ORAL CONTRACEPTION: INSTRUCTIONS AND INFORMATION Possible Benefits of Oral Contraception 1. 95-99.5% effective at preventing pregnancy if used correctly 2. Regulates menstrual cycle, less bleeding, less cramping 3. May decrease risk of: ovarian cyst, ovarian/endometrial cancer, pelvic infection, ectopic pregnancy, PMS/PMDD symptoms, menstrual migraines, benign breast conditions, excess body hair growth, anemia, symptoms of endometriosis, uterine fibroids. Possible Minor Side Effects (Should resolve within the first three months) 1. Spotting or break-through bleeding 6. Nausea 2. Breast Tenderness 7. Missed periods 3. Changes in vaginal discharge 8. Changes in acne 4. Fluid retention (3-5 pound water weight gain) 9. Mild headache 5. Mood changes 10. Change in libido Possible Major Side Effects 1. Hypertension 2. Heart Attack 3. Gallbladder disease 4. Stroke 5. Blood clots in legs or lungs 6. Liver tumors WARNING SIGN OF MAJOR SIDE EFFECTS (ACHES) 1. Abdominal pain, severe 2. Chest pain/severe cough/shortness of breath 3. Headache, severe 4. Eye pain/visual changes 5. Severe leg pain in calf or thigh and/or swelling, heat or redness If you experience any of the above symptoms, you need to be evaluated by a health care provider and inform the provider you are on hormonal birth control. - Return to clinic if you develop severe mood swings or depression, become jaundiced (yellow-colored skin), miss 2 periods, or have signs of pregnancy. Stop the pill if you develop, jaundice, breast lump, fainting attacks or collapse, seizure, difficulty speaking, blood pressure > 160/95, or severe allergic skin rash. Stop the pill if you become immobilized (wheelchair or bedridden) after an accident or major surgery. Division of Student Affairs Student Health Services 400 Patroon Creek Blvd, Suite 200, Albany, NY 12206 Phone: 518-442-5454 Fax: 518-442-5444 www.albany.edu Contraindications/Risk factors 1. Smoker (especially if > 35 years of age) 2. Migraines with auras 3. Hypertension 4. Heart disease 5. Rheumatoid arthritis 6. Unexplained breast mass 7. Gall bladder disease 8. Liver tumor 9. Obesity 10. Deep vein thrombosis/pulmonary embolism 11. Prolonged immobilization 12. Systemic lupus erythematosus 13. Cervical cancer 14. Breast cancer 15. Cirrhosis of Liver INSTRUCTIONS FOR TAKING ORAL CONTRACEPTION PILLS 1. You may start taking the pills according to several different schedules: no single way is best, and you should follow the advice of your provider. a. Start on the first day of your period. (No back up method needed) b. Start on first Sunday after the period begins (need back up method for 7 days) c. Quick start – starting on day of office visit (must verify no pregnancy and also must use 7 day back up method) 2. If starting birth control the day after emergency contraception is taken, then must use back up method for 14 days. 3. Take one pill daily, at the same time every day (3-4 hour window) 4. After finishing the pack, continue with the next pack on the next day without skipping any days. WHAT TO DO IF YOU MISS A PILL(S) 1. If you miss one pill: Take the forgotten pill immediately. Take your next pill at the usual time, even if it means taking 2 pills in one day. Use back up method for 7 days. 2. If you miss 2 pills in a row (more than 48 hour late) anywhere in pack: Take both missed pills as soon as you remember. Then continue taking rest of the pack as usual. Use back up method for 7 days. 3. If you miss 2 or more pills during the third week of cycle or 3 pills in a row at any time of the month: Take 2 pills immediately then finish rest of active pills (1 daily), skip placebos and start next pack. Use back up for 14 days. There is an increased risk of spotting/break through bleeding any time pills are missed or taken late. This bleeding can continue for the rest of the pack. Nausea may also occur when taking more than 1 pill at a time. Important INFORMATION TO KNOW WHEN ON HORMONAL BIRTH CONTROL 1. The pill does not prevent sexually transmitted infections or HIV. In addition to the pill, condom use is strongly recommended. 2. Some drugs can decrease the efficacy of the pill, or vice versa. (i.e. antibiotics, anticonvulsants, tricyclic antidepressants, antipsychotics, ace inhibitors, potassium sparing drugs, St. John Wort). Always inform your health care provider that you are on hormonal birth control. 3. If no menses occurred during the pill free week and you have taken the pills correctly, continue with the next pack as scheduled. If no menses after next pack, then you will need to have a pregnancy test. 4. You will need a pregnancy test if you had not taken your pills correctly and you do not get a menses during the pill free week. 5. Women who use contact lenses may note some visual changes or change in lens tolerance with pill use due to dry eyes. Normal saline drops may help. 6. If scheduled for major surgery, you must stop pills 1 month prior to surgery. 7. Repeated vomiting or diarrhea can decrease absorption of the pill. Treat it as if you had missed pills and use back up for at least 7 days. Call the University at Albany Health Center if you have any questions, concerns, or unsure what to do. (revised 3/5/13)dw