How to Know if the Birth Control Pill is Working

Duly Care
Jul 2
7 min read

The birth control pill is one of the most common ways that women can use to prevent an unintended pregnancy. But even though it is widely used, many women still wonder: how do I know if the birth control pill is working? What signs should I look for? These are very real and important questions.

This blog will help you understand how the birth control pill works, how to know if it is working properly, and what signs may suggest it did not work. We will also talk about what can make the pill less effective and how to avoid that.

Key Takeaways:

The birth control pill is a hormonal medication taken daily to prevent an unintended pregnancy. These contain synthetic versions of the natural female hormones estrogen and progesterone.
The birth control pill prevents pregnancy by preventing ovulation, thickening the cervical mucus and thinning the inner lining of the uterus.
When the birth control pill is taken consistently and correctly, it is over 99% effective at preventing pregnancy. Signs like regular or lighter periods and no pregnancy occurring suggest it is effective.
If pills are missed, taken late, not absorbed completely, or taken with other medications that interfere with the pills, then the effectiveness may drop. Symptoms like a missed period, nausea, or breast tenderness may signal pregnancy and should be checked with a test.

What is the Birth Control Pill?

The birth control pill, also known as oral contraceptive pill, is a hormonal medication taken daily to prevent an unintended pregnancy. It contains synthetic versions of the natural female hormones estrogen and progesterone.

There are two main types of the birth control pill - the combined oral contraceptive pill (COCP), which contains both estrogen and progestin (the synthetic form of progesterone), and the progestin-only pill (POP), which contains only progestin. The COCP is the most commonly used type of birth control pill, whereas the POP is usually recommended for women who cannot take estrogen due to medical reasons.

How Does The Birth Control Pill Work?

When we say the birth control pill "is working," we mean it is preventing pregnancy. The pill works to prevent pregnancy in three ways:

Stopping the release of an egg from the ovary each month (a process known as ovulation), which prevents fertilisation of the egg by sperm and the start of a possible pregnancy.
Thickening the cervical mucus, which makes it more difficult for the sperm to reach the egg.
Thinning the inner lining of the uterus, which prevents a fertilised egg from attaching, growing and developing into a pregnancy.

If these things happen, then the birth control pill is doing its job. But the tricky part is that you cannot always feel these changes. So, how can you tell?

How to Know if the Birth Control Pill Is Working

There is no instant or sure-shot way to "know" the birth control pill working. It does not give a signal. However, there are signs that suggest it is functioning as expected:

Pregnancy has not occurred: No pregnancy is the clearest sign that the birth control pill is working. For women who are sexually active and not using any other form of contraception, not becoming pregnant indicates that the pill is doing its job.
The pill is being taken correctly: If the birth control pill is taken at the same time every day without missing any doses, it is likely working effectively. This is especially important for the progestin-only pill (POP), which must be taken at the exact same time each day. The combined oral contraceptive pill (COCP) offers a slightly longer window for when it must be taken, but it still requires consistency.
The birth control pill is over 99% effective at preventing pregnancy when taken correctly and consistently. It must be remembered that no birth control method is 100% effective, and there is a small failure rate for all of them. So, less than 1% women using the birth control pill can get pregnant even if they are using it correctly and consistently.
Periods have become regular or lighter: Many women notice that their periods become more regular or lighter when taking the birth control pill. Cramping may also decrease. This is a common effect of the COCP, which regulates the menstrual cycle by balancing the estrogen and progesterone. Although changes in the period are not a guaranteed sign of the pill's effectiveness, they usually indicate that the hormones in the pill are working.

Some women expect noticeable changes, such as mood swings, clearer skin, or weight changes, but not all women experience these visible side effects or symptoms of the pill changes. The absence of strong changes does not mean the pill is not working.

The birth control pill does not become effective against pregnancy immediately when started. How soon it becomes effective depends on the type of pill. For combined oral contraceptive pills (COCPs), if the first pill is taken within the first five days of the period, it begins working right away. If started at any other time, it takes seven days to become effective, and a backup method like condoms should be used during this time. For progestin-only pills (POPs), protection begins after 48 hours, regardless of when they are started in the cycle. Until the pill becomes effective, it is important to use another method of contraception to prevent pregnancy.

How to Know if the Birth Control Pill Is Not Working

There are some situations in which the birth control pill might not work properly:

Pills are missed or taken late: Missing pills is one of the main reasons the birth control pill can fail. For the COCP, taking a pill more than 24 hours late may reduce its effectiveness. For the POP, even being three hours late can increase the risk of pregnancy.
Vomiting or severe diarrhoea occurs: If vomiting happens within two hours of taking the birth control pill or if there is ongoing severe diarrhoea, the body might not absorb the pill fully. This can lower the pill's effectiveness.
Certain medications are taken: Some medications, such as enzyme-inducing antibiotics, seizure medicines, and herbal supplements like St. John’s Wort, can interfere with the effectiveness of the birth control pill.
Pregnancy symptoms appear: Some signs, such as a missed period, nausea, or breast tenderness, may raise concern about a possible pregnancy. However, these symptoms are also common side effects for many women during the first few months of using the birth control pill, especially the combined oral contraceptive pill. If these symptoms continue for more than a couple of months, or if the period does not occur at all when expected, it is important to take a pregnancy test to rule out a possible pregnancy.

How to Make Sure the Birth Control Pill Works Properly

To ensure that the birth control pill functions as intended, the following practices are important:

Take it at the same time every day: This is crucial, particularly for women using the progestin-only pill. Setting a daily reminder can help maintain consistency.
Do not skip doses: The birth control pill should be taken every day, regardless of illness or sexual activity on that day.
Check interactions with other medicines: Before starting any new medication or supplement, consult a doctor to make sure it does not interfere with the birth control pill.
Use a backup method when needed: If one or more pills are missed or taken late, using condoms during sex for the next seven days helps maintain protection, especially with COCPs. With POPs, even one missed pill or a delay of more than three hours (or twelve for desogestrel-based POPs) means a backup method should be used for the next 48 hours.
Read the specific instructions for the pill brand: Each type of birth control pill has slightly different directions.

Conclusion

There is no instant or sure-shot way to tell you that the birth control pill has worked. But if you take it correctly and consistently, it is a very effective way to prevent pregnancy. Know the signs of a possible pregnancy, and do not hesitate to check in with your doctor if something feels off.

Frequently Asked Questions (FAQs)

Can the birth control pill stop working suddenly?
The birth control pill does not usually stop working suddenly without a cause. However, missing doses, taking certain medications, or experiencing vomiting or diarrhoea can reduce its effectiveness unexpectedly.
Does spotting mean the birth control pill is not working?
Spotting (light bleeding between periods) is a common side effect for some women, especially in the first few months of starting the birth control pill. It does not mean the pill has failed or is not working.
Can stress affect how well the birth control pill works?
Stress does not reduce the effectiveness of the birth control pill directly. However, extreme stress can lead to forgetting pills, which may lower its effectiveness.

Important

This blog, including its text, images, and infographics, is for educational purposes only and not a substitute for professional medical advice. For personalised advice, always consult a doctor.