Birth Control

Types of Contraception

There are many types of birth control, including hormonal, permanent, emergency, barrier, and natural methods.

Deciding which one is best for you is a personal decision that you must make based on your health needs and each method’s effectiveness rate.

We at Rocket Health offer birth control pills.

How Does Birth Control Pills Work?

Most oral contraceptives, commonly called "the pill," contain a combination of estrogen and progestin. The combination pill reduces the risk of pregnancy by:

- Preventing ovulation
- Keeping the mucus in the cervix thick and impenetrable to sperm
- Keeping the lining of the uterus thin

Benefits and Downside of Pills

The pill makes menstrual bleeding more regular, with fewer days of flow and overall lighter flow. Other benefits of the pill include a reduction in:

- Menstrual cramps or pain
- Risk of ovarian cancer or cancer of the endometrium (uterine lining)
- Acne
- Iron-deficiency anemia (a low blood count due to low iron levels)

One potential downside of the pill is that in order to maximize efficacy, you have to remember to take it every day, ideally at the same time of day. Some women find this difficult or inconvenient.


When taken properly, birth control pills are a highly effective form of contraception; however, skipping pills or forgetting to restart the pill after the week of your period will decrease efficacy. Approximately 9 out of every 100 women who take birth control pills for one year will have an unintended pregnancy.

Missed pills are a common cause of pregnancy. In general, if you forget to take an active pill (containing hormones), you should take it as soon as possible and take the next one at the usual time it is due. If you miss more than two pills, use a backup method of birth control (eg, condoms) for seven days.

Side Effects

Possible side effects of the pill include:

- Nausea, breast tenderness, bloating, and mood changes – These typically improve within two to three months without treatment.

- Bleeding between periods – Irregular bleeding, also called "breakthrough bleeding" or "spotting," is particularly common during the first few months of taking the pill. It almost always resolves without any treatment within two to three months. Forgetting a pill can also cause breakthrough bleeding.

Taking birth control pills does not cause weight gain.

If you are taking the pill, tell your doctor right away if you experience abdominal pain, chest pain, severe headaches, eye problems, or severe leg pain. These could be symptoms of several serious conditions including heart attack, blood clot, stroke, and liver or gallbladder disease.

Potential complications — When the pill was first introduced in the 1960s, the doses of both hormones (estrogen and progestin) were quite high. Because of this, cardiovascular complications occurred, such as high blood pressure, heart attacks, strokes, and blood clots in the legs and lungs.

The pills prescribed today have much lower doses of progestin and estrogen, which has decreased the risk of these complications. As a result, birth control pills are now considered a reliable and safe option for most healthy, nonsmoking women. While there is a very small risk of blood clots, this risk is actually lower than the risk in pregnant women or those who have recently given birth.

Experts have studied the possible association between taking the pill and the risk of breast cancer. While these studies have had mixed results, there is some evidence that women who take the pill do have a slightly higher risk of getting breast cancer later in life than women who do not. However, if there is an increase in risk, it is very small, especially in younger women. It's important to balance this against the benefits of the pill, which include not only pregnancy prevention but a reduction in the risk of ovarian and endometrial cancer (see above).

Who should not take the pill?

Because of an increased risk of complications, you should not take the pill if you:

- Are 35 or older and smoke cigarettes (as this puts you at high risk for cardiovascular complications such as blood clots or heart attack)

- Are pregnant

- Have had blood clots or a stroke in the past (as this increases your risk of blood clots while taking the pill)

- Have a history of an "estrogen-dependent" tumor (eg, breast or uterine cancer)

- Have abnormal or unexplained menstrual bleeding (in which case the cause of the bleeding should be investigated before starting the pill)

- Have active liver disease (the pill could worsen the liver disease)

- Have migraine headaches associated with certain visual or other neurologic symptoms (eg, aura), which increases your risk of stroke

Some women may take the pill under certain circumstances, but need close monitoring. Talk with your doctor if you:

- Have high blood pressure – You may experience a further increase in blood pressure and should be monitored more frequently while on the pill.

- Take certain medication for seizures (epilepsy) – In this case, the pill may be slightly less effective in preventing pregnancy because the seizure medicines change the way it is metabolized.

- Have diabetes mellitus – Women with diabetes and kidney disease or vascular complications from diabetes should not use the pill.

- Medication interactions — The pill may not work as well to prevent pregnancy if you also take certain other medications.

- Anticonvulsants — Some anticonvulsants decrease the effectiveness of birth control pills. As a result, women who take these anticonvulsants are advised to avoid hormonal birth control methods (with the exception of depo-medroxyprogesterone acetate [Depo-Provera]).

If you take any anti-seizure medications, it's important to talk with your doctor about possible interactions before starting the pill or another hormonal birth control method.

Antibiotics — Rifampicin, which is used to treat tuberculosis, can decrease the efficacy of hormonal birth control. As a result, women who take rifampicin are advised to avoid most hormonal birth control methods, with the exception of depo-medroxyprogesterone acetate (Depo-Provera). Other alternative options include an intrauterine device (IUD), condoms, or a diaphragm, or sterilization.

Contrary to popular belief, other (more commonly used) antibiotics do not affect the efficacy of hormonal birth control methods. Backup contraception is not needed when you take these antibiotics.