin, while "mini-pills" contain only the hormone progestin, also called "progestin-only pills." These hormones help prevent a woman's ovaries from releasing an egg; it thickens her cervical mucus, which can make it difficult for sperm to travel or survive; and thins the lining of her uterus to prevent embryo implantation.

When taken correctly, the pill can be 99.9% effective in preventing pregnancy. However, it does not protect against sexually transmitted diseases (STD) including HIV/AIDS.

Contraceptive pills are not for all women

You can only buy pills in pharmacies with a doctor's prescription. Women who want to take contraceptive pills should consult with her obstetrician-gynecologist first.

What will your doctor look at? "Doctors have to consider first the patient’s age, her menstrual cycle if she has regular or irregular menstruation," explains Dr. Maria Carla Esquivias-Chua, M.D., an obstetrician-gynecologist at MCEC Mother and Child Ob-Gyn Ultrasound and Pedia Clinic, in Kamuning, Quezon City and at Capitol Medical Center.

Your doctor will need to know if you have symptoms like pain or undiagnosed bleeding between periods, your lifestyle, and family history. He needs to consider these factors because he needs to exercise caution. While contraceptive pills are generally safe, there are risks involved. It is why it's crucial to consult your doctor first to check if it's safe for you to take the pill.

A woman who is older than 35 and smokes is likely to be prescribed progestin-only pills because it is safer for them than combination pills. It is also prescribed for women with a family history of thrombosis (blood clotting disorder), vein inflammation, breast cancer, heart issues, migraine with aura or seeing flashing zigzag lines, poorly managed hypertension, diabetes, and liver disease.

How to use contraceptive pills

Planned Parenthood, a non-profit organization that delivers vital reproductive health care, sex education, and information to millions of women, men, and young people worldwide, outlines how to use several types of contraceptive pills.

You need to drink your Day-1 tablet on the first day of your menstruation and continue to take the consecutive pills once a day. Take it at the same time daily or at least within the three-hour window of the same time every day. Remember, the pill's effectiveness lies in taking them correctly.

The tablets are usually numbered and have arrows to help you track which tablet to take next. Drinking the pills out of order or forgetting to take a tablet will significantly decrease its effectiveness, so try to seamlessly incorporate taking the tablet in your daily routine, like after breakfast or lunch. Some women even set alarms and reminders, so they don't forget to take their pill.

Combination pills 28-day pack

Of the 28 tablets, 21 contain hormones, while seven are placebos or hormone-free pills. Take the 21 tablets during the first three weeks (Day 1 to 21), and the next hormone-free tablet on your fourth week (Day 22-28). It's designed to ease you into the habit of remembering to take your pill. You should be taking placebos during the time you should expect your period. When you finished the last placebo pill, start your next pack on the next day (Day 29).

Combination pills 21-day pack

All 21 pills contain active hormones, so take them religiously in the first three weeks (Day 1 to 21). On the next seven days (Day 22-28), you will not take any pills, and you should expect your period within your fourth week. Start your next pack on the 8th pill-free day (Day 29), regardless if you still have your period or if it has stopped.

Progestin-only pills or mini-pills

Progestin-only pills come in 28-day packs. All 28 capsules contain hormones, meaning there are no placebo pills. You need to take one within a three-hour window every day.

How to use the pill to stop or delay your period

Stopping or delaying your period can help manage various menstrual symptoms such as cramps, regulate your menstrual flow if it's too strong or used in managing endometriosis. If you don't want to get your period, skip the placebo pills in your pack and start a new box on Day 22. You may have some spotting or bleeding when you use the contraceptive pills to skip your period. If you do this every month, you may start not having your period at all after six months. Talk to your ob-gyn about proper management.

How to use the pill after pregnancy and giving birth

New moms are usually advised to wait six weeks before being sexually active again to give their body time to heal and recover from pregnancy and childbirth. If needed, doctors delay prescribing contraceptive pills to new moms until after at least three to four weeks after giving birth. Often, new moms are prescribed progestin-only pills, so they can still continue to breastfeed as it does not affect breast milk production.

What to do if you miss a pill

You have to take it the moment you remember that you forgot to take it. It could mean that you might be taking two pills in one day, even two at the same time. Unprotected sex is not recommended during the next seven days after you missed one tablet. If you are not planning pregnancy yet, better to use other forms of contraception as well, such as a condom, to be safe.

If you miss two or more consecutive pills again, consider other forms of contraception. You may have no more use for the rest of the pills in your pack, so it's crucial to talk to your doctor about what's the best course of action. "If you stop taking the pill in the middle of a pack, it can disrupt your menstrual cycle, and it could take a while for it to normalize," Dr. Esquivias-Chua said.

If you don't get your period, take a pregnancy test and consult your doctor before starting the next pack.

Remember, once you start on a pill, you need to go to your doctor for regular checkups every year. You need to take pap smear tests, transvaginal ultrasounds and have your doctor check for overall reproductive health to help determine whether you can continue taking pills or need to stop.

Side effects and warning signs

A doctor's prescription does not guarantee that taking contraceptive pills won't lead side effects. The reactions will vary for every woman. Some will be "hiyang" and they don't feel any side effects. Those who do experience it may find it manageable and does not disrupt their daily life. Let your doctor know if you have these side effects to manage your contraception like switching brands.

  • Migraines
  • Mood changes
  • Changes in sexual drive
  • Weight gain
  • Nausea
  • Breast tenderness
  • Irregular bleeding or spotting

Alert your doctor right away if you notice the following:

  • Abdominal pain, especially on the right side of your stomach, below your rib cage
  • Chest or arm pain, shortness of breath, coughing up blood
  • Headaches, severe and not relieved by aspirin or Tylenol
  • Eye problems, blurred vision, flashing lights, double vision, blindness
  • Swelling, redness, numbness, tingling or pain in the legs

Contraceptive pills can help women in many ways, but only when taken as prescribed and she works closely with her doctor.

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