9 Things to know before going on the pill

The pill has been around for decades, giving us control over our reproductive health, and ultimately our quality of life. If you’re considering your birth control options, at any phase of your life, here are the most important things to know before making that decision:


The pill is 91% effective - 9 out of 100 pill users get pregnant each year (mostly missed and forgotten pills). The pill is 99% effective, with perfect use.

The more disciplined you are with taking the pill regularly – every day, on time – the more reliable it will be. This helps keep hormone levels from fluctuating. However, there’s still a very small chance that you could become pregnant, even if you always take your pills correctly. The point being, take it at the same time every day!

Read more on: “Advice to make sure you never miss your pill.” https://www.mydynamics.co.za/condition/womens-health/


Protection may not be immediate.

Protection may not be immediate depending on the type of pill you’re taking and where you are in your cycle. Check with a healthcare professional whether you need to use a backup method of birth control when you start the pill.


Give your body time to adjust to the hormones.

Some women may experience some side effects when they start taking the pill, including:


-mood swings


-breast tenderness


-spotting/bleeding between periods

-weight gain ( a temporary side effect due to fluid retention, not extra fat)


This usually settles down as your body adjusts to the new hormones – usually after three cycles. If you plan on using the pill to control acne or abnormal bleeding, it can take three to four months to see the benefits. If your symptoms are impacting your quality of life, speak to your doctor about changing to a different pill or birth control method.


There is no evidence that the pill makes you gain weight.

There has been lots of research examining the link between hormonal contraception and weight gain – the majority showing that there is limited evidence that birth control pills are associated with weight gain, and any weight gain that occurs after beginning birth control is usually due to water retention.

As reported by Healthline, one literature review found that study participants gained, on average, fewer than 4.4 pounds (1.99kg) after 6 or 12 months of using a progestin-only pill.

If you gain much more than that, its likely that your weight gain is caused by something else.


There is risk for some complications – but it’s rare.

The pill has been used for decades and is safe for most women. However, a small percentage of women who take the combination (estrogen-containing) birth control pill have an increased risk of developing blood clots, breast cancer, cervical cancer and liver disorders.


The combined pill may help with heavy periods or painful periods, PMS (premenstrual syndrome), PMDD, acne or endometriosis.

The pill is not only taken to prevent pregnancy, and many women use the pill for its other benefits:


-Regulate or lighten your period

-Prevent anaemia (by making periods lighter/shorter)

-Less menstrual cramps (dysmenorrhea)

-Manage premenstrual syndrome (PMS) and premenstrual dysmorphic disorder (PMDD)

-Treat polycystic ovary syndrome (PCOS)

-Treat endometriosis or uterine fibroids

-Improve acne


There's a three-hour window for taking your birth control pill "on time".

If you’re on a progestin-only pill, taking a pill “on time” means taking it within the same three-hour window daily; it doesn’t lower the pill’s efficacy. For combination progestin-estrogen pills, according to Planned Parenthood, as long as you take one pill every day, you’ll be protected. Although you don’t have to take your combination pill at the exact same time every day, it’s advised to take it at the same time to keep you in the habit of remembering your pill.

Read more on: “What to do if you miss a pill?” https://www.mydynamics.co.za/condition/womens-health/


The pill does not protect against STDs & STIs.

The pill prevents pregnancy but it won’t protect you from sexually transmitted diseases (STDs) or infections (STIs), such as genital herpes, chlamydia and HIV. If you need to prevent STDs, use a condom.


The pill interacts with some medications and supplements.

The biggest risk for the pill not working, is missing a pill, vomiting and severe diarrhea for more than 24 hours.Certain types of medication can also affect the effectiveness of the pill, so inform your doctor or nurse when any of the following are prescribed:


The antibiotics, rifampicin and rifabutin. With respect to the other broad-spectrum antibiotics, there is still uncertainty – as reported in the journal, Contraception – and because of that, you can use a backup method while you’re on the course of antibiotics.

-The antifungal, griseofulvin (topical antifungals have no effect)

-Certain antiretroviral medicines (used to treat HIV)

-Certain anti-seizure medicines

-Herbal supplements, including St John’s Wort


If you are on any of these while you’re on the pill, use condoms as a backup, or, if you’re going to be on them for a long time, you would need to switch to a different method of birth control.



  1. Cleveland Clinic. (2020). Birth Control: The Pill. Cleveland Clinic [Online]. Accessed on 10 March 2023. Available from https://my.clevelandclinic.org/health/drugs/3977-birth-control-the-pill 
  2. Holland, K. (2021). Oral Birth Control and Weight Gain: What You Need to Know. Healthline [Online]. Accessed on 10 March 2023. Available from https://www.healthline.com/health/how-to-lose-weight- on-birth-control#what-the-research-says 
  3. Kliff, S. (2017). 7 facts anyone taking birth control should know. Vox [Online]. Accessed on 13 March 2023. Available from https://www.vox.com/2014/9/19/6418767/birth-control-pills-effectiveness- how-to-use-common-questions
  4. Mayo Clinic. (2023). Combination birth control pills. Mayo Clinic [Online]. Accessed on 10 March 2023. Available from https://www.mayoclinic.org/tests-procedures/combination-birth-control- pills/about/pac-20385282
  5. National Health Service. (2020). Combined pill. NHS [Online]. Accessed on 10 March 2023. Available from https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/ 

These articles are for information purposes only. It cannot replace the diagnosis of a healthcare provider. Pharma Dynamics gives no warranty as to the accuracy of the information contained in such articles and shall not, under any circumstances, be liable for any consequences which may be suffered as a result of a user’s reliance thereon.

The information the reader is about to be referred to may not comply with the South Africa regulatory requirements. Information relevant to the South African environment is available from the Company and in the Professional Information/Patient Information Leaflet/Instructions for Use approved by the Regulatory Authority.

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