Endometriosis for Parents: How To Take Continuous Oral Contraceptive Pills

Single-Yellow-GirlTaking the Pill continuously means that your daughter will take one active pill (containing the female hormones estrogen and progesterone) every day without a break. This will help keep the lining of her uterus very thin. She will not take any placebo (inactive) pills and she will not have a regular monthly period. She may have some irregular spotting or bleeding as her body gets used to this new medicine, especially in the first six months of treatment.

The GYN team will explain to your daughter how to use the Pill pack. She will be told to start taking the Pill on a Sunday, on the first day of her menstrual period, or on the day of her appointment with her gynecologist.

  1. She should take 1 pill at the same time each day until she finishes the pack. The best time is ½ an hour after a full meal. She may feel mildly nauseous during the first month, but this usually goes away.
  2. After completing a 21–day pack, she should immediately start a new package of pills the next day.

Please remind your daughter: to take her pill at exactly the same time everyday. A good time to take the Pill is at 6, 7, or 8pm every evening. It is not a good idea to tell her to take the Pill when she wakes up or before she goes to sleep, as those times will likely vary on school nights and weekends.

Young women have shared creative ways to remember to take their pill such as writing a reminder on a calendar, or setting a cell phone alarm, which ensures that they take their pill at a consistent time each day. Try to think of a special way that your daughter can remember to take her pill.

What if my daughter forgets to take one or more hormonal pills?

  • If she misses 1 or 2 active (hormone) pills in a row, she should take the pill(s) as soon as possible and then continue taking 1 pill each day. She can take 2 pills on the same day (one at the moment she remembers and the other at the regular time) or even 2 at the same time.
  • If she misses 3 or more active (hormone) pills in a row, she should take all 3 hormone pills as soon as possible and then continue taking 1 pill each day.
  • If your daughter is sexually active and does not use condoms, she should call the GYN team to find out if she should also take emergency contraception (EC). She should use condoms for the next 7 days.
  • Note: If she is taking very low dose hormone pills with just 20ug of ethinyl estradiol and misses 2 pills, she should follow the instructions for missing 3 or more pills.

Your daughter may have breakthrough bleeding (spotting) if she forgets to take her pill on time; some women/teens’ bodies are so sensitive that they will bleed if they take their pill just 20 minutes late. If she misses pills she may get an extra menstrual period.

What if my daughter complains about the oral contraceptive pills that she was prescribed?

If your daughter is not happy with the Pill that she is taking and the effects they have on her body, please encourage her to talk to the GYN team. She should NOT just give up and stop taking the pills. Most likely her gynecologist will be able to give her a prescription for a different type of oral contraceptive pill or another type of hormonal medication. There are many types of hormonal pills and they affect people differently. Your daughter may like some, but not others. Be prepared that she might need to try a few different types of hormonal pills until she finds the one that works best for her.

Hormonal pills (also called oral contraceptive pills) can be a very effective treatment for endometriosis. Encourage your daughter to ask questions about the Pill before she considers taking it.