Birth control pills are a convenient form of contraception used by many women today. However, it is important that you understand both the risks and the rewards when using birth control pills. When used correctly and consistently, they are one of the most effective methods of preventing pregnancy.

1. Birth control pills take time to work.
   Though most pills will be effective in most women after seven days, it is recommended that you continue to use another form of contraception while taking your first full pack of pills.
   
   Leave the pills in their original container to help you keep track of your medication. This is vital because the pills must be taken on time (ideally no more than 24 hours apart) and in proper order to ensure their effectiveness.
   
   
2. Take the pill with regularity.
   In order for birth control pills to work effectively, you must remember to take the pill every day at the same time of day. When always used correctly, birth control pills have an effectiveness rate of over 99 percent. Under typical use (less than perfect use), the effectiveness rate drops to 95 percent. This effectiveness may be further reduced by some medications, including certain antibiotics.
   
   
3. Visit your gynecologist regularly.
   Women on birth control pills will need to see their gynecologist once a year. The exam should include a blood pressure measurement, breast and pelvic exams and a Pap test. Some women may require more frequent follow-up visits.
   
   
4. Don't smoke while taking birth control pills.
   Women taking birth control pills are urged not to smoke. Cigarette smoking may decrease the effectiveness of the pill and may increase the risk of heart attacks, strokes and blood clots.
   
   This risk is higher for women over the age of 35 and women who smoke 15 or more cigarettes a day.
   
   
5. Maintain good communication with your doctor.
   You should always talk with your doctor before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications. These substances may interfere with the effectiveness of birth control pills, or cause other complications.
   
   
6. Be familiar with your brand of birth control pills.
   There are more than 40 brands of birth control pills available in the United States. Each contains slightly different forms of hormones or doses and is taken differently. Therefore, you should be familiar with the brand of pills you are taking and carefully follow all usage instructions.
   
   
7. Birth control pills can be used for a one-time emergency.
   Women who do not regularly take birth control pills can use a higher dose form in a one-time emergency if they had unprotected sex but do not want to become pregnant (morning after pill). The Food and Drug Administration (FDA) approved the sale of levonorgestrel (Plan B) without prescription for women aged 18 and older in August 2006. Levonorgestrel, commonly referred as the morning after pill, contains a high dose of the most common ingredients in regular birth control pills.
   
   Taken within 72 hours of unprotected sex, the two-pill series can significantly reduce the chance of pregnancy. Women are encouraged to take the pills with food to reduce the risk of nausea and/or vomiting.
   
   However, this method will not work if taken more than one time during a one-month period, or if a patient is already pregnant.
   
   
8. Birth control pills may not be safe for everyone.
   Although the pill is safe for most women to take, women with certain conditions may be advised against it. If you have blood clots, certain cancers, a history of heart attack or stroke, or may be pregnant, you should not take birth control pills.
   
   
9. Stop taking birth control pills if you may be pregnant.
   Women should immediately stop taking birth control pills if they become pregnant, or suspect they might be pregnant, to prevent serious consequences for the unborn child. Women who recently delivered a baby and who are not breastfeeding may resume taking birth control pills two weeks after the birth.
   
   
10. Alternate forms are available for breastfeeding mothers.
    Birth control pills that contain estrogen are not recommended while breastfeeding because they can decrease the amount or quality of breast milk or even pass through the milk into the feeding infant. Some doctors prescribe progestin-only pills for breastfeeding mothers. However, recent research has suggested that this practice may increase the risk of diabetes if they had gestational diabetes during their pregnancy. More studies are necessary to confirm this link.
    
    
11. Bleeding can occur during the first few months.
    One of the most common side effects of birth control pills is bleeding during the first three months (metrorrhagia). This is called "spotting" when slight or "breakthrough" when heavy. Women are generally advised to continue taking the pill as prescribed and wait one week before contacting their doctor.
    
    After three months, women should report any missed or irregular menstrual periods and any irregular vaginal bleeding that they may experience.
    
    
12. Be aware of side effects that require medical attention.
    The most common side effects associated with birth control pills do not require medical attention. However, symptoms that are bothersome should be reported to a doctor, and you should seek immediate emergency medical assistance if you experience any of the following: