OP: Caution: Pill - Take only as directed

Any of the hormonal systems for contraception are just what the name implies. They afford contraceptive protection by confusing the body. The mechanism for confusing the body is varying natural and artificial hormone levels. This is true for the pill, patch, ring, implant and shot. Do not holler that any of these are not available. Somewhere in the world, each is in use. The pill remains the most common and is the one most frequently misused.

Each of these systems should be used exactly as prescribed. Follow the directions from your prescriber and read the package insert. Ask questions until you fully understand. Then do what is told you. Taking the pill regularly is important. OK, an hour off is not really a big deal. If you take the pill two hours early one night and two hours late the next, that is a four hour increase between pills. During those four hours, or sixteen percent of prescribed administration, the strength of the hormones in your system decreases. This leads to confusion in your reproductive tract and can lead to the release of an egg. Do not follow the advice of your friends on “the pill.” There are at least forty different pills on the market. Some you take every day; some, you stop a week each month; some you change color of the pill for a week. Some use one hormone; some two; some add a third. Each has a different regimen. Follow yours.

Recently, two people have posted saying that they were on the pill, careless about taking it and, then, took a morning after pill. One was erratic so she took all the pills she had missed and her period came early. Some morning after pills are variations of the regular pill. Some regular pills, in different dosage, are actually used as emergency contraception. Mixing these all up leaves your body wondering what is going on and anything is possible.

For younger women (arbitrarily defined as under eighteen) there are many additional considerations to pregnancy. Using myself as an example: My breasts started to bud just before my twelfth birthday; my periods began almost a year later; I became fairly regular by seventeen; my breasts continued to grow past my 20th birthday. I am fairly typical with a year shift in either direction. Starting with the breast buds, my, and your, hormones started to change from those of a little girl (essentially sexless) to those of a mature woman (with all the attendant sexuality). The shifting hormones caused commensurate physical changes. Those are the days of wild mood swings, pimples, erratic spotting, irregular periods, and, unnoticeably, irregular ovulation, breast development, addition of body hair. That is without the interference of additional or unnatural hormones.

If you add contraceptive hormones to this mix, any or all of these developments may change. Not taking the pills on a regular schedule can actually affect physical development. Adding strong shots of hormones (regular pills and morning after pills) can affect breast development, facial hair, moods, cognitive development, acne and, especially pregnancy. Erratic pill schedules not do not decrease chances of pregnancy, they may increase chance of pregnancy. If your doctor puts you on the pill because of difficult periods, she will be monitoring closely and the schedule should be followed just as carefully even if you are not sexually active.

To read some recent posts (and in my experience) some young women are as casual with the pill as with aspirin. Hormones are serious drugs with serious effects and serious side-effects. Self-medicating with other hormones (morning after pill) while on prescribed medications (birth control pill) is playing with fire.

If you do not exactly what to do, call the doctor’s office and get advice. The first bit of advice I give is to use additional protection until after the next period. With two of the young women who have recently posted, it would be to stop all medication for two menstrual cycles and start over.

This is continued and expanded upon at post 26 in this thread. Please read it.


Posted: 30 Sep 04:27


Somehow missed this post, but better late: thank you Brandye :)
I'm working my ways through the Guttmacher Institute site. I hadn't heard of it and it seems to include a hell lot of articles! A bit of a pity the search-function uses a logical "or" instead of an "and" when using multiple keywords, but perhaps Google can assist me there :)


Posted: 30 Sep 04:28

What I dont get is that they tell you to start taking them on the Sunday after your period when you first begin. (Or at least my doctor did) And that I would get my period on a Tuesday. But yet theres 21 days of the hormone pills and then 7 days of placebos... well the Sunday and Monday right before my period I'm taking placebos... and my period ends on the Monday the next week when I've already been back on the hormone pills for two days. Shouldnt the placebos just be on the days when I'm having my period?

I wish I had thought to take them at night. I didnt want to take them in the morning because I frequently wake up at different times, so I decided noon would be a good time to take it. For some reason I forgot that that would mean I have to take them to school with me everyday. :( Is it possible to slowly switch times? Like I know we were talking about the whole taking it at the same time, but what if, I was to take one at noon the one day, and keep adding half an hour to my time everyday so that eventually I was at night? Would that not work? So it would take me like 3 weeks to change it to 10:30/11 which is what I would prefer.


Posted: 30 Sep 04:30

your body isn't going to be like a machine...the minute you take a placebo, your period starts.. and the minute you start taking the hormone ones... your period ends.
Mine is the same way.... I start the placebos, but my period doesn't usually show up till about tue/wed. By the time sunday comes and its time to start a new pack... I am still having a light period.
It is that drop in hormone level from taking the placebos (and not real pills) that triggers your period to start. This isn't automatic...hence the 2-3 delay.
Like some of those pills, Seasonale... you constantly take the hormone pills and only take the placebos like everyone 3 months or something.... so then you get your period only 4 times a year.


Posted: 30 Sep 04:30

Many questions posted here in the last month or so indicate a general lack of understanding of how hormonal contraception – pill, patch, ring, shot – works. This post is a simplified physiology of pregnancy (and preventing pregnancy). Starting with the “normal” menstrual cycle, this is a description of what the female reproductive organs are doing.

Day 1 is the first day of menstrual flow. This begins because a couple days earlier the mix of hormones (mainly progestin and estrogen) in the blood stream has become that of a non-pregnant woman who needs a flush of the uterus. So, the flow starts. The hormone mix remains at this level until the uterus has shed the nutrient rich lining which has gotten ready for pregnancy that did not occur. When the uterus is empty, the hormones begin a fresh cycle of preparing for pregnancy. This causes the uterus lining to build up again until about the fifteenth day when the hormone mix tells an ovary to release an egg. The egg passes down the fallopian tubes searching for a sperm to fertilize it. During this time of fertility, we tend to have a higher sex drive, or at least receptivity, and we tend to generate more vaginal juices to prepare for accepting a penis. If the egg finds a sperm, the fertilized egg gets to the uterus and embeds itself in the lining to begin growth. If the egg does not encounter a sperm, it passes on through and can sometimes be seen on the lining of the pants if it gets that far in one piece. Spotting can occur as the egg passes whether or not it embeds itself in the uterine lining.

If the egg does not implant itself in the lining, the hormones then begin to reverse their course and at about the twenty-fifth day are at a level that the uterus is told that it is not pregnant, flush and start over. And a couple days later the flow begins again.

If we use hormonal contraception, the additional hormones are used to fool the body. By keeping the level of hormones just slightly elevated above what the body is making, the ovary thinks the body is pregnant and will not release an egg. To keep this message going to the ovary, requires a “therapeutic level” of the drug. Therapeutic level is the concentration of whatever drug that will cause the desired reaction in the body. In this case, this is the level of hormones to prevent ovulation. The drugs we introduce into our bodies have a “half-life.” That is the length of time it takes for one-half of the dose to leave the system. We pee it away. Estrogen has a rather long half-life (measured in days) because it is a naturally occurring substance in the body. But in the modern very low dose pills, the therapeutic level is only slightly above the natural level and will disappear in little more than twenty-four hours. If the level falls below “therapeutic” in mid-cycle, the ovary will release an egg and you will be fertile.

Using the pill, the level of drug is raised above the therapeutic level about forty-five minutes after taking the pill and then it begins to be reduced until your next pill. This causes little spikes and valleys in the level in the bloodstream. The patch and the ring are introducing a constant, steady dose and therefore require lower peak levels of hormones. They are tolerated by more women.

The very fact that the artificial hormones make the body think it is pregnant leads to the side-effects. Light periods almost always result because the lining of the uterus does not build up as rapidly. Breasts may become tender as they do in the early weeks of pregnancy. Libido may be reduced. Mood swings may occur. In younger women, say under 19, these side-effects can be confused with normal adolescent behaviour. A century ago, adolescence was classified as a mental disease because of the erratic behaviour and mood swings. Today, these side-effects are mild and most women will adjust within a month or so. In the beginning, pills had ten times the current drug. Side effects were much more pronounced and some women could not tolerate them at all. Today, almost all women tolerate them quite well or the side-effects can easily be controlled. With those old pills, however, there was a greater margin for error. A missed pill was no big deal and some drug interactions were not even noticed. Today, the margin is so slim that the therapeutic level is dependent upon care by the patient and caution by the prescriber. Today, if you miss a pill, you should use a backup birth control method for five to seven days. And other medications or dietary supplements can spell pregnancy.

On another post in this thread is a partial list of those drugs that commonly interfere with hormonal contraception. Look it over. Simply stated, any time you are prescribed any anti-biotics, steroids or psychotropic drugs (especially anti-depressants) you should tell the doctor you are on hormonal contraception and ask about drug interactions. This is true whether you are taking the pill or using other delivery methods. These other drugs, generally, reduce the hormones and allow the ovaries to release eggs. Hormonal contraceptives can also affect other drugs – sometimes making them stronger and sometimes making them weaker. Analgesics and blood thinners are among these. The “potentiating effects” on nicotine are related to increased stroke in older women. But, then, the major source of nicotine has other deleterious effects and the risks of pregnancy should be weighed against other effects. I ping on smoking patients, warn them but do not take them off the pill.

Equal care needs to be taken with dietary supplements. In Europe where we commonly have both allopathic and homeopathic physicians, natural drugs rather chemical drugs are commonly available. Herbalists and naturopaths, in various countries, also may be writing prescriptions for other than what pharmaceutical companies consider drugs. Most grocery stores and health food stores have “natural” chemicals that can inhibit effectiveness of hormonal contraception. These have not often been appropriately tested for drug interactions.

St John’s Wart, the most popular of the “natural” anti-depressants is a major problem. While we cannot say definitively that it may cause ovulation and pregnancy, it does create erratic bleeding while on the pill. Moreover, its effect on the brain is similar to that of chemical anti-depressants know to interfere with hormonal contraception. Stay away from it while on the pill. It is believed that megadosing vitamin E (much over the normal 400 unit dose) will negate hormonal contraception. Chamomile tea or extract has the effect on the brain that some sedatives have. It is suspected, though not proven, to interfere with contraception.

Given just what is here, ignoring many volumes written on the subject, the risks that women take in switching pills, taking others pills, adding morning after pills when a pill has been missed and then getting another formulation without seeing a doctor, scares me. This is not taking an Excedrin for a headache, this is messing with the endocrine and reproductive systems. Given that you are functioning barely into the therapeutic range of the hormones, the risks of not following directions exactly are considerable.


Posted: 30 Sep 04:31

Take only as directed!!!! A few weeks ago, a woman posted her experience of taking two packs in a row even with her doctor's approval. Not good. She had a three week long light period and discomfort. A few others posted not so very good experiences similar to this.

The hormones women have the most difficulty adjusting to are those that reduce the number periods. What is happening is that the uterine lining continues to build, albeit at a slower pace, and it sloughs off and puts them in a state of a constant low flow. Whilst some women do "adjust their periods" periodically, it is not a good practice. As for adding a week, not a good idea. You just may ovulate when you stopped taking it.

Most pills (and you are on the most commonly used in the UK) have been developed and tested for the 21 days on and 7 off regimen. Departing from this can actually increase the chances for pregnancy.

As for my NHS colleague who gave you the prescription and ushered you out: a pox upon him. There are good pamphlets available from the NHS and Planned Parenthood. At least those should have been given you. I am glad you have found this thread helpful.


Posted: 30 Sep 19:49

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