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Hormonal Contraception

Non-contraceptive Benefits

Reduction in ovarian cancer

Reduction in endometrial cancer

Decreased pain with menstruation

Decreased hair growth

Reduction of acne

Decreased blood loss during menses, leading to decreased anemia and increased iron stores

Decreased benign breast disease, ie. Fibrocystic breasts

Protection against and treatment for endometriosis

Treatment for polycystic ovarian disease

Absolute Contraindications

Please tell one of the midwives if you currently have or have ever had one of these conditions:

Current known or suspected pregnancy

Blood clots

Vein infections

Stroke or cerebrovascular disease

Coronary occlusion or heart attack

Liver damage, impaired liver function, or acute hepatitis

Benign or malignant liver tumor

Estrogen dependent cancer/tumors

Undiagnosed abnormal genital bleeding

Cancer of reproductive system

Classic migraine headaches with aura

Relative contraindications

(should be discussed with your midwife)

Smoking over age 35

High blood pressure (greater than 140/90)

Diabetes mellitus


Heart, kidney, or gallbladder disease

History of severe depression


Condoms should be used along with hormonal methods for any situations where sexually transmitted

infection is a possible risk.

Hormonal contraception should be used with a back-up method, like condoms, in the first month.

Antibiotics may decrease the effectiveness of hormonal contraception.

Possible side effects:

It is not at all unusual to have irregular spotting in the first three to four cycles after initiating hormonal

contraceptives. If this is occurring beyond the third cycle/pill pack, please call us so that we may

discuss other alternatives for you.




Breast tenderness

Skin changes

Warning Signs to Report to Midwife:

Headaches- severe, persistent, of sudden onset, or different than the headaches you normally


Visual disturbances- blurring of vision, flashing lights, double vision, floaters, periods of temporary


Unexplained severe chest pain or shortness of breath

Unexplained severe abdominal pain

Severe calf or thigh pain

Temporary numbness or paralysis of any part of the face or body

Slurring of speech

Coughing up blood tinged sputum

Marked increase in blood pressure

How to start taking oral contraceptives (you have two options):

Start your new pill pack/patch/nuvaring on the first day of your next menstrual period (You are likely to

have better cycle control with this method)

OR Start your new pill pack/patch/nuvaring on the Sunday following the start of your next menstrual


What do I do if I miss a pill?:

If you miss any of the 7 reminder pills/placebo pills in your 28 day pill pack, you are not at increased

risk of pregnancy. You should discard the reminder pills you missed and finish the rest of the pack.

Start your next pack on your usual day.

If you miss any of the 21 hormonal pills:

Back up contraception

Completely missing a pill or even taking a pill as much as 12 hours

late, may decrease your protection against pregnancy. Use a back up method such as condoms

or abstinence for the next seven days

How late are you in taking your pill?

Less than 24 hours: take the missed pill right away, return to your daily pill taking routine, take your next pill at the usual time

24 hours: take both the missed pill and today’s pill at the same time. More than 24 hours(you completely missed one pill and

are late for or completely missed a second pill, too): Take the last pill you missed right away, take the next pill on time,

throw out the other missed pills, take the rest of the pills in the package right on schedule.

If you have not taken your pills on schedule and have had unprotected sex in the last 72 hours, you

may want to use emergency contraception to reduce the risk of pregnancy. Please call us to discuss

this option.