Hormonal Methods of Family Planning 209
If you have any of the following health problems, try to
use a method other than combined birth control pills. But if
you cannot, it is still better to take the combined pill than to
become pregnant. Try not to take combined pills if you:
• smoke and are over 35 years old. You have a greater
chance of having a stroke or heart attack if you take
combined pills.
• have diabetes or epilepsy. If you are taking medicine
for seizures (“fits”), you will need to take a stronger (50
micrograms of estrogen) birth control pill. Get medical
advice from a health worker or doctor.
• have high blood pressure (more than 140/90). If you
have ever been told you have high
blood pressure or think you might
have it, have your blood pressure
checked by a health worker. If
you weigh too much, have
frequent headaches, get out
of breath easily, feel weak or
dizzy often, or feel pain in
the left shoulder or chest,
you should be tested for
high blood pressure.
Common side effects of combined pills:
• Irregular bleeding or spotting (bleeding at other times
than your normal monthly bleeding). Combined pills often
make your monthly bleeding shorter and lighter. It is also
normal to sometimes skip your monthly bleeding. This is
the most common side effect of combined birth control
pills. To reduce spotting, be extra careful to take the pill
at the same time every day. If the spotting continues, talk
with a health worker to see if changing doses of progestin
or estrogen will help.
• Nausea. Nausea, the feeling that you want to throw up,
usually goes away after 1 or 2 months. If it bothers you, try
taking the pills with food or at another time of day. Some
women find that taking the pill just before going to sleep at
night helps.
• Headaches. Mild headaches in the first few months
are common. A mild pain medicine should help. If the
headache is severe or comes with blurred eyesight, this
could be a serious warning sign, see page 210.
➤ If you are
breastfeeding, be
sure to wait until
your milk is coming in
well before starting
to take the combined
pills. This usually
takes about 3 weeks.
➤ If you are bothered
by any body changes
after starting birth
control pills, talk
to a health worker.
She might suggest a
different pill.
➤ If your monthly
bleeding does not
come at the normal
time and you have
missed some pills,
continue to take your
pills but see a health
worker to find out if
you are pregnant.
Where Women Have No Doctor 2012