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A Beginner’s Guide to The Pill: Everything You Need to Know

So, you’re considering going on The Pill. And with a name as ominous as that, who wouldn’t have questions? Fear not, collegiettes—we’ve got the answers. We got some advice from the experts, and we’re here to give a run-down on everything you should know before delving into the world of oral contraception.

Birth control pills can help us with everything from preventing pregnancy to eliminating acne and minimizing menstrual cramps. It’s important to remember, however, that there are also risks associated with these pills. Rozalyn Yannacone, a Registered Nurse Practitioner at Bucknell University who specializes in gynecological services, shares some tips on how to deal with the ups and downs of birth control.

The Pill, Explained

So, what is the Pill, anyway? 

Basically, there are two types of pills—combination pills (containing estrogen and progestin) and progestin-only pills (sometimes called mini pills). Like any hormone, ingredients contained in the Pill can have profound effects on your body, and frankly we’re not qualified to delve into the science specifics! At the basic level, though, the Pill works in a few different ways:

  • It thickens the mucus in your cervix, making it nearly impossible for sperm to access your eggs.
  • It thins your uterine lining, meaning that even if an egg is fertilized, it won’t be able to attach to your uterus
  • It can ovulation (science-talk for when your egg leaves the overies and becomes available for fertilization)

The final bullet is extremely important to note, because if you do notice any signs of ovulation while on the Pill, it may not be working! Consult your gynecologist stat and she’ll work with you to figure out what’s going on—it will all depend on what type you’re taking.

No matter what pill you’re on, you’ll be required to take it (or a placebo if you’re on a combination brand) every single day—and most likely at the same time everyday! So, if that sounds like something you’re not ready to commit to, you should reconsider choosing the Pill as your form of birth control. When it comes to the Pill, forgetting a dose can completely ruin the pack’s efficacy!

Benefits of the Pill

By now you’ve probably figured out that the Pill prevents pregnancy. But what you may not know is that pregnancy-prevention is far from the Pill’s only benefit! In fact, the Pill is often prescribed to collegiettes for reasons other than contraception. Here’s the low-down of some awesome Pill-related benefits:

  • Got killer cramps? Not anymore!
  • Sick of hormone-induced acne? Say buh-bye!
  • Suffer from Polycystic Ovary Syndrome? The Pill can help!

Ask your gynocologist for an explanation about the reasoning behind these benefits and whether or not she thinks that the Pill can produce them for you. If you’ve got debilitating cramps, aggitating hormone imbalances or flare-up acne that just won’t settle down, the Pill may be the answer to your prayers. Thanks, birth control!

Starting Your Birth Control

According to Yannacone, the first three months of taking birth control pills—as well as other birth control methods including the ring and patch—can be difficult. It often takes time for your body to adjust, and most women experience at least a few negative (albeit totally minor) symptoms. During the first month, adjustment bleeding is common. With adjustment bleeding, it is common to see some unexpected spotting even if you aren’t technically on your period. Alternatively, the opposite can occur—some women will stop menstrating altogether! Finally, many collegiettes may also experience nausea, breast tenderness and turbulant emotions during their first few days on the Pill.

So, if these symptoms are initially normal, when should we expect them so stop? “By the third month with the pill, what you see is what you get forever,” says Yannacone. She notes that it’s important to remember that you may have to stick it out for a few months in order to see how your body will react to the Pill. Of course, if her patients are experiencing symptoms like extreme and overwhelming nausea or severe weight gain within the first few days of their pill packs, Yannacone will usually switch them to a different type of pill fairly quickly. In general, however, by the third month, emotional fluctuations should be fairly nonexistent and nausea should no longer be a part of daily life. Breast tenderness should also disappear, although collegiettes may experience increased breast fullness (it’s apparently rare, but many of us are convinced it’s happened to us!) for the entirety of the time that they remain on the Pill—we’ll take it!  

But what if you’ve already started and have been mysteriously symptomless? That’s totally normal too! You’re simply one of the lucky ducks out there who go through the transition as seamlessly as possible—congrats!

Finding the “Perfect Pill” 

As it turns out, finding the right pill is no one-and-done deal. “There is no way to pick a perfect pill for everybody,” says Yannacone. “It’s trial and error.”

Although she always starts collegiettes with a low dosage, Yannacone says that she will switch them to different types of pills or dosages of pills if they are still experiencing negative symptoms like nausea, breakthrough bleeding or excessive mood swings after three months (or less than three months, depending on the severity of those symptoms).
The necessity of upping the dosage of the Pill makes sense once you understand the biology of the birth control pills. Most pills have the same estrogen hormones but different brands have different levels and types of progestins. If a woman is having trouble with her pills—say she is experiencing spotting even when she is not having her period—an increase of progestin (or perhaps a different type of progestin) can help the uterine lining thicken, meaning that the breakthrough bleeding will stop.
“It all has to do with the makeup of the body and how each person responds to pills,” says Yannacone. A birth control pill that works great for one of her patients can cause nausea and weight gain for another—so it really is a gamble at first!
It’s also important to realize that the brand of pill may not be the problem. In fact, you may not have chosen the right form of birth control. Some collegiettes experience nausea from the Pill that never, ever subsides. For these women, options like NuvaRing or an IUD may be a better bet. There’s tons of options out there, including shots, patches, and of course, condoms—only you and your gyno will truly know which method works best with your lifestyle.

Ramifications of Using the Pill

Those rumors about the Pill causing infertility? Totally false, according to Yannacone. “Birth control pills do not affect your ability to have children.”
There is a nuance, however, for a specific subset of women who suffer from over suppression. Over suppression occurs only in women who have irregular periods while on the Pill (as in 7 to 10 periods a year instead of 11 to 13). These women often have a difficult time getting pregnant once they stop using the Pill because it can take a while for their bodies to begin ovulating again. While the average woman typically begins ovulating and getting regular periods about 3 to 6 months after they stop using the Pill, women who experience over suppression will have irregular periods for far longer. So, if you’re not on a period-suppressing pill (remember, some can purposely stop them altogether!) and you experience fewer than 10 periods a year, check in with your doctor about switching to a different method of contraception, just to be safe.

In addition, Yannacone says that the only real infertility danger for most women occurs because of STDs. “Many women think that because they are on the Pill, they don’t need to use condoms. As a result, they get STDs (most commonly Gonorrhea or Chlamydia) that damage their reproductive organs and result in infertility.” Here that, collegiettes? STDs are not something to mess around with, which is why the safest method of birth control always involves doubling up with condoms. After all, is it really worth the risk?

The Pill’s Biggest Danger 

While the Pill is relatively safe, often super beneficial, and taken by millions of women each and every day, there is one major health concern you need to be wary of. 

Keara, a Hamilton collegiette, can’t take birth control pills because of the potential of blood clots. “I can’t take birth control and I think that it’s important that other girls are aware of why,” she says. “Nobody in my family knew that we hada genetic predisposition to blood clotting called a Protein C deficiency. My sister started taking birth control to help regulate her period, and ended up having a pulmonary embolism.”
According to Yannacone, birth control pills actually change the body’s clotting mechanisms, meaning that collegiettes who are on the Pill may be more prone to strokes and heart attacks—both of which result from blood clots.

Don’t worry too much though, girls! We’re trying to inform you, not terrify you! Luckily, there are five danger signs that can immediately help you identify an issue: migraine headaches, blurred vision, leg pain, chest pain and abdominal pain. These five warning signs are indicative of a possible stroke or heart attack as a result of blood clots, so if you or one of your friends experience any of these symptoms while taking birth control, see a doctor immediately.

The Big Picture

All in all, if you’re sexually active you should be using some form of birth control. “In college, you are at a time in your life when a pregnancy is not ideal,” says Yannacone. “So it is important to protect yourself in some way.” 

Birth control pills can be great—they can help you have clearer skin, shorter periods and milder menstrual cramps. They can protect you from pregnancy and prevent excessive mood swings. They can even increase your breast size by a cup size or two.
But with every perk comes some downsides, so stay tuned in to your body as you begin to take the pills. If you’re still experiencing nausea, breast tenderness and adjustment bleeding after three months (or severe symptoms before those three months have passed), see your doctor to discuss changing pills or changing birth control methods. And if you experience migraine headaches, blurred vision, leg pain, chest pain or abdominal pain, head to the doctor immediately as you may be experiencing the Pill’s biggest danger: blood clots. 

Finally, it should go without saying that you should never rely solely on web searches when trying to understand any health process—birth control included! It’s absolutely necessary that you find a gynocologist that you feel totally comfortable with and discuss your options, symptoms, questions and concerns on a regular basis. Trust us, she’ll love to help!

Jenni is a senior at Bucknell University where she will soon graduate with a degree in Psychology and minors in Creative Writing and Italian. Although Bucknell is in Lewisburg, PA (hello, corn fields!), her home is actually all the way in Seattle, WA. While at school, she enjoys hanging out with her sorority sisters, tutoring in the Writing Center, running and cooking/ eating delicious food. After spending a semester abroad in Florence, Italy during her junior year, she is itching to continue traveling and loves anything associated with food, cooking, health and writing. She is currently finishing up her time as an Editorial Intern for Her Campus and will be headed to Boston University in the fall to begin working on a Masters degree in Journalism.
Emily Platt is a former National Contributing Writer, Beauty Editor, Career Editor, and Editorial Intern for Her Campus. She studied at Vassar College and held additional internships at Cosmopolitan.com and MarthaStewartWeddings.com. Emily loves emojis, Beach Body workouts, and her cats. She takes pride in her single mysteriously-white eyelash.