Key Points for Providers and Clients

Take one pill every day.
For greatest effectiveness a woman must take pills daily and start each new pack of pills on time.
Bleeding changes are common but not harmful.
Typically, irregular bleeding for the first few months and then lighter and more regular bleeding.
Take any missed pill as soon as possible.
Missing pills risks pregnancy and may make some side effects worse.
Can be given to women at any time to start later.
If pregnancy cannot be ruled out, a provider can give her pills to take later, when her monthly bleeding begins.

Who can and cannot use combined oral contraceptives

Safe and Suitable for Nearly All Women

Nearly all women can use COCs safely and effectively, including women who:

Have or have not had children
Are not married
Are of any age, including adolescents and women over 40 years old
Have just had an abortion or miscarriage
Smoke cigarettes—if under 35 years old
Have anemia now or had in the past
Have varicose veins
Are infected with HIV, whether or not on antiretroviral therapy (see Combined Oral Contraceptives for Women With HIV)

Women can begin using COCs:

Without a pelvic examination
Without any blood tests or other routine laboratory tests
Without cervical cancer screening
Without a breast examination
Even when a woman is not having monthly bleeding at the time, if it is reasonably certain she is not pregnant

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