Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Blood clots: This medication may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities. If you have a history of clotting you may be at increased risk of experiencing blood-clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision or difficulty speaking, contact your doctor immediately.
Blood pressure: You should not take this medication if you have high blood pressure that is not controlled by medication. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Breast cancer: Increasing age and a strong family history are the most significant risk factors for the development of breast cancer. Other established risk factors include obesity, not having had children, and a late age at first full-term pregnancy. The identified groups of women that may be at increased risk of developing breast cancer before menopause are women who have used birth control pills for more than 8 years or who started using them at an early age. For a few women, the use of birth control pills may accelerate the growth of an existing but undiagnosed breast cancer.
If you are taking birth control pills, learn how to perform a breast self-examination. Notify your doctor any time you detect a lump. A yearly clinical breast examination is also recommended because, if breast cancer develops, medications that contain estrogen may cause a rapid progression.
Depression: Hormones, such as estrogen, have been known to cause mood swings and symptoms of depression. If you have had clinical depression in the past, you may be more likely to experience it again while taking this medication. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Diabetes: Current low-dose birth control pills affect glucose control very little. If you have diabetes or a family history of diabetes, monitor your blood glucose closely to detect any worsening of blood sugar control after starting birth control pills.
Eyes: Women who are pregnant or who take birth control pills may experience fluid build-up in the cornea of the eye, which may cause visual disturbances and changes in tolerance to contact lenses, especially rigid contact lenses. Wearers of soft contact lenses usually do not experience difficulties. If you experience visual changes or alterations in tolerance to contact lenses, you may need to stop wearing the lenses temporarily or permanently.
Fibroids: If you have fibroids (leiomyomata), your doctor should closely monitor your condition. If sudden enlargement, pain, or tenderness occurs, contact your doctor to see if you need to stop taking the medication.
Heart disease: Cigarette smoking increases the risk of serious heart disease and death. Taking birth control pills increases this risk, especially with increasing age. Studies show evidence that women who smoke and are over 35 years old should not use birth control pills.
Other women who have a high risk for heart disease include those with diabetes, high blood pressure, or abnormal cholesterol levels, or those with a family history of these conditions. Taking birth control pills also appears to increase the risk of heart disease in women with these conditions.
For low-risk, non-smoking women of any age, the benefits of birth control pill use outweigh the possible cardiovascular risks of low-dose pills.
Migraine and Headache: This medication may cause an increase in migraine headache frequency or cause migraines to develop. If you begin to experience severe headaches or an increase in the number of headaches that occur, contact your doctor.
Other cancers: There is some evidence that long-term use of oral contraceptives may increase the risk of cervical cancer or liver cancer. There is some debate about how significant this risk is. If you have concerns, discuss this with your doctor.
Regular check-ups: You should have a yearly physical examination and follow-up visit with your doctor.
Return to fertility: After stopping birth control therapy, you should wait for at least one normal menstrual cycle has occurred before attempting to become pregnant. This allows for the pregnancy to be accurately dated. An alternative birth control method (e.g., condoms) should be used during this time.
If you do not menstruate for 6 months or more after stopping birth control pills, notify your doctor.
Sexually transmitted infections: Birth control pills do not protect against sexually transmitted diseases, including HIV/AIDS. For protection against these, use latex condoms.
Stroke: This medication increases the risk of a stroke or "mini-strokes" occurring. If you experience signs of a stroke or mini-stroke, such as confusion, difficulty speaking, loss of coordination, sudden headache or vision changes, contact your doctor as soon as possible.
Pregnancy: This medication should not be taken during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: The use of birth control pills while breast-feeding is not recommended. The hormones in the medication pass into breast milk and may reduce its quantity and quality. The long-term effects on the developing child are not known.