When beginning a birth control pill regimen, it’s important to understand the available options, appropriate timing and dosage, and potential side effects. This can ensure your medication is effective and safe.
If you’re considering starting or switching birth control pills, your doctor should be able to answer any questions you have regarding which birth control options are safe for you and what options may best suit your needs.
If you decide you want to take birth control pills, you’ll need to figure out when you can start.
Read on to learn more about your options and what the experts say.
Birth control pills contain synthetic hormones that work to prevent pregnancy. These hormones can stop ovulation and make it more difficult for sperm to enter your uterus. They can also alter your uterine lining, which can reduce the likelihood of an egg implanting.
There are many brands of birth control pills to choose from, and they may have different regimens. Some packs have 24 days of active pills and 4 days of placebos. Others contain all active pills and no placebos. Placebo pills allow for bleeding similar to a regular menstrual period.
You’ll want to discuss these options with your doctor, as every birth control option won’t be right for every person.
When you take them exactly as directed — known as “perfect use” — birth control pills are up to 99% effective.
Once you have your birth control pack, you may want to start right away. But before you do, there are some things to note.
First, look at what type of pill it is.
For combination pills — pills that contain both estrogen and progestin — Sherry Ross, MD, OB-GYN, and women’s health expert in Los Angeles, recommends starting the pack on the first day of your period.
“This gives you protection against getting pregnant that month and reduces the likelihood of irregular bleeding,” she said.
If you take your first pill within 5 days of your period, you’re protected immediately.
However, if you want to start sooner and your period isn’t for a few weeks, you can still begin taking your birth control pills, but you won’t be protected right away.
“If you start the pill pack midcycle, you’ll need backup birth control,” Ross said. That means you should use condoms or another form of birth control during your first week of starting birth control pills. After 1 week, the pills will protect against pregnancy.
You can also start progestin-only pills mid-cycle. You’ll want to have a backup method in place for the first 2 days.
After those 2 days, your birth control pills should be able to provide protection against pregnancy.
Because the pill is meant to mimic your menstrual cycle while preventing ovulation, Ross said starting the pill on the first day of your cycle or the first Sunday after your cycle starts is recommended.
When you start midcycle, you’re quite literally going against your body’s natural hormonal rhythm. Because of this, you may experience irregular bleeding while your body adjusts.
This irregular bleeding, or spotting, is almost a given during your first pack, but it could linger as long as a couple of months. Be sure to plan for this in case it happens.
Although there’s no health benefit to starting your birth control midcycle, there are some benefits to starting birth control sooner.
It mostly comes down to convenience.
Starting right away might make more sense for you if you’re more likely to forget your doctor’s instructions for how to take the pill by the time your next period rolls around.
You may even want to skip your next period, which would affect when you start your pills.
“If you want to delay or even skip your next period, starting midcycle might make more sense for you,” said Fahimeh Sasan, DO, assistant professor of obstetrics, gynecology and reproductive science, Icahn School of Medicine at Mount Sinai.
Just know you’re not protected immediately, so it’s important to use an additional method of birth control in the meantime.
According to Ross, any potential benefits are outweighed by the side effects that can come with starting midcycle.
“If you do so, you will definitely be out of sync with the pill pack and have irregular bleeding,” she said.
Because pills are meant to be taken at a particular point in your natural monthly cycle, how much you stray from this will affect how well you adjust.
“The only reason for a woman to start the birth control midcycle is if she is already having irregular periods and wants to regulate her cycle or if she is eager to get started on contraception,” Ross said.
Birth control pills are incredibly effective, but only if they’re taken correctly.
That means following all directions from your doctor and taking them at the same time every day.
“The birth control pill must be taken daily in order for it to work,” Sasan said. “The most common reason women will have birth control failure is that they were not taking the pill correctly on a daily basis.”
If you decide to start midcycle, make sure you know when pregnancy protection starts. It’s not immediate, and it varies by pill type.
If this concerns you, you may want to consider starting the pack at the beginning of your period.
Otherwise, stock up on backup contraceptives for any potential sexual activity you may have before the pill’s protection kicks in.
Some other tips to make sure your pill is working sufficiently include:
- Never skip pills, even if you’re not having sex.
- Understand that diarrhea or vomiting can affect how well the pill is absorbed.
- Certain antibiotics can alter the pill’s effectiveness.
If any of these apply to you, contact your doctor to find out the next steps to avoid an unintended pregnancy.
When in doubt, use backup contraception.
Not all birth control options are right for every woman, so be sure to talk with your doctor about the details of your medical history.
You should also take your lifestyle into consideration. If you know you can be forgetful or that you may have difficulty taking a pill every day, the pill may not be the best option for you.
If you’ve recently been pregnant or are currently nursing, you’ll want to talk with your doctor as well. They might prescribe a progestin-only pill or ask you to wait before starting the combined pill.
If you’re concerned about the potential side effects of birth control, such as breast tenderness, bloating, or mood issues, there are other options available.
Deciding which birth control to use and how to start are questions that your doctor can help you answer while keeping your individual circumstances in mind.
With the help of your doctor, you should be able to find the birth control option that works best for you.
Birth control pills come with different regimens and can affect each person differently. doctors recommend starting birth control pills on the first day of your cycle. Doing so means fewer side effects and more effectiveness.
If you start midcycle, you may experience side effects, and you won’t be protected from pregnancy right away.
It’s important to consult with a healthcare professional to discuss the potential benefits and risks associated with any birth control method you’re starting.