About to Start Using Birth Control Pills? Here’s How to Take Them

Anytime you want. But when you start affects how soon you’ll be protected against pregnancy.

Let’s break it down by pill type.

If you’re taking combination birth control pills

You can start combination pills anytime, but here’s how timing impacts how soon you’ll be protected against pregnancy:

• If you start within 5 days after your period starts: You’ll be protected right away, as long as you start taking your pills within 5 days of starting your period. That means, if you get your period on Sunday morning and start the pill any time before Friday morning, you’ll be protected right away.
• If you start any other time: Starting at any other time means that you’ll need to take it for 7 consecutive days before you’re protected against pregnancy. During this time, you’ll definitely need to use another method — like condoms or another barrier — if you’re having penis-in-vagina sex and don’t want to get pregnant.

If you’re taking a progestin-only pill

Progestin-only pills, aka minipills, can be started any time, depending on the brand.

These pills work fast and offer protection against pregnancy after two consecutive pills (48 hours). If you don’t want to wait 48 hours before having sex, use another method of birth control in the meantime.

The only exception is if you’re taking the progestin-only pill Slynd.

If you start taking Slynd on the first day of your period, you’ll be protected right away. If you start at any other time, then protection doesn’t take effect for 48 hours.

Again, this depends on the type you’re taking. Dosing schedules vary between types and brands.

You don’t need to take the pill with food. But, if you’re prone to nausea, it’s best not to take them on an empty stomach.

As long as you follow the recommended dosing schedule for the type you’re taking — which we’ll get to in a sec — you can choose a time of day to take them that works for you.

This should be a time that’s convenient and easy to incorporate into a routine, so you won’t forget (think: with your morning coffee or before you brush your teeth).

Let’s look at the dosing deets for each type.

Combination pills

You don’t ~technically~ need to take combination birth control pills at the same time every day, but doing so is recommended to help you get into the habit and not forget.

How many days in a row you take a pill depends on the brand. That’s because combo pills come in different dosing packs, from 21 days up to 365 days.

With most brands, you take at least 3 weeks of active pills and 2 to 7 days of inactive pills or no pills at all. This is called cyclical dosing, and most people get a period during this week “off” the active pills.

There are also brands that offer:

• Continuous dosing. This involves taking an active pill every day without the need for inactive pills.
• Extended dosing. This involves short breaks three or four times per year, where you take inactive pills or no pills at all.

Here’s how to take each:

• 21-day pack: Take one pill per day for 21 days, and wait a week before starting a new pack. You’ll get a period the week you’re not taking the pill.
• 28-day pack: Take one pill per day for 28 days, and start a new pack on day 29. Depending on the brand, the first 21 or 24 pills contain estrogen and progestin. The remaining pills might be estrogen-only, be inactive, or contain a dietary supplement. You should get a period during this time.
• 91-day pack: Take one pill per day for 84 days. Depending on the brand, up to the last 7 pills will be inactive or estrogen-only, which is when you’ll get your period. With this dosing, you only get a period every 3 months.
• 365-day pack: Take one pill per day every day for an entire year. With continuous daily dosing of active pills, you shouldn’t get a period for the entire year.

Progestin-only pills

Unlike combination pills, it does matter when you take progestin-only pills.

Progestin-only pills need to be taken within the same 3 hours every day to be effective.

This means, if you take your pill at 8 a.m., taking it after 11 a.m. the next day puts you at risk for pregnancy.

Most progestin-only pills come in 28-day packs and all 28 pills are active. To be protected, you have to take all 28 without a break.

You might get a period during the last week of the pack, but many people only have mild spotting or no bleeding at all.

The brand Slynd is slightly different when it comes to its dosing schedule. As long as you take one pill per day, Slynd progestin-only pills don’t need to be taken within the same 3 hours to be effective. Their packs have 24 active pills and 4 inactive pills.

As long as you’ve only missed one pill, it’s NBD. Just take it as soon as you remember, even if you have to double-up.

There could be. Like any medication, the pill can cause side effects in some people. Most people who take the pill don’t have any problems, though.

Side effects, if any, usually only last 2 to 3 months as your body adjusts to the hormones.

After starting the pill, you might experience:

• headaches
• sore breasts
• nausea
• period changes

FYI, some of the pill’s side effects can be a good thing. The pill may help with:

• heavy periods
• cramps
• acne
• premenstrual syndrome (PMS)
• premenstrual dysphoric disorder (PMDD)

Birth control pills are generally safe, but they can increase your risk of blood clots.

Blood clot warning signs

Birth control-related blood clots are rare, but it’s wise to know what to watch for. See a healthcare professional right away if you experience:

• chest pain or discomfort
• sudden severe back or jaw pain, sweating, and nausea
• trouble breathing
• aching in your leg
• severe abdominal pain
• sudden severe headache
• vision changes

Very!

We’re talking up to 99 percent effective when taken exactly as directed, according to Planned Parenthood.

It’s your body, so you can stop if you want to. Just remember that stopping means you can get pregnant. So, unless that’s your intention, you’ll need to use another birth control method.

Depending on your reasons for stopping, it might be a good idea to talk with a healthcare professional first.

If you’re looking to switch birth control, a healthcare professional will tell you how to do it safely, since some overlapping may be required.

You’ll also want to talk with a doctor first if you’re on the pill for medical reasons other than pregnancy prevention, like polycystic ovary syndrome or endometriosis.

If you want to try to get pregnant, it could take some time, depending on the type of pill used.

When you go off the pill, your body will need some time to adjust to the change in hormones — like it did at the start. This means you might have spotting or irregular periods for a while.

Starting birth control pills usually goes off without a hitch, and most people don’t have any side effects.

Follow the instructions given by your healthcare professional, and read the info that comes with your pills to know exactly when protection kicks in for your particular brand.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.