Frequently Questions About Birth Control Pills

Do I have to get permission from my parents to go on the pill if I’m younger than 18?

It depends where you live. In some states, you can get a prescription without permission. Ask your doctor or pharmacist about the laws in your area. A sexual education counselor might be able to give you some ideas about how to bring up the subject with your parents. Even if you decide against that, they can talk to you privately if you’re confused, unsure, or just curious about sexual activity.

Do I need a prescription? If so, where can I get it?

In most states you need a prescription from a doctor. A few only require you to talk to your pharmacist about your health history. Ask your doctor or pharmacist about the laws in your state, or look online.

How old do I have to be to take the pill?

There’s no minimum age once you start to get your period, but some doctors suggest waiting until around 16 to give your body a chance to properly establish its cycle. It’s a good idea to talk to your doctor, parents, or a counselor to make sure you’re physically and mentally ready, both for the pill and for sex.

How soon after I go on the pill does it start to work?

It depends in part on the type of pill. There are two main kinds:

  • Combination pill. This one blends the hormones estrogen and progestin. It’s the most common.
  • Mini pill. It’s progestin only. This one’s for women who can’t or won’t take estrogen.

Depending on when in your cycle you start the pill and how closely you follow your doctor’s instructions, it’s a fairly safe bet that after your first 7 days on the pill (no matter which type), you won’t get pregnant from unprotected sex. Though it’s effective when used correctly, every year around 8 of every 100 women gets pregnant while on the pill.

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Do I have to take it at the exact same time every day?

Yes. It works best when you take it at the same time every day. If you’re just 3 hours late on a progestin-only pill or mini-pill, you’ll need backup birth control, like a condom, until you can get back on track (about 2 days). For the more common combination pill that blends estrogen and progestin, you have a little more leeway. But effectiveness also starts to go down after just a few hours.

Will it make my cycle more regular?

Yes. In many cases, the pill will make your cycle more predictable. You’re more likely to get your period at the same time each month. Cramps and bleeding could be lighter, too. You might even miss a period now and then. But effects vary in part because the amount and type of hormones can differ depending on the prescription. Talk to your doctor about the type that’s best for you.

Will it make me gain weight?

It’s unlikely. A review of more than 40 studies on the subject found no link between the pill and weight gain. That doesn’t mean the bathroom scale won’t tick up a little. And you might even feel a bit heavier around your thighs, hips, and breasts. But that’s likely a sign of water weight and bloating, not fat accumulation.

Will the pill make my breasts larger?

It can and often does, especially at first. Part of this is simply that the estrogen and progestin in the pills make you retain fluid, and it often collects in your breasts. But the hormones can also cause you to grow more breast tissue. This often goes away after a few cycles or after you go off the pill.

Does it help clear up acne?

It might, especially if you tend to break out during your period. Some birth control pills seem to slow overactive oil glands in your skin. Tell your doctor if you’re interested in this benefit. They might prescribe an extra drug called spironolactone that could work with the pill to help control your acne even better.

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What should I do if I miss a day?

For combination pills, you should be OK as long as you take the extra pill the next day. But if you miss 2 or more days in a row, avoid sex or use backup birth control for 7 days. Take one extra pill as soon as you realize you’ve missed a dose, and then continue as normal.

It can be confusing, especially if you’re near the part of the month where you take non-hormone pills or none at all. Call your doctor if you aren’t sure exactly what to do.

For progestin-only mini pills, it’s the same for 12 hours, a day, or 2 (or 3) as it is for a few hours. Simply take an extra pill as soon as you remember, then continue with your normal daily time. After about 2 days you should be protected from pregnancy again, but you should use backup protection for a week. Just keep in mind that if you had sex during between the time you missed the dose and the time your pills kick in again, you could have gotten pregnant. Talk to your doctor about other measures like emergency contraception.

What is emergency contraception?

Sometimes called a morning after pill, it’s made from a higher dose of hormones and works to prevent pregnancy or implantation for a few days after you have unprotected sex. Talk to your doctor or pharmacist about when and how best to use this emergency medication.

What happens if I take other medications with the pill?

It might not work as well if you take certain other drugs, like anti-seizure medications, antibiotics, herbal supplements like St. John’s wort, and some drugs used to treat HIV. Tell your doctor about all medications, supplements, and recreational drugs you take. They can tell you about any possible effects on the pill.

Does alcohol affect the way the pill works?

You’re no more likely to get pregnant from sex if you drink alcohol with the pill. But your decisions about having sex might not be as wise. Also, the pill can slow the amount of time it takes for alcohol to leave your body. If you drink too much, you could stay tipsy longer.

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Does this mean I don’t need to use condoms?

The pill protects you against pregnancy only. You still need to use a condom to prevent sexually transmitted diseases, including HIV. And it doesn’t hurt to have an extra layer of protection against pregnancy as well, in case you get off track with the pill.

WebMD Medical Reference Reviewed by Nivin Todd, MD on January 30, 2019

Sources

SOURCES:

CDC: “Teens Visiting a Health Clinic.”

Cleveland Clinic: “Birth Control: The Pill.’

Columbia University Go Ask Alice: “Does taking the pill increase the size of your breasts?”

Cornell Health: “Missed a Birth Control Pill? Here’s what to do.”

Informed Health Online: “Contraception: Do hormonal contraceptives cause weight gain?”

Mayo Clinic: “Morning-after pill,” “Birth control pills for acne?” “Birth control pill FAQ: Benefits, risks and choices.”

Nemours Foundation: “For Teens: Birth Control Pill.”

Princeton University The Emergency Contraception Website: “Answers To Frequently Asked Questions About … “

StatPearls: “Oral Contraceptive Pills.”

University of Michigan Health Service: “The Pill.”

UC Davis Student Health and Counseling Services: “Alcohol.”

U.S. Department of Health and Human Services Office on Women's Health: “Acne.”

Sexetc.org: “Sex In The States.”

U.S. Department of Health and Human Services: “Birth Control Pill.”

Virtua Penn Medicine: “4 Essential Questions About Teen Birth Control.”

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