How do I use the birth control pill?

What are the different types of birth control pills?

There are 2 types of birth control pills (combination pills and progestin-only pills), and many different brands.

Combination Pills (COCs):

As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take your combination pill at the exact same time every day. But taking it at the same time is a good idea because it helps keep you in the habit of remembering your pill.

Progestin-Only Pills (aka POPs or Mini Pills):

Progestin-only pills have 1 kind of hormone (progestin) — these pills don’t have any estrogen. You must take a progestin-only pill within the same 3 hours every day to be protected from pregnancy.

The one exception is Slynd (a different type of progestin-only pill): you take 1 pill a day, but you don’t need to take Slynd within the same 3-hour window every day. It’s best to take it around the same time if you can to help you stay on schedule.

How do I use the different types of birth control pills?

Combination Pills (COCs):

As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take your combination pill at the exact same time every day. But taking it at the same time is a good idea because it helps keep you in the habit of remembering your pill. You can also use an alarm, calendar reminder, or our birth control app to help you remember. Most combination pills come in 28-day or 21-day packs.

If you have 28-day packs:

Take 1 pill every day for 28 days (four weeks) in a row, and then start a new pack on day 29. The last pills in 28-day packs of combination pills do not have hormones in them. These pills are called "reminder" or “placebo” pills — they help remind you to take your pill every day and start your next pack on time. How many days you take hormone-free reminder pills depends on the brand of pill. Most pill packs have hormone-free pills for 7 days, but sometimes there are less. The reminder pills may contain iron or other supplements. You get your period during the week you take these reminder pills. You’ll still be protected from pregnancy even if you don’t take the reminder pills — just remember to start your next pack on time.

If you have 21-day packs:

Take 1 pill every day for 21 days (3 weeks) in a row. Then don’t take any pills for seven days (week 4). You’ll get your period during the fourth week while you aren’t taking any pills. It’s important to take every pill in a 21-day pack because there are no reminder (hormone-free) pills. The hormone pills will prevent pregnancy even if you have sex during the week when you don’t take any pills.  Start your next pack after not taking your pills for 7 days — you may want to use an alarm or reminder to help you stay on track.

If you have 91-day packs:

Some combination pills have 12 weeks (3 months) of hormone pills in a row, followed by up to 1 week of hormone-free reminder pills. This is so you’ll only have your period once every 3 months. The hormones will prevent pregnancy even if you have sex during the reminder pill week. You can also use other pill brands to skip your period by skipping the reminder pills. Read more about how to use pills to skip your period.

Progestin-Only Pills (aka POPs or Mini Pills):

You must take progestin-only pills within the same 3 hours every day to be protected from pregnancy. For example, if you take your progestin-only pill at 12:00 p.m., taking it after 3:00 p.m. the next day puts you at risk for pregnancy. Alarms, reminders, or birth control apps can help you take your pill on time.

Progestin-only pills come in 28-day (4 week) packs. Take 1 pill every day for 28 days (4 weeks) in a row, then start a new pack the day after you finish the old pack (day 29). All 28 pills have hormones, so you must take every pill in a progestin-only pack to be protected from pregnancy — there is no hormone-free week. You may get your period during the fourth week. You could also have bleeding on and off throughout the month (spotting), or get no period at all.

There’s also a newer type of progestin-only pill called Slynd that’s a little different than other POPs. Slynd packs have 24 “active” hormone pills and 4 hormone-free “reminder” (placebo) pills. You don’t have to take the hormone-free pills, but make sure you remember to start your next pack on time. And you don’t need to take Slynd within the same 3 hours every day — as long as you take one pill every day, you’ll be protected from pregnancy.

How do I use the pill to stop my period?

Skipping your period with the combination pill is safe and super easy. Basically you just take a pill with hormones every day and skip your hormone-free “reminder” pills. You can do this two ways:

• You can use a brand of pills that has 3 months of hormone pills in a row, so you only get your period 4 times a year.

• You can skip the hormone-free reminder pills in your pack and jump right to the next pack. You can do this every month, or just whenever you want to skip your period.

You may have some bleeding or spotting when you use the pill to skip your period — that’s totally normal. If you skip your hormone-free week every month, the spotting should go away after about 6 months.

There’s nothing dangerous or harmful about using the pill to skip your period. And it comes in really handy if you want a special occasion (like a vacation or a hot date) to be period-free.

You can only skip your period with combination pills. If you’re using a progestin-only pill (POP or Mini Pill), take every pill in your pill pack. But many people who use POPs don’t get periods anyway.

When can I start taking birth control pills?

You can start taking birth control pills as soon as you get them — any day of the week, and anytime during your menstrual cycle. But when you’ll be protected from pregnancy depends on when you start and the kind of pill you’re using. You may need to use a backup birth control method (like condoms) for up to the first 7 days.

Talk with your nurse or doctor about the best time for you to start taking the pill.

Combination Pills (COCs):

You can start the combination pill at any time.

• If you start taking combination pills within 5 days after your period starts, you’ll be protected from pregnancy right away. For example, if you get your period Monday morning, you can start the pill anytime until Saturday morning and be protected from pregnancy right away.

• If you start combination pills any other time, you need to take the pill for 7 days before you’re protected from pregnancy. Use another method of birth control — like a condom — if you have penis-in-vagina sex during the first week on the pill.

Progestin-Only Pills (POPs or Mini Pills):

You can start progestin-only pills at any time. You’ll be protected from pregnancy after 48 hours (2 days) on the pill. If you have penis-in-vagina sex during those first 2 days, use another method of birth control, like a condom.

You must take progestin-only pills at the same time every day. If you take it more than 3 hours past your usual time, use a backup method of birth control for the next 48 hours (2 days).

A new type of progestin-only pill called Slynd works a little differently. If you start taking Slynd within the first 5 days of your period, you’ll be protected from pregnancy right away. If you start taking Slynd more than 5 days after your period starts, use another method of birth control (like condoms) for the next 7 days if you have vaginal sex.  And you don’t need to take Slynd within the same 3 hours every day, like you do with other progestin-only pills. As long as you take one pill a day, you’re protected from pregnancy.

Starting the pill after taking emergency contraception:

If you took a levonorgestrel emergency contraception pill (like Plan B or other over-the-counter brands), you can start taking the pill right away. 

If you recently took the ella emergency contraception pill, don’t start taking your birth control pills until it’s been 6 days or more since you had unprotected sex.

If you start using the birth control pill after taking any emergency contraception pill — like Plan B or ella — use a backup birth control method (like condoms) for 7 days.

Starting the pill after pregnancy:

You can get pregnant again shortly after being pregnant, so talk with your nurse or doctor about starting your birth control as soon as you can.  

You can start taking the progestin-only pill right after an abortion, miscarriage, or childbirth.

You can start taking the combination pill right after an abortion or miscarriage. In general, you can start taking the combination pill 3 weeks after giving birth (but wait 3 weeks whether you're breastfeeding or not). Read more about breastfeeding and birth control pills.

What do I do if I want to get pregnant?

If you decide you want to get pregnant, just stop taking the pill. No matter what kind of birth control pill you’re on, it’s possible to get pregnant right after you stop taking it. It can take a few months for your period to go back to the cycle you had before you started taking the pill, but you can still get pregnant during that time.

More questions from patients: