Family Planning of Clallam County
Client Information for Informed Consent
THE PILL
COMBINED ORAL CONTRACEPTIVES (COCs)
BIRTH CONTROL PILLS
Before using the pill, you need to know the possible advantages, disadvantages, risks, and warning signs to watch for. We have listed them here for you. Be sure to read the manufacturer’s information, too. We are happy to answer your questions.
Other methods of birth control are available. We will offer you information about their use, effectiveness, advantages, disadvantages, risks, and warning signs. You should read these materials, as well. Let us know if you have any questions about them.
You may notice some differences between the information the manufacturer provides and the information we provide. Please consult your clinician if you have questions about any difference you observe.
The pill is a combined hormone, oral contraceptive that is taken daily. It contains the hormones estrogen and progestin — similar to hormones produced by a woman’s body. They keep the ovaries from releasing eggs. They also thicken the cervical mucus so sperm cannot enter the uterus. For every 100 women who use the pill, about eight will become pregnant the first year with typical use. Fewer than one out of 100 will become pregnant with perfect use.
While there is some evidence that the pill may be somewhat less effective in heavier or obese women, it may still be a good option for them. It may also be less effective if it is taken with certain drugs, especially some that are used to control seizures or treat certain mental illnesses and HIV/AIDS. Be sure to talk with your clinician if you take any other medicine — including herbs and over-the-counter medicine. Tell other clinicians you see that you are using the pill.
The pill offers no protection against sexually transmitted infections (STIs). Condoms are the best way for sexually active people to reduce the risk of STIs. Always use a condom if you or your partner has other sex partners.
Advantages of the Pill
• more regular periods
• fewer menstrual cramps
• less blood loss
• less iron deficiency anemia
• some protection against noncancerous breast tumors and ovarian cysts
• nothing to do right before sex to make it work
• some protection against cancers of the ovaries and uterus
• decreased risk of PID (pelvic inflammatory disease)
• decreased risk of ectopic pregnancy
• can decrease number of periods
• less acne
• ability to become pregnant should return quickly
Disadvantages of the Pill
Possible side-effects that usually clear up after two or three months include
• nausea, vomiting
• breast discomfort
• spotting between periods
Risks of using the Pill
Users have a slightly greater risk than non-users of developing certain serious problems that may cause death in rare cases, including
• blood clots in the legs that can travel to the lungs
• heart attack or stroke
• liver tumors
What are your annual chances of developing a blood clot compared to other women?
• Four out of 100,000 if you don’t use any hormonal birth control and are not pregnant.
• Ten to 30 out of 100,000 if you are taking the pill.
• About 60 out of 100,000 if you become pregnant.
The more risk factors a woman has for heart disease, the greater the chance of developing certain serious health problems while using the pill. Risk factors include
• being older than 35
• tobacco use
• diabetes
• high blood pressure
• high levels of cholesterol
Tell your clinician if you have any of these risk factors or conditions and about any other past or current medical problems or concerns you may have. Your clinician will help you to decide if the pill is right for you. Sometimes special tests or follow up may be needed.
The Pill cannot be used by women who
• are 35 or older and use tobacco
• have controlled high blood pressure and use tobacco
• have uncontrolled high blood pressure
• have had stroke, heart attack, or angina
• have had serious heart valve problems
• have had blood clots in the veins or arteries
• have certain inherited blood-clotting disorders
• have diabetes with vascular disease
• have had serious liver disease
• have had cancer of the breast or liver
• have had migraine with aura
• are, or think they are, pregnant
• will be on prolonged bed rest, for example after major surgery
Warning Signs — Call the health center right away if you have
• sharp or crushing chest pain or coughing blood
• unusual swelling or pain in the legs or arms
• sudden severe headaches
• changes in the frequency, severity, or associated symptoms of your headache
• aura — gradual onset, yet short-term visual experience of arcing, bright, flashing zig-zag lines
• shortness of breath
• severe pain in the stomach or abdomen
• yellowing of the skin or eyes
• severe depression
• unusually heavy bleeding from the vagina
• a new lump in the breast
• no period after having a period every month
Regular physical examinations for routine health care and for screening sexually transmitted infections and cancer are strongly recommended.
FYI — ADDITIONAL WARNINGS about YASMIN and YAZ
YASMIN & Yaz are different from other birth control pills because they contain the progestin drospirenone. Drospirenone may increase potassium levels, and this could cause serious heart and health problems. You should not take YASMIN or YAZ if you have had, now have, or develop in the future, diseases of the kidneys, liver, or adrenal glands. Before taking YASMIN or YAZ, be sure to tell your clinician if you are currently taking any of the following medicines
• NSAIDS — ibuprofen (Motrin, Advil), naprosyn (Aleve), and others
• potassium-sparing diuretics (spironolactone and others)
• potassium supplements
• ACE inhibitors (Capoten, Vasotec, Zestril, and others)
• angiotensin-II receptor antagonists (Cozaar, Diovan, Avapro, and others)
Instructions for Using:
COMBINED ORAL CONTRACEPTIVES – BIRTH CONTROL PILLS – THE PILL – COCs
How to Take Your Pills:
You may start your pills according to one of several schedules - depending upon your pill brand and your individual circumstances. Discuss with your clinician what schedule best suits your circumstances.
• Start today if you are not pregnant or took EC yesterday.
• Start on the first day of your menstrual period.
• Start on the first Sunday after your menstrual period begins. (If your period begins on Sunday, start the pills that day.)
After an abortion, you may:
• Start on the day of the abortion.
• Start on the day after the abortion.
• Start on the Sunday after the abortion.
Swallow one pill a day, ideally at the same time every day. However, earlier or later than usual is better than not at all! Take all the hormone pills first, finish with the spacer pills, and then start a new pack. (Never a day without a pill!)
Unless you start your first pack on the first day of your period, you may not be fully protected from pregnancy for the first week of pills. If you have sex during the first week on pills, use additional protection - such as a condom or a vaginal contraceptive (foam, cream, insert, or film).
What to Do If You Miss Pills (Use additional protection for one week anytime you miss pills)
One pill missed: Take it as soon as you can, take the next pill at your usual time, and then continue with daily pill-taking.
Two pills missed during the first 2 weeks: Take 2 pills daily for 2 days, and then continue with daily pill taking.
Two pills missed during the third week: Use emergency contraception (PlanB) and start a new pack of pills.
Three or more pills missed, anytime: Use emergency contraception (PlanB) and start a new pack of pills.
Spacer pills missed: Not a problem! Discard any missed pills and continue with your usual schedule.
11/09 3 of 3 FPCC 5.03