Birth control pill

While the Paragard and hormonal methods that don’t contain estrogen—the shot, the Mirena IUD, the implant and the mini-pill—are safe for people who are postpartum to use immediately after giving birth, combination pills, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen can increase a postpartum person’s risk of blood clots.

It depends on what type of pill you’re on and how far into the pill pack you are. If you’re on the combination pill, and it’s been 48 hours or less since your last pill, just take it as soon as you remember. Take the pill you missed even if that means you’re taking two at the same time. If you take two pills at once, you might feel nauseated, so try taking them with food. If it’s been more than 48 hours since your last pill, take one of the missed pills as soon as you remember, leaving the other one in the pack. Then take today’s dose at the time you normally would AND use a back-up method of birth control, like condoms, every time you have sex for the next seven days. The first week of your pills is the most important to prevent ovulation. If you miss a pill in the first week, that’s a bigger deal than a missed pill in a later week. In addition to taking your missed pill ASAP, you will also need to use a back-up method of birth control every time you have sex for the next seven days. If you’re on any brand of mini-pill (also called the progestin-only pill) besides Slynd, there are totally different rules. If you’re more than 3 hours late taking a pill during any week of your pill pack, you could get pregnant if you have unprotected sex, and you need to use a back-up method for 48 hours.

Yes, it’s absolutely safe to take two pills in one day, including taking two pills at once. That said, the most effective and best way to take your birth control pill is to take one every day (and if you’re taking the mini-pill, it’s extra important to take it at the same time every day). Regularly taking more than one pill a day won’t make your birth control more effective.

However, if you miss a pill, take it as soon as you remember, even if that means it’s at the same time as your next regularly scheduled dose. You might feel nauseated if you have to do this, especially if you need to take two pills at once, so take your pills with food.

That’s fine—the easiest thing is probably to finish out your current pack on schedule and start the next pack at the time you prefer. In that case you shouldn’t need any backup.

If you can’t wait for your next pack, just make sure you don’t allow more than 24 hours to pass between pills. So, for example, if you want to switch from morning to afternoon, you have to take 2 pills in one day—one at the old time and one at the new time. That’s probably better than waiting 36 hours and worrying about backup for a week! Only catch is you may also have to relabel your pill pack, because if you take the “Wednesday” pill on Tuesday night and forget to change the rest of the pack, confusion may abound.

Any form of birth control is better than no birth control when it comes to the environment. Still some people insist on “green” contraception. We say: Any effective method of contraception is green since the impact of birth control pales in comparison to the impact of another human.

Still others say, “green contraception” means “hormone free.” We don’t dispute that that is one way to look at the issue. And fortunately, there are many contraceptives already on the market that are hormone free: condoms (male and female), Paragard IUD, diaphragms, cervical cap, and the sponge.

But a lot more goes into a green stamp of approval. The Paragard IUD is generally thought to be the “greenest” contraceptive. It’s hormone-free, long lasting (up to a decade embracing the reduce portion of the “reduce, reuse, recycle” mantra), made from small amounts of cheap, plentiful metal (copper), and 99% effective. If for whatever reason you don’t feel like the IUD is right for you, choose another method. Because when it comes to having sex, the greenest thing you can do is use birth control.

The only type of antibiotic that’s been shown to lessen the effectiveness of the pill is rifamycins—including rifampin, rifapentine, rifalazil and rifaximin. Rifampin can be used to treat tuberculosis, but is no longer the first choice for treatment and not typically prescribed in the US.

No, most forms of birth control are not effective immediately, so you want to check with you doctor before having unprotected sex. Until then, use a condom for added protection.

Doctors have argued since 1968 that the pill can safely be sold over-the-counter. That means rather than go to a doctor or clinic for a prescription, a woman could go to a drug store to pick up a pack of pills in the same way she can now buy aspirin. Behind-the-counter means a woman would ask a pharmacist for the pill, but she still wouldn’t need a prescription from a doctor. Over 50 drugs that were once prescription-only are now OTC in the U.S., including Sudafed, Cortaid, Advil, Nyquil, Monistat, and Claritin.

Women in over 80 countries can already buy the pill without a prescription—including women just across the border in Mexico. As medications go, the pill is very safe—safer than having a baby, driving, smoking, or taking daily aspirin.

That said, the pill does have risks for women with certain medical conditions, but one study in El Paso showed that women who answered 15 questions were pretty accurate in choosing whether the pill was safe for them.

Yes. A group of scientists in the North Carolina Research Triangle put together all the studies printed after 1990 that look at women using the pill and their rates of ovarian cancer. They found that women who had ever used the pill for birth control were 25% less likely to develop ovarian cancer later in their lives.

The pill offered the strongest protection from ovarian cancer when women used it for a year or longer. Women who used the pill for 10 years were 50% less likely to develop ovarian cancer. The pill’s protective effect lasted for a long time, too—up to 20 years after women stopped taking it.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

If you throw up within two hours of taking your pill, treat it as a missed pill and take the next pill in your pack right away. Depending on which type of pill you use and where you are in your pill pack, you may need to use a back-up method like condoms for the next seven days to prevent pregnancy.

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. That’s true for continuous use of the pill too—although if you experience spotting, you may want to take an occasional break (3 days minimum, 7 days max) to manage it.

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 worse migraines may make it risky to use methods with estrogen.