Home > Health Guides by Topic > Sexuality & Sexual Health > Contraception/Birth Control > Birth Control Pills Birth Control Pills:
A Guide for Teens
Birth control pills (also called oral contraceptive pills) are a type of female hormonal birth control method, and are very effective at preventing pregnancy.
| Out of 100 women using combination birth control pills | |
| Typical use: 5 women become pregnant |  |
| Perfect use: 1 or fewer women become pregnant |  |
| Out of 100 women using progestin-only birth control pills | |
| Typical Use: 5 women become pregnant | |
| Perfect Use: 2 women become pregnant |  |
What are birth control pills and how do they work?
Birth control pills (also known as "The Pill") are small tablets that you swallow each day. Most pills contain two types of synthetic (man-made) female hormones; estrogen and progestin (which are normally produced by the ovaries). These pills are called "combination oral contraceptives", and there are many different types available.
The hormones in the pills prevent pregnancy by suppressing your pituitary gland, which stops the development and release of the egg in the ovary (ovulation). The progestin also helps to prevent the sperm from reaching the egg and changes the lining of the uterus.
Another type of pill contains only one hormone (progestin), and is called either the "progestin-only pill", or the "mini-Pill". It works by suppressing ovulation and helping to prevent the male's sperm from reaching the egg.
Which birth control pill should I take?
First, talk with your health care provider about whether the Pill is right for you. If it is, discuss which pill and what dosage is best for you.
The combined pill with both estrogen and progestin is slightly more effective than the progestin-only pill. However, some people's bodies don't react well to the estrogen in the combined pill, so it is better for them to take the progestin-only pill.
How effective is the Pill against pregnancy?
The Pill is very effective if you take it exactly as you are supposed to - one pill a day, taken at the same time each day. You should also use back-up contraception such as condoms if you have diarrhea or vomiting, or are taking a medication that could change the effectiveness of the birth control pill. Using condoms is always important to lessen your chances of getting an STD.
Combination Pill
If you take the combination pill every day at the same time, it is more than 99% effective. This means that if 100 women take the combination pill every day, less than 1 woman will become pregnant in a year.
Although it's obvious that the combination pill is most effective against pregnancy when it is taken every day at the same time, perfect use hardly ever happens. That’s why it is often considered 95% effective. This means that if 100 women use the combination pill, but do not take it perfectly, 5 or more women will become pregnant in a year.
Progestin-Only Pill
If you take the progestin-only pill every day at the same time, it is 98% effective. This means that if 100 women take the progestin-only pill every day at the same time, 2 women will become pregnant in a year.
The typical woman does not take the progestin-only pill at exactly the same time every day. That’s why we say it is 95% effective. This means that if 100 women use the progestin-only pill, but do not take it perfectly, 5 women will become pregnant in a year.
How effective is the Pill against STDs?
Birth control pills are NOT effective against sexually transmitted diseases. You should always use condoms to protect yourself from getting an STD.
Do I need to use other forms of contraception with the Pill?
Birth control pills do not protect a woman from getting a sexually transmitted disease. So it is very important to also use a condom when having sexual intercourse. Condoms are an important second method if you miss more than one pill in a row, during the first month of pills (to be extra safe), when you are taking other medications that change the effectiveness of the Pill, or when you are sick and diarrhea or vomiting occur. (Anytime you get a new medication, ask your health care provider if it changes the effectiveness of the birth control pill.)
Are there medical benefits of the Pill?
Birth control pills not only prevent pregnancy, but they also have medical benefits. Many teen girls take the birth control pill just for its medical benefits and not for its protection against pregnancy.
What are the possible side effects of the oral contraceptive pill?
Most women have no side effects when taking the oral contraceptive pill, but it is possible to have irregular periods, nausea, headaches, or weight change. Each type of oral contraceptive pill can affect a young woman differently.
If side effects occur, they are usually mild and go away in the first three to four cycles. If you do have side effects, talk with your health care provider. If the side effects are uncomfortable or if they don't go away, your health care provider may switch you to a different kind of oral contraceptive pill.
Are there any serious side effects that I should be worried about?
Most young women who take the oral contraceptive pill have few or no problems. If you do have any of the following problems, call your health care provider right away.
Remember: ACHES
Abdominal or stomach pain (severe)
Chest pain (severe), cough, shortness of breath
Headache (severe), dizziness, weakness, or numbness
Eye problems (vision loss or blurring), speech problems
Severe leg pain (calf or thigh)
The oral contraceptive pill is much more than a birth control pill. Adolescent girls and young women are frequently prescribed the oral contraceptive pill just for its medical benefits. It is a very safe and effective treatment for many types of medical problems, including PCOS, irregular menstrual periods, menstrual cramps, acne, PMS, and endometriosis.
Can anybody take the Pill?
Almost all teens and young women can take the Pill. There are only a few reasons why your health care provider might feel that you need to choose other methods of birth control. These reasons are called "contraindications".
Contraindications for taking combined oral contraceptives:
Where can I get birth control pills?
You can get a prescription for birth control pills from your health care provider. He or she will check your blood pressure and weight, ask you about your family and personal history, and ask whether you smoke and if you use condoms. If you have no problems that would make the birth control pills a problem for your health, your health care provider will probably write you a prescription right then. You can buy birth control pills at drug stores. They usually cost between $15-$50 for a monthly pill pack, depending on the type you get. It is normal to have a follow-up visit with your health care provider after your first 3 months on the Pill to check your weight and blood pressure. Make sure that you make an appointment way before you run out of pills so that you always have them on hand.
Do I have to have a pelvic exam before going on the Pill?
No. Although it is important for teens to have checkups as part of their general health care, a pelvic exam is not needed to start birth control pills.
How long can I be on oral contraceptives?
It is safe for you to be on the Pill for years, whether to regulate your menstrual cycle, treat your cramps, or as hormone replacement or birth control.
Do I need to take a break from the Pill?
There is no medical reason that you need to take a "break" from the Pill.
Is there any trouble getting pregnant after using the Pill?
There is no change in fertility with the use of the Pill.
Does the Pill cause birth defects?
No, the Pill does not cause birth defects or affect the health of future children.
Does the Pill cause cancer?
No. The Pill actually protects against cancer of the ovaries and cancer of the lining of the uterus. A woman is half as likely to get cancer of the uterus or ovaries if she takes the Pill. Most experts believe that taking oral contraceptive pills does not cause any increased risk of developing breast cancer. Even girls with a family history of breast cancer can take the Pill.
How do I take birth control pills?
The most common pill packs come with 21 active hormone pills and seven placebo pills, but some packs have 23, 24, or even 28 active pills. The example shown below is for a 28–day pill pack in which you take 21 active hormone pills, and then seven placebo pills that contain no active hormones. These last seven pills are just "reminder" pills in most pill brands. They are taken during the fourth week, including during your period. With packages that have 24 active pills, the last 4 are "reminder" pills. There are also pill packages that have 84 active pills for continuous hormones and 7 "reminder" pills. Your health care provider will tell you whether you will be taking the active pills continuously or in cycles as illustrated below.
Can I take more than 21 days of Pills in a row?
Some girls prefer to take 42 pills (2 packages of pills), 63 pills, or even continuous pills because of cramps, PMS, or convenience. In fact one new Pill type comes in a package with 84 pills and 7 reminder pills, and another with 84 pills and then 7 low dose estrogen pills. Talk to your health care provider about whether extended Pill taking makes sense for you.
The extended Pill taking works best with monophasic Pills (all one dose, all one color). The downside is that some girls get more irregular, unexpected spotting and the insurance company may not allow the extra packages without a medical reason.
What if I forget to take one or more combined pills?
Emergency contraception is recommended if you have had unprotected intercourse during the time you missed your pills. If you are 17 or older, you can buy "Plan B" without a prescription. If you are under 17, you will need a prescription from your health care provider.
What if I forget to take one or more progestin birth control Pills?
If you forget even one progestin-only Pill, take it as soon as your remember. Take the next pill as usual, so you might take two pills in one day. Continue to take the rest of the pack as usual and use a back-up method for the rest of the month. Start the next pack on time.
What if my period is very, very light while I'm taking the Pill?
Your period may be so light when you are on the Pill that you may have only a brown smudge on a tampon, pad, or underwear. The hormone doses in the pills are very low. Therefore, not much uterus lining builds up, so very little blood needs to come out each month. If you have not missed any Pills and it is time for you to get your period, and you have used a back-up method when recommended, this counts as your period.
Does it mean I'm pregnant if I don't get my menstrual period while I'm on the Pill?
Not usually. At times, you may not get your menstrual period while using birth control pills. This can be normal. If you miss one menstrual period and you have not missed any pills and have used a back-up method (if and when it was required), everything is probably fine. Just start a new pack of pills at the usual time. But if you are concerned, check with your health care provider and get a pregnancy test.
If you miss one or more Pills and miss your period, keep taking your Pills, but see your health care provider for a pregnancy test.
If you miss two periods in a row, you should see your health care provider to see if you are pregnant, even if you missed no Pills. Keep taking your Pills in the meantime.
Missing menstrual periods or having a very light menstrual flow is extremely common and does not mean there is anything wrong with you.
What if I'm not happy with the Pill that I'm taking?
If you are not happy with the Pills that you are taking and the effects they have on you, talk to your health care provider. Don't just give up and stop taking them. Your provider can give you a prescription for a different type of pill. There are many types, and they affect people differently. Some you will like, and some you won't. You may have to try a few different types before you find the type that works best for you.
Can I smoke and take the pill?
The pill is much safer in women who do not smoke. So if you were thinking of quitting, this is a great reason. Smokers who are over 35 years old are 40 times more likely to have a heart attack and stroke than nonsmokers. So teens who are smokers can take the Pill, but you will be MUCH healthier and safer if you quit. (Click here for information on how to quit.)
How do I talk to my parents about the Pill?
If you are going on the Pill, it's good to share the information with your parents. They will be a good source to go to if you have any questions or concerns about taking the pill. If you are starting on the pill for cramps, irregular periods, or acne, the pills are simply a medication that you are taking to treat your problem. Talk with your parents about how the pills will help your medical problems. If you parents still have concerns, have them read Oral Contraceptive Pills and Teens: A Guide for Parents. If you are taking oral contraceptives as birth control to protect yourself from getting pregnant, talking to your parents may be more difficult since you will be talking about having sex. But even though it may be hard to tell them, it is usually helpful for them to know so that you will be able to go to them whenever you have a question or a problem with the Pill or with your relationships. Some teens, though, decide that keeping the decisions confidential (private) is better for them.
Updated: 11/16/2009
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