When Should I Start Birth Control Pills?

When to Take the Birth Control Pill

Many women may not know when to start birth control pills.

You may wonder if it is safe to start taking birth control pills at the beginning, end, or middle of the menstrual cycle.

The answer often depends on the type of pill and the individual’s needs.

Birth control pills are a safe and effective method of preventing unwanted pregnancy. For some people, the pill can also help reduce symptoms caused by processes such as heavy bleeding and irregular cycles.

In this article, we examine whether a person should start using birth control pills in the middle of their period, and the benefits, risks, and side effects of doing so.

Can Birth Control Pills Be Started in the Middle of the Menstrual Cycle?

It may take several days for the pill to start preventing pregnancy.

To understand how the pill works, it’s important to know what happens during a typical menstrual cycle.

How Does the Menstrual Cycle Happen?

The average menstrual cycle is 28 days:

1-7. Days: This is the beginning of a period in which bleeding usually occurs for about 4 to 8 days. During this time, a person’s hormone levels, especially estrogen, are low and growths called follicles develop in the ovaries.

Day 8: The person usually stops bleeding and one of the follicles begins to secrete estrogen and grows. This estrogen causes the uterus to thicken.

11-13. Days: Estrogen levels peak and there is a rise in luteinizing hormone (LH). This hormone eventually causes the follicle to burst and release an egg.

Day 14: This is typically the day of ovulation, when the follicle releases an egg. This egg usually lives for about 12 to 24 hours. If there is sperm during this time, it can fertilize the egg. Sperm can live in the body for 3 to 5 days.

Days 15–24: The egg travels through the fallopian tube to the uterus, regardless of whether fertilization has occurred or not. The ruptured follicle will now begin to produce the hormone progesterone, which makes the uterine lining thicker and creates an ideal environment for a fertilized egg to implant.

Days 24-28: If the egg has not been fertilized, it will break apart during this time. Estrogen and progesterone levels begin to drop, causing the uterus to shed its lining and the onset of the person’s next period.

Birth Control Pill To Take On Which Day Of Menstruation

If there is no health problem, you can start taking birth control pills at any point during the menstrual cycle.

However, it may take several days for the pill to establish a consistent hormone cycle that prevents pregnancy.

By starting the pill mid-cycle, around the ovulation point, a person is at risk of pregnancy and should use a backup method of birth control until they have been using the pill for at least 7 days. To be more careful, use another form of birth control, such as condoms and foam, during the first month.

You can find other articles on birth control here.

How and When to Start the Birth Control Pill?

There is no hard and fast rule about when to start the birth control pill. Advice about when to start also depends on what type of pill a woman is taking. There are two main types of birth control pills:

Combination pill containing synthetic versions of the hormones estrogen and progesterone. These hormones reduce the likelihood of fertilization and implantation as well as the occurrence of ovulation.

A mini-pill containing only a synthetic version of progesterone. It is also known as the progestin-only pill. The mini-pill prevents pregnancy primarily by causing thickening of the cervical mucus and thinning of the uterine lining. This reduces the chances of fertilization and implantation of an egg.

Combined Birth Control Pills

Doctors recommend starting combination birth control pills on the first day of a menstrual period or the first Sunday after starting your period.

Starting on the first Sunday serves two purposes: it provides a consistent day to start pills and can affect menstrual timing so a person is unlikely to be over the weekend. This may or may not benefit some people.

However, not everyone has a regular menstrual cycle. A person can start their period and get it again after 2 weeks. In this situation, some people may find it difficult to time their pills to the “start of a cycle”.

For someone with irregular periods, the best time to start taking the medication may be when they are ready to start regulating their periods.

However, people who do not start taking birth control pills during their term should use another form of contraception (birth control) for at least the first 2 days. It may be wise to use other contraceptive measures for a full cycle.

It is very important to use the mini-pill in the same 3-hour window every day for maximum effectiveness. A person should choose a memorable and easy to remember time of the day.

Many people set a daily reminder to ensure they take their pills at the same time each day.

The Benefits and Risks of Starting a Birth Control Pill Mid-Cycle

While the health benefits of starting the pill mid-cycle are not clear, some people may find it more convenient to start taking birth control pills as soon as possible.

However, starting the birth control pill in the middle of the menstrual cycle means that a person will not be protected from pregnancy immediately.

Anyone who chooses to start the pill outside of the first 5 days of the menstrual cycle should at least use a backup method of contraception such as a condom:

7 days if you are using the combination pill

2 days if you are using regular pills

Another possible risk of starting the birth control pill in the middle of the menstrual cycle is that a woman could already be pregnant. However, a Danish study shows that taking birth control pills early in pregnancy will not harm the fetus.

Starting in the middle of the menstrual cycle, it may also take longer for a person’s body to adjust to the new hormone cycle. In some people, this can cause spotting or irregular bleeding. After you start using the pill, it may take some time for your menstrual cycle to become more regular.

Side Effects of Starting the Birth Control Pill in the Middle of the Menstrual Cycle

The possible side effects of birth control pills are the same regardless of when a person starts taking them:

  • breast tenderness
  • dizziness
  • Headache
  • Irregular menstrual bleeding
  • mood changes
  • Nausea

Typically, these symptoms subside within 3 months of taking the drug. However, if a person continues to experience bothersome side effects after this time, they may want to talk to their doctor about switching to another birth control pill.

Summary of Getting Started with the Birth Control Pill

Deciding when to start birth control pills largely depends on personal preference and the type of pill. A person who starts the pill during the first 5 days of starting treatment should be protected against pregnancy immediately.

The person who chooses to start the pill in the middle of the menstrual cycle should use backup contraception (birth control method) for at least 7 days if you are using the combination pill and for at least 2 days if you are using the regular pill.

To be extra careful, a person may want to consider using another method of contraception during the first month of taking either contraceptive.

MedicalNewsToday, Can you start the birth control pill midcycle?, 2018


Balaagh, SA (nd). Starting birth control pills. Retrieved from https://www.healthywomen.org/content/ask-expert/1789/starting-birth-control-pills

Birth control pills. (2017, January). Retrieved from https://kidshealth.org/en/teens/contraception-birth.html

Birth control pills: General information. (2018, May 18). Retrieved from https://youngwomenshealth.org/birth-control-pills-all-guides/

Charlton, BM, Mølgaard-Nielsen, D., Svanström, H., Wohlfahrt, J., Pasternak, B., & Melbye, M. (2016). Maternal use of oral contraceptives and risk of birth defects in Denmark: Prospective, nationwide cohort study. BMJ, 352, h6712. Retrieved from https://www.bmj.com/content/352/bmj.h6712

US selected practice recommendations for contraceptive use, 2016: Combined hormonal contraceptives. (2017, February 1). Retrieved from https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html

US selected practice recommendations for contraceptive use, 2016: Progestin-only pills. (2017, February 1). Retrieved from https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/progestin.html

What happens during the typical menstrual cycle? (2018, March 16). Retrieved from https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle

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