Birth control pill

Spotting refers to a small amount vaginal bleeding that is unpredictable or irregular and not related to your period. Spotting can be a normal side effect of some birth control methods, especially progestin-only ones like the shot, implant, mini-pill, and hormonal IUDs as well as with low-dose combination birth control pills. When birth control causes spotting, it isn’t dangerous and generally doesn’t make you lose that much blood, even though it might seem like it.

The short answer is yes—there’s no reason to take a break from the pill unless you’ve decided you want to get pregnant or switch to another method. That’s true for continuous use of the pill too—although if you experience bothersome unexpected bleeding or spotting, you may want to take an occasional break (3-7 days) to manage it. If you take a break for more than 7 days, you’ll need to use a backup method, like condoms, for 7 days after you restart your pills.

There’s been lots of research on birth control pills over the years and the consensus is that long-term use doesn’t affect your ability to get pregnant once you stop taking the pill. It’s always a good idea to stay current on your annual health exams, whether you use the pill or another method. Our health changes over time, and some changes like rising blood pressure or worsening migraines may make it risky to use methods with estrogen, which is in the combination pill. If you have a new or worsening health condition, talk to a health care provider to make sure the pill is still safe for you.

The main ways hormonal birth control prevents pregnancy is by stopping ovulation (when the ovary releases an egg). The pill, patch, ring, and shot are most reliable at blocking ovulation, so people using these methods may have fewer ovarian cysts. If you tend to get ovarian cysts, using these methods helps to prevent future cysts. The progestin-only, a.k.a., mini-pill, has an unpredictable effect on ovulation and may lead to more cysts. These almost always disappear on their own, but if you’ve had problems with cysts in the past, the mini-pill may not be the best option for you.

There are positive and negative things to say about every method. And everyone’s different—so what you experience may not be the same as what someone else experiences. And what side effects are “worth it” to you might be different than for someone else.

You can start by thinking about what’s most important to you about your method. Is your top priority using the method that will be the most effective at preventing pregnancy? Something easy to use? Something that makes your period lighter? Something that you can stop and start without seeing a provider? There are birth control options for all of these. It’s also common to try more than one birth control option before finding one that works for you, so don’t settle if your current option isn’t working.

Basically, you need to figure out what time it is in your home time zone and take it at that time. For example, if you live in Washington, DC, and you travel to Spain, which is 6 hours ahead, you should take your pill 6 hours later in the day than you normally would. So if you take your pill at 9AM in DC, you should take it at 3PM in Spain.


Also, if you’re traveling long enough that you’ll be starting a new pack of pills while you’re gone, don’t forget to stick them in your suitcase!

There are a lot of great things about being on birth control that go beyond pregnancy prevention. Protection against ovarian cancer, an added boost to your vitamin D levels, lighter and less painful periods, the list goes on.

Most people who use hormonal birth control—combination pill, patch, ring, implant, shot, and hormonal IUDs—will have less painful periods than those who don’t. This is because these methods of birth control make the lining of the uterus thinner. There’s less tissue in the uterus to shed (that’s what happens when you have your period), so periods are lighter. One special note on the implant and the shot: for some people, these methods cause more days of spotting or bleeding in between periods, but periods become lighter and less painful overall.

Using a method of birth control with estrogen, like the combination pill, patch, and ring, increases your risk of forming a blood clot, but if you have no history of stroke, blood clots, or heart attack, and your family members have never experienced a blood clot, the risk is still quite low. If you have a history of these medical conditions, you have a higher risk of forming a new blood clot already so adding birth control with estrogen to the mix increases that risk and isn’t recommended.

Progestin-only methods like the implant, mini-pill, shot, and IUDs don’t increase your risk. If you’re worried about blood clots, we recommend talking to a health care provider about which birth control options are the safest for you.

Yes, it’s okay to switch what time of day you take your pills but depending on the type of pill you are taking (combination or progestin-only pill) and if you are switching to a later time or an earlier time in the day, you might need a backup method of birth control after switching times. If you move the time earlier in the day (i.e. from afternoon to morning), it will be less than 24 hours between pills, so go ahead and switch the time—you don’t need a backup method for either type of pill.

If you want to switch to later in the day and you’re taking the combination pill (the most common type of pill) (the most common type), go ahead and switch the time since the time of day you take your pills doesn’t matter for them to work as birth control (but taking them at a consistent time can help you remember to take them every day). If it’s been 48 hours or more since you took your last pill, you’ll need to use a backup birth control method if you have sex for the first seven days after restarting.

If you want to switch to later in the day and you’re taking the progestin-only, mini-pill (other than Slynd, you don’t need to use a backup method if the new time is less than three hours after your original time. (For example, you were taking it at 7pm and now you are going to take it at 9pm). If the new time is more than three hours after the old time, then you’ll need to treat it as a missed pill and use a backup method, like condoms or internal condoms if you have sex for the first two days after switching the time.

Try this: If you just started the pill in the last few months, it’s possible bleeding between periods will most likely fix itself.

Also, taking your pills at the same time each day and not skipping pills and then doubling up can decrease chances of spotting or bleeding between periods. STIs and pregnancy can also cause you to have bleeding between periods, so you might want to check with a health care provider to be sure those aren’t the reason for the bleeding.

Hormones in birth control can get into the environment through pee. But—and this is a big but—it is small compared to other sources of estrogen. Current research finds that the contribution of EE2 (the primary active ingredient in the pill, ring, and patch) to the total amount of estrogen in of our environment is small. Bigger—much bigger—sources of estrogen in the environment come from industrial and manufacturing processes, agricultural fertilizers and pesticides, the drugs we give livestock. and the waste and runoff produced by these sources. Avoiding birth control with estrogen hormones will not eliminate the environmental impacts of estrogenic compounds.

Lots of people have a hard time remembering to stay on top of their birth control method. And with busy lives and a million other things on our minds, who can blame us?

If you struggle to remember to take your pill, change your patch or ring, or get your shot, we recommend setting a reminder on your phone or trying to take your pill, change your patch, or swap out your ring at the same time as you do something else.