Taking Oral Contraceptive Pills (OCPs)

Oral Contraceptive Pills (OCPs) are birth control pills taken by mouth. They are the most common form of birth control chosen by females to prevent pregnancy.  They are also often taken to help regulate menstrual cycles. If you have chosen to take OCPs as your birth control method, here are a few guidelines regarding how to take your pills and common side effects that may be experienced.


When to start

When starting OCPs, your provider or nurse should have discussed when to start taking your pills based during your clinical appointment. Pills are usually started following either a “same day” or ”Sunday” start. A “same day” start simply means that you start taking your pills on the same day that your period starts. A “Sunday “start means that you would start taking your pills on the Sunday after your period started (e.g. your period started on Thursday, you would start taking your first pill on Sunday).


Daily Routine

Any time of day is fine to take your pills as long as it is about the same time every day (within a couple hours of the same time). It’s best to pick a time when you are most likely to have a routine schedule. Taking your pills on a routine basis every day about the same time keeps your hormones at a steady level. Fluctuations in the time you take your pill may increase the chance of getting pregnant and may also cause irregular spotting or breakthrough bleeding when you should not be having a period.

OCPs that come in a pack of 28 pills should be taken every day to complete the pack. Once you have finished all of the pills, you will start your next pack on the very next day and continue to take your pills daily. Do not skip pills!! It is important to take all of the pills including the placebo pills in the pack unless specifically instructed to do otherwise by your provider. Taking your placebos will keep you taking pills on a daily routine and many OCPs are formulated to give you a boost of iron to help prevent anemia concerns with your menstrual cycles. Take your pills daily even when you are having your period. Some OCPS do come in a pack of 21 pills, with no pills to take for 7 days of a cycle. These are much less common and less preferred. It is recommended not to stop your OCPs unless instructed by your healthcare provider.

OCPs are not 100% effective and we suggest that you always use condoms as back-up and for STD protection!! Also, a second form of contraception is recommended to use when taking antibiotics due to the possible decrease in effectiveness of the OCP while taking antibiotics. Do not stop OCPs while taking the antibiotics, unless instructed by your healthcare provider.


Forgetting to Take Your Pills

  • If you forget to take a pill, take it as soon as you remember it.
  • If you missed the pill all together, take 2 pills the next day. This would be the pill you missed, plus the pill for the current day. Use back up birth control such as condoms for the next week in addition to your OCP.
  • If you missed 2 pills on 2 consecutive days, do not take 3 pills all together. Take the 2 pills that you missed and on the next day, take another 2 pills. On the next day, continue taking 1 pill daily. This will put you back on track. Use condoms for 2 weeks in addition to your OCPs.
  • If you have missed 3 pills consecutively, there is no make-up schedule available. You will need to use condoms for back up birth control and discard your pack of pills. After your period starts, you will need to start over with a new pack of OCPs.

If you are frequently missing pills, you need to discuss other birth control options with your healthcare provider.


Common Side Effects:

Common side effects that usually get better after the first few months of starting an OCP are listed below. Your body usually takes a few months to get adjusted to the new hormones. If side effects do not improve, contact the Student Health Center or your provider before your scheduled follow up appointment. It is always best to give your healthcare provider a thorough health history so that the best birth control can be selected for your use to prevent unwanted or negative side effects from occurring.

  • Slight swelling of hands, feet or abdomen
  • Breast swelling or tenderness
  • Dizziness
  • Nausea
  • Headaches
  • Slight weight gain
  • Small amount of breakthrough bleeding
  • No menstrual cycle. This is not a major problem and sometimes is expected depending on the specific OCP selected.

More Serious Side Effects:

OCPs are capable of having very negative side effects, some which could lead to serious complications or death. If any of these side effects listed below occur, contact your health care provider immediately.

  • Emotional changes
  • Numbness or tingling in the arms or legs
  • Blurred vision
  • Chest pains
  • Skin rash
  • Leg cramps
  • Severe abdominal pains
  • Severe headaches
  • Breast lumps
  • Jaundice

If Student Health Services is not immediately available, and/or the symptoms are more emergent, contact 911. OCPs have been associated with blood clots, heart attacks, strokes and liver damage.

If at any time you have questions regarding your OCP, please feel free to call the Student Health Services and speak with a nurse or provider regarding your concerns.