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User's guide to oral contraceptives

Before you start your oral contraceptive (pills), check your package closely and verify whether it contains 21 or 28 pills.

  • 21 pills: take one pill a day for 21 days, then stop for 7 days.
  • 28 pills: take one pill a day for 28 days. The last seven pills (days 22 to 28) do not contain homones. They serve the purpose of helping you keep the habit of taking a pill a day. When the package is empty, start a new one the day after.
    Make sure you always have an extra package.

Make sure you always have an additional contraceptive handy (condom or spermicide), for cases when the efficiency of the pill would be reduced.

When do I start my first package ?

There are 3 options:

  • the first day of your period;
  • the Sunday after the first day of your period (if your period starts on a Sunday, take your pill that same day);
  • the fifth day of you period.

You must remember which day of the week you started your first package, because all the others should be started on that same day. (For example, if you started the first one on a Sunday, you should start all the others on a Sunday as well).

At what time should the pill be taken ?

It should be taken every day at approximately the same time.

The best way to remember about your pill is to take it during a regular daily activity like supper, brushing your teeth of bedtime.

Even if the pill causes nausea, you must keep on taking it. You can avoid nausea by changing the time of intake (for example, after you meal). In case of persistent nausea , see your doctor.

When does the pill start working ?

  • If you start your first package on the first day of your period, it starts working immediately, if you do not forget to take any.
  • If you start your first package the next Sunday or the fifth day of your period, the pill will work after one week. Therefore you must use an additional contraceptive during the first seven days of your first package.

What to do in case of bleeding in between periods ?

You must not stop the pill, even though there is bleeding (or brown spotting) in between periods. There is no need to worry because the pill is still working (if you have not forgotten to take any). The bleeding should strop within the first three months of using the pill. If the bleeding persists after three months, keep taking the pill and talk to your doctor.

What to do in case of forgotten pills ?

  • If you forgot one pill

             1. Take it as soon as you become aware of it.

             2. Take the next pill at the same time as usual.

  • If you forgot two consecutive pills

             1. Take two pills on the day you become aware of it, and two pills the day after.

             2. Then keep on taking one pill a day till the end of your package.

             3. Use an additional contraceptive (condom or specmicide) during the next seven days, if                  you have sexual relations.

             4. If you had sexuel relations during the days you forgot your pill or during the three previous                 days, talk to your doctor to determine whether you need the morning after pill.

  • If you forgot three pills or more

             1. Discard the pills you forgot to take.

             2. Keep on taking on pill a day until the day you usually start your package.

             3. That day, discard the rest of your package and start a new one (same day as usual).

Example: You started a new package on a Sunday as usual, and then you forgot to take your pill on Monday, Tuesday and Wednesday. Discard these three pills. Then take one on Thursday, Friday and Saturday, as usual. Discard the rest of the package, and start a new one on Sunday

             4. If you have sexual relations, you must use an additional contraceptive (condom or                  spermicide), during the seven days after you forgot your pill.

             5. If you had sexual relations during the days you forgot the pill or during the three previous days,                  talk to your doctor to determine whether you need the morning after pill.

What to do if you do not start a package on the right day ?

If you do not start package on the right day, you can become pregnant. Therefore you must use an additional contraceptive (condom or spermicide) during the next seven days if you have sexual relations.

              1. If you start one day late, do the same as for one forgotten pill.

              2. If you start two days late, do the same as for two forgotten pills.

              3. If you start three days late or more, do the same as for three or more forgotten pills.


Note. If you had sexual relations during the days you forgot your pill or during the three previous days, talk to you doctor to get the morning after pill.

In what other cases would the pill not work totally ?

Antibiotics

You must remember that several antibiotics reduce the efficiency of the pill. If you have been prescribed antibiotics, you must use an additional contraceptive (condom or spermicide) during the duration of the treatment as well as during the seven days following it.

Do not stop the pill because it is important that you stick to your routine.

Other drugs might have a similar effect on the pill. Always check with your doctor or with your pharmacist if the drug you have to take is one of them.

Vomiting

Vomiting can reduce the efficiency of the pill. If you vomit within three hours after you took your pill, you must take another one. Ask your doctor what should be done in this case.

Diarrhea

A significant diarrhea for several days might reduce the efficiency of the pill. Therefore, if you have sexual relations, you must use an additional contraceptive (condom or spermicide) for the duration of diarrhea as well as for seven days after it stops.

If you had sexual relations during the three days prior to a significant diarrhea, talk to your doctor to determine whether you need the morning after pill.

What to do if you do not menstruate at the end of a package ?

Keep on taking your pills. It is advised to do a pregnancy test in the following cases:

  • If you forgot any pills.
  • If you took antibiotics or any other drugs.
  • If you had a significant diarrhea or serious vomiting.

If you do not menstruate for two consecutive months, see your doctor.

Should you quit the pill after a few years ?

No. If you do not have any side-effects, you can take the pill for as long as need an efficient contraceptive. Quitting the pill for a few months does not have any beneficial effect on your health and often causes an unwanted pregnancy.

Note. Don't forget that as soon as you quit the pill, you can become pregnant. It is a false assumption to think that the pill will still work for a little while after you stop it. Therefore, if you do not wish to become pregnant, you must use another contraceptive as soon as you are off the pill.
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