The Pill for Hormone Treatment

How does the pill work?

Estrogen and progesterone are hormones released from your ovaries. When you take hormone pills (also called the pill), your body knows that estrogen and progesterone are coming from somewhere else - from the pills. Because your ovaries don't need to release hormones, they take a little nap. While the ovaries are napping, they don't release hormones, and don't release an egg (ovulation), which is how the pill works for period control.

The pill can be used to treat other conditions affected by estrogen and progesterone. These include irregular or absent menstrual periods, heavy periods, menstrual cramps, endometriosis or polycystic ovary syndrome (PCOS).  The pill can help regulate hormone levels, which may ease symptoms like headaches, seizures or acne.

Forgetting pills or taking them at different times of the day can cause the ovaries to wake up. When that happens, the ovaries release hormones and may release an egg, which can cause irregular bleeding.

How do I use the pill?

• Start your first pack of pills as directed.
  • You may be told to start on the first day of your next period, or
  • On a specific day of the week after your next period begins, or
  • On the day you are in the clinic.
• After starting the pill, continue taking 1 pill every day. There should not be any days that you do not take a pill with typical pill packaging.
• In the package of pills the first 21-24 days are hormone pills and the last 4 to 7 are usually placebo pills (non-hormonal). Most people start bleeding on the second or third day of the placebo pills.
• If you are taking the pills with an extended cycle, your doctor will tell you when to expect bleeding or how to manage breakthrough bleeding.

What if I forget to take a pill?

• If you forget to take a hormone pill at your usual time, take your pill as soon as you remember. Then take the next pill at the usual time. You may be taking 2 pills that day.
• If you forget to take a hormone pill for 1 whole day, take 2 hormone pills the next day at the regular time.
• If you forget to take a hormone pill for 2 or more days call the clinic for instructions.
• Forgotten placebo pills do not need to be made up.
• If you have questions about what to do with missed or late pills, call the clinic.

What are the side effects?

Most people do not have any side effects with the pill. However, during the first 3 months you may experience:

• Bleeding or spotting during the hormone pills. This is called breakthrough bleeding and usually happens more during month 1, less during month 2, and by month 3 most people have regular bleeding during the placebo pills. If breakthrough bleeding continues after month 3, you should be evaluated.
• While other side effects are not common, you may have nausea, breast tenderness, headaches, or mood changes. If this happens, it is usually mild and doesn't last long.
• If you are having side effects that are making you feel miserable, call the clinic. Do not stop taking your pills.
• The pill does not cause weight gain.

Danger signs of the pill

Call your clinic immediately if you have:

• Dizziness
• Vision changes

Consider immediate evaluation if you experience the following:

Rarely the patch can cause a blood clot. These typically form in the backs of the legs but can travel to other parts of the body.

• Severe headaches (the worst headache you’ve ever had)
• Chest pain
• Shortness of breath

What else do I need to know?

• Never run out of pills. You can always call the pharmacy for refill.  If out of refills, call the clinic.

• Never take someone else's pills or share your pills with anyone else.
• If you are having a problem, don't just stop taking the pill. Call the clinic.
• There are more than 100 different pills. If you feel miserable while taking the pill you were prescribed, call the clinic and ask to change to another pill that might be better for you.

Questions?

This information is not specific to you but provides general information. If you have any questions, call your clinic or health care provider.

Reviewed by GYN 7/2022

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