The mini-pill

While the Paragard and hormonal methods that don’t contain estrogen—the shot, the Mirena IUD, the implant and the mini-pill—are safe for people who are postpartum to use immediately after giving birth, combination pills, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen can increase a postpartum person’s risk of blood clots.

It depends on what type of pill you’re on and how far into the pill pack you are. If you’re on the combination pill, and it’s been 48 hours or less since your last pill, just take it as soon as you remember. Take the pill you missed even if that means you’re taking two at the same time. If you take two pills at once, you might feel nauseated, so try taking them with food. If it’s been more than 48 hours since your last pill, take one of the missed pills as soon as you remember, leaving the other one in the pack. Then take today’s dose at the time you normally would AND use a back-up method of birth control, like condoms, every time you have sex for the next seven days. The first week of your pills is the most important to prevent ovulation. If you miss a pill in the first week, that’s a bigger deal than a missed pill in a later week. In addition to taking your missed pill ASAP, you will also need to use a back-up method of birth control every time you have sex for the next seven days. If you’re on any brand of mini-pill (also called the progestin-only pill) besides Slynd, there are totally different rules. If you’re more than 3 hours late taking a pill during any week of your pill pack, you could get pregnant if you have unprotected sex, and you need to use a back-up method for 48 hours.

One of the main ways hormonal birth control prevents pregnancy is by stopping ovulation—meaning that the egg never leaves the ovary. The pill, the patch, the ring, and the shot are the methods that are the most reliable at blocking ovulation, so people using these methods may have fewer ovarian cysts. If you tend to get ovarian cysts, your provider may recommend one of these methods to prevent future cysts. The progestin-only pill, also called the mini-pill, has an unpredictable effect on ovulation and may actually lead to more cysts. These cysts almost always disappear on their own, but if you’ve had problems with cysts in the past, the mini-pill may not be the best birth control for you.

That depends on whether you have insurance and, if so, what kind, but the average is around $25 per month. You might be able to pay less if you use a generic rather than brand-name pill or if you can find an online pharmacy that offers cheaper prices. Be sure to ask your provider about those options.

If you’re on Medicaid you can probably get on the pill for free and private insurance probably covers everything except for your copay.

Also, check with the family planning clinics around you and find out if they offer free or low cost birth control pills. Most do.

Check out our pill page for more information!

Basically you need to figure out what time it is in your home time zone and take it at that time. For example, if you live in Washington, DC, and you travel to Spain, which is 6 hours ahead, you should take your pill 6 hours later in the day than you normally would. So if you take your pill at 9AM in DC, you should take it at 3PM in Spain.

If you remember your pill by setting an alarm on your phone, however, make sure to adjust it as needed when you’re on the road. If it’s easier (for example, if your usual pill time falls in the middle of the night wherever you’re visiting), you can change your schedule, as long as you don’t go more than 24 hours without a pill. So, if you live in DC and you go to Spain and want to stay on a 9AM schedule, it’s totally fine to take your next pill at 9AM Spanish time (18 hours after your last East Coast pill). But if you’re taking a progestin-only pill (also called the mini pill), the rules are different. You need to take it within 3 hours of your normal time or you’ve missed that dose. So even if that means taking it late at night, you have to stick to your regular schedule.

Also, if you’re traveling long enough that you’ll be starting a new pack of pills while you’re gone, don’t forget to stick them in your suitcase!

Yes, it’s okay to switch what time of day you take your pills but depending on the type of pill you are taking (combination or progestin-only pill) and if you are switching to a later time or an earlier time in the day, you might need a backup method of birth control after switching times. If you move the time earlier in the day (i.e. from afternoon to morning), it will be less than 24hrs between pills, so go ahead and switch the time—you don’t need a backup method for either type of pill.

If you want to switch to later in the day and you’re taking the combination pill (the most common type), go ahead and switch the time since the time of day you take your pills doesn’t matter for them to work as birth control (but taking them at a consistent time can help you remember to take them every day). If it’s been 48hrs or more since you took your last pill, you’ll need to use a backup birth control method if you have sex for the first seven days after restarting.

If you want to switch to later in the day and you’re taking the progestin-only pill (a.k.a. mini pill), you don’t need to use a backup method if the new time is less than three hours after your original time. (For example, you were taking it at 7pm and now you are going to take it at 9pm). If the new time is more than three hours after the old time, then you’ll need to use a backup method if you have sex for the first two days after switching the time.

In a word, no. The best way to guard against sexually transmitted infections (STIs) if you’re having sex is still the good ol’ condom. If you’re concerned about both pregnancy and STIs, doubling up with the pill and condoms is a great option.

Any form of birth control is better than no birth control when it comes to the environment. But let’s look a little closer at the claim that hormones in birth control are getting into the environment through pee. The simple answer is: yes, it is. But—and this is a big but—it is small compared to other sources of estrogen. Current research finds that the contribution of EE2 (the primary active ingredient in the pill, the ring, and the patch) to the total amount of estrogen in of our waterways is small. Bigger—much bigger—sources of estrogen in the environment come from industrial and manufacturing processes; agricultural fertilizers and pesticides; the drugs we give livestock; and the waste and runoff produced by these sources. Simply removing hormones from contraceptives will not eliminate the environmental impacts of estrogenic compounds. It’s much better to buy organic food if you can and even better to tell Congress to do its job and regulate chemicals, than to forego birth control. From Mother Earth’s standpoint, any form of birth control is better than no birth control.For purists who don’t want to add any hormones to the environment or to their body, no matter how small, there are options for you. Natural latex condoms and the copper IUD are two frequently cited examples of ultra-green contraceptives.

Any form of birth control is better than no birth control when it comes to the environment. Still some people insist on “green” contraception. We say: Any effective method of contraception is green since the impact of birth control pales in comparison to the impact of another human.

Still others say, “green contraception” means “hormone free.” We don’t dispute that that is one way to look at the issue. And fortunately, there are many contraceptives already on the market that are hormone free: condoms (male and female), Paragard IUD, diaphragms, cervical cap, and the sponge.

But a lot more goes into a green stamp of approval. The Paragard IUD is generally thought to be the “greenest” contraceptive. It’s hormone-free, long lasting (up to a decade embracing the reduce portion of the “reduce, reuse, recycle” mantra), made from small amounts of cheap, plentiful metal (copper), and 99% effective. If for whatever reason you don’t feel like the IUD is right for you, choose another method. Because when it comes to having sex, the greenest thing you can do is use birth control.

It depends on your situation. Unless you’re in a totally exclusive relationship and you and your partner have both been tested recently for every single STI, using condoms with whatever other birth control method you choose is a good idea. Basically, if there’s any chance you or your partner could have an STI, the only way to decrease the risk of transmitting it is by using condoms, internal condoms, dental dams, and/or PrEP, (a medication which decreases the risk of getting HIV.) Other forms of birth control don’t protect against STIs.

Using a condom with another form of birth control is called dual protection. It means you’re being super-safe and protecting yourself against both pregnancy and STIs.

The only type of antibiotic that’s been shown to lessen the effectiveness of the pill is rifamycins—including rifampin, rifapentine, rifalazil and rifaximin. Rifampin can be used to treat tuberculosis, but is no longer the first choice for treatment and not typically prescribed in the US.

No, most forms of birth control are not effective immediately, so you want to check with you doctor before having unprotected sex. Until then, use a condom for added protection.