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Sometimes I take my birth control pill in the morning, sometimes at night. Is that a problem?
Oct. 29, 2001 -- It matters very much when you take your birth control pill. Taking "the pill" irregularly may defeat the main purpose for taking it -- prevention of pregnancy -- and may result in conception at a time when you don't want this to occur.
Most modern birth control pills are able to prevent pregnancy while provoking fewer side effects than formulations available in the past. This is because new and improved oral contraceptives contain reduced doses of the female hormones estrogen and progesterone. Today's reformulated, or low-dose, birth control pills are safer than older versions but a bit trickier to use.
The key difference is timing. While it depends on the particular brand, for most low-dose birth control pills the following generalizations hold true: (1) If you are more than an hour or two late in taking a pill, you increase the risk that the medication won't work properly; (2) the farther you deviate from your schedule, the greater your odds of obtaining undesirable effects. The most common adverse result is breakthrough bleeding -- vaginal spotting or bleeding that occurs between periods. Another, far more serious consequence is unplanned pregnancy.
On the brighter side, when taken correctly birth control pills are one of the most effective kinds of contraception. The chance of becoming pregnant is less than 1% -- or one pregnancy per 100 women per year of use -- when used perfectly without missing any pills. Since none of us is perfect, however, typical failure rates are about 3% per year, according to several brands of oral contraceptives listed in Physician's Desk Reference.
In order to obtain maximum effectiveness from your birth control pill, it is extremely important to follow your doctor's directions. Carefully read the patient package-insert instructions that come with your birth control pill. If you've lost or misplaced yours, ask your pharmacist for another copy.
Briefly, the correct way to take oral contraceptives is this: Take one pill every day at the same time each day. Your chosen time could be before going to sleep, after waking up, or when brushing your teeth. But be consistent. For information about what to do if you completely forget to take one or more pills, see the recent answer to "Missed Birth Control Pills."
If you frequently have trouble remembering to take your pill at the right time, schedule an appointment to discuss this problem with your health care provider. You can learn some techniques that may help make pill-taking easier for you. Or you and your provider may want to consider switching your prescription to another type of contraception.
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