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Estrogen and Progestin (Oral Contraceptives)

(ess' troe jen) (proe jes tin)

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IMPORTANT WARNING:   Return to top

Cigarette smoking increases the risk of serious side effects from oral contraceptives, including heart attacks, blood clots, and strokes. This risk is higher for women over 35 years old and heavy smokers (15 or more cigarettes per day). If you take oral contraceptives, you should not smoke.

Why is this medication prescribed?   Return to top

Oral contraceptives (birth-control pills) are used to prevent pregnancy. Estrogen and progestin are two female sex hormones. Combinations of estrogen and progestin work by preventing ovulation (the release of eggs from the ovaries). They also change the lining of the uterus (womb) to prevent pregnancy from developing and change the mucus at the cervix (opening of the uterus) to prevent sperm (male reproductive cells) from entering. Oral contraceptives are a very effective method of birth control, but they do not prevent the spread of human immunodeficiency virus [HIV, the virus that causes acquired immunodeficiency syndrome (AIDS)] and other sexually transmitted diseases.

Some brands of oral contraceptives are also used to treat acne in certain patients. Oral contraceptives treat acne by decreasing the amounts of certain natural substances that can cause acne.

One type of oral contraceptives (Yaz) is also used to relieve the symptoms of premenstrual dysphoric disorder (physical and emotional symptoms that occur before the menstrual period each month) in women who have chosen to use an oral contraceptive to prevent pregnancy.

How should this medicine be used?   Return to top

Oral contraceptives come in packets of 21, 28, or 91 tablets to take by mouth once a day, every day or almost every day of a regular cycle. To avoid nausea, take oral contraceptives with food or milk. Take your oral contraceptive at the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take your oral contraceptive exactly as directed. Do not take more or less of it, take it more often, or take it for a longer time than prescribed by your doctor.

Oral contraceptives come in many different brands. Different brands of oral contraceptives contain slightly different medications or doses, are taken in slightly different ways, and have different risks and benefits. Be sure that you know which brand of oral contraceptives you are using and exactly how you should use it. Ask your doctor or pharmacist for a copy of the manufacturer's information for the patient and read it carefully.

If you have a 21-tablet packet, take one tablet daily for 21 days and then none for 7 days. Then start a new packet.

If you have a 28-tablet packet, take one tablet daily for 28 days. The last set of tablets in most 28 day packets are a different color. These tablets are reminder tablets. They do not contain any active ingredients but may contain iron. Taking one of these tablets every day will help you remember to start your next packet of birth control pills on time. One type of 28-tablet packet contains tablets that are all the same color. All of the tablets in this type of packet contain active ingredients. Whether your packet includes reminder tablets or only active tablets, you should take one tablet daily continuously for 28 days in the order specified in your packet. Start a new packet the day after you take your 28th tablet.

If you have a 91-day tablet packet, take one tablet daily for 91 days. Your packet will contain three trays of tablets. Start with the first tablet on the first tray and continue taking one tablet every day in the order specified on the packet until you have taken all of the tablets on all of the trays. The last set of tablets are a different color. These tablets may contain an inactive ingredient, or they may contain a very low dose of estrogen. Start your new packet the day after you take your 91st tablet.

Your doctor will tell you when you should start taking your oral contraceptive. Oral contraceptives are usually started on the first or fifth day of your menstrual period or on the first Sunday after or on which bleeding begins. Your doctor will also tell you whether you need to use another method of birth control during the first 7 days that you take your oral contraceptive and will help you choose a method. Follow these directions carefully.

You will probably experience withdrawal bleeding similar to a menstrual period while you are taking the inactive tablets or the low dose estrogen tablets or during the week that you do not take your oral contraceptive. If you are taking the type of packet that only contains active tablets, you will not experience any scheduled bleeding, but you may experience unexpected bleeding and spotting, especially at the beginning of your treatment. Be sure to start taking your new packet on schedule even if you are still bleeding.

You may need to use a backup method of birth control if you vomit or have diarrhea while you are taking an oral contraceptive. Talk to your doctor about this before you begin to take your oral contraceptive so that you can prepare a backup method of birth control in case it is needed. If you vomit or have diarrhea while you are taking an oral contraceptive, call your doctor to find out how long you should use the backup method.

If you have recently given birth, wait until 4 weeks after delivering to begin taking oral contraceptives. If you have had an abortion or miscarriage, talk to your doctor about when you should begin taking oral contraceptives.

Oral contraceptives will work only as long as they are taken regularly. Continue to take oral contraceptives every day even if you are spotting or bleeding, have an upset stomach, or do not think that you are likely to become pregnant. Do not stop taking oral contraceptives without talking to your doctor.

Other uses for this medicine   Return to top

Oral contraceptives are also sometimes used to treat heavy or irregular menstruation and endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body and causes pain, heavy or irregular menstruation [periods], and other symptoms). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?   Return to top

Before taking oral contraceptives,

What special dietary instructions should I follow?   Return to top

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?   Return to top

If you miss doses of your oral contraceptive, you may not be protected from pregnancy. You may need to use a backup method of birth control for 7 days or until the end of the cycle. Every brand of oral contraceptives comes with specific directions to follow if you miss one or more doses. Carefully read the directions in the manufacturer's information for the patient that came with your oral contraceptive. If you have any questions, call your doctor or pharmacist. Continue to take your tablets as scheduled and use a backup method of birth control until your questions are answered.

What side effects can this medication cause?   Return to top

Oral contraceptives may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

Oral contraceptives may increase the chance that you will develop liver tumors. These tumors are not a form of cancer, but they can break and cause serious bleeding inside the body. Oral contraceptives may also increase the chance that you will develop breast or liver cancer, or have a heart attack, a stroke, or a serious blood clot. Talk to your doctor about the risks of using oral contraceptives.

Oral contraceptives may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?   Return to top

Keep this medication in the packet it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose   Return to top

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

What other information should I know?   Return to top

Keep all appointments with your doctor and the laboratory. You should have a complete physical examination every year, including blood pressure measurements, breast and pelvic exams, and a Pap test. Follow your doctor's directions for examining your breasts; report any lumps immediately.

Before you have any laboratory tests, tell the laboratory personnel that you take oral contraceptives.

If you wish to stop taking oral contraceptives and become pregnant, your doctor may tell you to use another method of birth control until you begin to menstruate regularly again. It may take a long time for you to become pregnant after you stop taking oral contraceptives, especially if you have never had a baby or if you had irregular, infrequent, or complete absence of menstrual periods before taking oral contraceptives. However, it is possible to become pregnant within days of stopping certain oral contraceptives. If you want to stop taking oral contraceptives but do not want to become pregnant, you should begin using another type of birth control as soon as you stop taking oral contraceptives. Discuss any questions that you may have with your doctor.

Oral contraceptives may decrease the amount of folate in your body. Folate is important for the development of a healthy baby, so you should talk to your doctor if you want to become pregnant soon after you stop taking oral contraceptives.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names   Return to top

  • Alesse®
  • Apri®
  • Aviane®
  • Brevicon®
  • Demulen®
  • Desogen®
  • Estrostep®
  • Estrostep® Fe
  • Genora®
  • Jenest®
  • Levlen®
  • Levlite®
  • Levora®
  • Lo/Ovral®
  • Loestrin®
  • Loestrin® Fe
  • Low-Ogestrel®
  • Lybrel®
  • Microgestin®
  • Microgestin® Fe
  • Mircette®
  • Modicon®
  • Necon®
  • Norinyl®
  • Nordette®
  • Nortrel®
  • Ogestrel®
  • Ortho-Cept®
  • Ortho-Cyclen®
  • Ortho-Novum®
  • Ortho Tri-Cyclen®
  • Ovcon®
  • Ovral®
  • Seasonale®
  • Seasonique®
  • Tri-Levlen®
  • Tri-Norinyl®
  • Triphasil®
  • Trivora®
  • Yasmin®
  • Yaz®
  • Zovia®

Other names   Return to top

  • Birth-control pills
  • ethinyl estradiol and desogestrel
  • ethinyl estradiol and drospirenone
  • ethinyl estradiol and ethynodiol
  • ethinyl estradiol and levonorgestrel
  • ethinyl estradiol and norethindrone
  • ethinyl estradiol and norgestimate
  • ethinyl estradiol and norgestrel
  • mestranol and norethindrone

Last Reviewed - 09/01/2008


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