The mini-pill

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.

Doctors have argued since 1968 that the pill can safely be sold over-the-counter. That means rather than go to a doctor or clinic for a prescription, a woman could go to a drug store to pick up a pack of pills in the same way she can now buy aspirin. Behind-the-counter means a woman would ask a pharmacist for the pill, but she still wouldn’t need a prescription from a doctor. Over 50 drugs that were once prescription-only are now OTC in the U.S., including Sudafed, Cortaid, Advil, Nyquil, Monistat, and Claritin.

Women in over 80 countries can already buy the pill without a prescription—including women just across the border in Mexico. As medications go, the pill is very safe—safer than having a baby, driving, smoking, or taking daily aspirin.

That said, the pill does have risks for women with certain medical conditions, but one study in El Paso showed that women who answered 15 questions were pretty accurate in choosing whether the pill was safe for them.

Yes. A group of scientists in the North Carolina Research Triangle put together all the studies printed after 1990 that look at women using the pill and their rates of ovarian cancer. They found that women who had ever used the pill for birth control were 25% less likely to develop ovarian cancer later in their lives.

The pill offered the strongest protection from ovarian cancer when women used it for a year or longer. Women who used the pill for 10 years were 50% less likely to develop ovarian cancer. The pill’s protective effect lasted for a long time, too—up to 20 years after women stopped taking it.

A cyst is basically a bubble—a collection of fluid with a thin wall around it. Functional cysts are formed when a follicle (the fluid-filled sac that develops around an egg during ovulation) grows larger than expected. Sometimes they can cause un-fun symptoms like abdominal discomfort, pelvic pain, pain during bowel movements, or pain during sex. Most cysts disappear on their own, but if they keep growing they can cause severe pelvic pain or pain that causes dizziness or fainting and comes with a fever or vomiting. If you have any of these severe symptoms, go see your health care provider ASAP. Some hormonal birth control methods—the ones that work by blocking ovulation—may mean fewer ovarian cysts. If you tend to get cysts, your provider might recommend you try a method like the pill, the ring, the patch, or the shot.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

If you throw up within two hours of taking your pill, treat it as a missed pill and take the next pill in your pack right away. Depending on which type of pill you use and where you are in your pill pack, you may need to use a back-up method like condoms for the next seven days to prevent pregnancy.

The short answer is yes—there’s no reason to take a break from the pill unless you’ve decided you want to get pregnant. That’s true for continuous use of the pill too—although if you experience spotting, you may want to take an occasional break (3 days minimum, 7 days max) to manage it.

There’s been lots of research on birth control pills over the years and the consensus is that long-term use doesn’t affect your ability to get pregnant once you stop taking the pill. It’s always a good idea to stay current on your annual health exams, whether you use the pill or another method. Our health changes over time, and some changes like rising blood pressure or worse migraines may make it risky to use methods with estrogen.

If you have dysmenorrhea (the medical term for extremely painful periods), hormonal birth control can make a big difference. Options like the combination pill or a hormonal IUD can reduce the level of pain and heaviness of your bleeding, basically making it easier for you to live your life when you have your period. There are a bunch of hormonal methods that can help regulate your periods, decrease bleeding, or even make your period go away completely.

If you’re just not vibing with your choice of birth control, it might be time to switch things up! But before you do, it’s important to take a second to ask yourself some questions to make sure you’re ready. Thinking about why you want to switch methods and what your needs are going forward will help you and your health care provider plan your next steps.

If you’d like to stop your birth control and try to get pregnant, here’s some information about returning to fertility after using different methods of birth control.

There are a lot of great things about being on birth control that go beyond pregnancy prevention. Protection against ovarian cancer, an added boost to your vitamin D levels, lighter and less painful periods, the list goes on.

For most people, the risk of blood clots when using the ring, the patch, or the combined birth control pill (which is the most common type of pill) is low. But smoking increases this risk. If you are over 35 and smoke 15 or more cigarettes a day, the combination pill, patch, and ring are not safe options for you. If you’re over 35 and you smoke less than 15 cigarettes a day, talk to your provider about whether these birth control methods are safe options for you. People who smoke can always use the IUD, the implant, the shot, the mini-pill (progestin-only pill), and any method that is hormone free (like condoms, for example).

If you feel like your birth control is changing your behavior, it’s time to talk to your health care provider. Everybody responds to birth control differently, and your provider can help you decide whether it’s time to try something else. It might be a matter of switching hormonal methods or deciding whether to avoid hormonal birth control altogether, or you may choose to wait it out since some negative side effects go away with time. The bottom line: If your current method is making you feel blah, don’t settle. There are a lot of methods to choose from and sometimes it can take a few tries to get it right.