Birth control pills come in packs. The most common type has 3 weeks of hormone pills. Some packs have sugar pills for the fourth week. During that fourth no-hormone week, you have your menstrual period. After the fourth week (28 days), you start a new pack.

Some birth control pills are packaged so that you take hormone pills continuously for a period of time. With pills packaged in this way, you may not have a monthly period or you may only have a period every couple of months.

How to start your first pack of pills

There are several ways you can start taking your first pack of pills. Talk with your doctor about when to start taking your pills:

• Quick start. During your medical appointment, take your first pill as soon as you get the pack from your doctor. Take the second pill the next day. During the first 7 days of pills, use a backup method of birth control, like a condom or diaphragm.
• Sunday start. Pick a Sunday to take your first pill, so that you do not have periods on the weekends. During the first 7 days of pills, use a backup method of birth control, like a condom or diaphragm.
• Fifth-day start. On the fifth day of your menstrual period, take your first pill.

Your daily pill routine

Take your hormone pills every day, at about the same time of day. To stay on track and prevent pregnancy, try these easy tricks:

• Pick a time. Link up your "pill time" with something you do every day, like brushing your teeth, eating a meal, or going to bed.
• Use your calendar. Mark the days you will start new packs. You might even want to cross off each day you take your pill.
• Check again. Each morning, check your pack to be sure you took yesterday's pill. If you find you've missed one, take it right away.

Remember that you may experience symptoms of pregnancy during the first month as your body adjusts to hormones. Birth control pills may also cause you to stop having periods, so don't panic if this happens. Take a home pregnancy test if that will ease your mind.

Watch for spotting or breakthrough bleeding if you are taking pills that are designed to prevent you from having periods every month. It takes a while for your body to adjust to the new schedule.

Talk to your doctor about taking a different brand of pill if you are bothered by symptoms of premenstrual syndrome.

Catch up on any pills that you miss by taking the pill that you missed and then the pill for that day at its regularly scheduled time. If you miss more than 3 pills, you may want to consider another method of birth control. Regardless of how many pills you miss, use another method of birth control until your next period.

Use another method of birth control if you are sick and experiencing vomiting or diarrhea because the pill may not stay in your digestive tract long enough to be effective. Antibiotics do not make the pills less effective, but drugs for tuberculosis do.

Stop taking the pills if you experience jaundice, abdominal pain, chest pain, leg pain, severe headaches or eye problems. Be especially alert for problems if you smoke. It's probably best if you quit smoking.