There is so, so, so much more to know about The Pill and we only had time to skim the surface! Please read through the following sites and then donate some dollaz so they (Planned Parenthood and Scarleteen) can continue to be free, accessible, comprehensive sex education resources on the internet :)

Birth Control Bingo: Minipills on Scarleteen
Birth Control Bingo: The Combination Pill on Scarleteen
Birth Control Pill on Planned Parenthood

Not sure where to even start when it comes to picking the birth control that’s right for you? Scarleteen has JUST the choose-your-own-adventure-er-I-mean-birth-control game for you over at their Birth Control Bingo resource.

We’ve also covered a few other birth control options here on ol’ OJST!
The Paraguard IUD (this is the BC I’m on!), Emergency Contraception, The Implant by Lucy Knisley, Condom Basics, The Internal (Female) Condom, aaaaaand in order to understand how contraception works you should prolly brush up on how folks get pregnant in the first place.

↓ Transcript Of Today's Comic
A person comes up to Erika, looking uncertain as they shrug their hands. They say, “Erika, I REALLY love banging, but I’m scared of getting pregnant! My friends have been telling me about some magic pill that keeps you from getting knocked up???”

Erika happily presents a tiny pill in her hands. “Yeah! The Pill is a little capsule of synthetic hormones you take orally every day that’ll stop your partner’s sperm from meeting any of your eggs.”

A cartoon drawing of the pill is shown protecting an unfertilized egg. “Not on my watch!”, it declares as it pushes a swimming sperm back with its hand.

Erika continues. “It’s a great contraception choice for folks who are super good at ROUTINE and can remember to take a pill at the same time every day.”

She points at a clock with one hand while miming the shape of a pregnant belly that says “Bun” with the other. “It is NOT a good option for Forgetful Frankies, because playing fast and loose with your schedule can quickly lead to a bun in the oven.”

At this, the person looks ready to rush off. “Ok, so I just gotta take this pill every day at the same time and my baby-makin’ fears are over! Woo, I’m gunna have SO much sex…”

Erika stops them, looking stern. “Hold your horny horses, there’s some more stuff to go over first!”

She gestures to two pills over her head. “There are TWO types of pills you can take that mostly do the same sorta thing, but with different hormone combinations. Since every body responds so differently to chemical changes, it’s impossible to know which pill’s the right one for your body without trying one out and seeing how you fare.”

Disgruntled, the person asks, “Ugh, where do I even start then? Tell me what you know about them first!”

The following comparison/infographic is prefaced with a winking Erika that says, “Keep in mind this is surface-level information, so you should definitely go do more in-depth research at PlannedParenthood.org and Scarleteen.com and hella talk with your doc!

Combination Pill
(Estrogen and progestin hormones)
  • Taken orally every day, roughly around the same time
  • 12 hour grace period before the pill is late

Effectiveness
  • Perfect Use: 99.7% (Less than 1 out of 100 folks will get pregnant in a year).
  • Typical Use: 91% (9 out of 100 folks will get pregnant in a year).
Source: scarleteen.com/birthcontrol_bingo_the_combination_pill

How it Works:
  • Prevents ovulation
  • Thickens cervical mucus
  • Makes the uterus less hospitable to a fertilized egg

A cartoon drawing includes an angry fertilized egg yelling, “Lemme implant!” to a smug uterine wall that says, “Not this time, buddy!”.

Possible Side Effects:
  • More regulated monthly bleeding
  • Lighter periods
  • Less cramping
  • Decreased PMS symptoms
  • Vaginal dryness
  • Skin changes
  • Spotting
  • Nausea
  • Headaches
  • Tender breasts
  • Mood changes
  • Decreased sexual desire
  • Weight gain
  • Possibly more yeast infections
  • And it can take longer to conceive after quitting the pill


The combination pill is NOT for you if you…
  • Smoke and are over 35
  • Get migraines
  • Breastfeed
  • Know you are sensitive to estrogens
  • Have had bad experiences on hormonal birth control that contained estrogen


The silhouette of a person is shown smoking while breastfeeding a baby with migraine lines coming off them. Their expression looks put out as they say, “Well, shit.”


Minipill
(Progestin-Only)
  • Taken orally every day at the same time.
  • 3 hour grace period before the pill is late.

Effectiveness:
  • Perfect Use: 99+% (Less than 1 out of 100 folks will get pregnant in a year)
  • Typical Use: 90% (10 out of 100 folks will get pregnant in a year)

Source: scarleteen.com/birth_control_bingo_minipills

How it Works:
  • Sometimes suppresses ovulation
  • Thickens cervical mucus


Includes cartoon sperm looking unhappy as it tries to penetrate thickened cervical mucus. It complains, saying, “Ew, it’s so thick. I hate it.”

Possible Side Effects:
  • Reduced or straight up absent periods
  • Unpredictable spotting
  • Less cramping
  • Decreased PMS symptoms
  • Weight gain
  • More yeast infections
  • And an increased risk of ovarian cysts.

Erika holds up the minipill and adds, “Unfortunately, it’s not as effective as its sibling, and you have to be really anal about taking it at pretty close to the exact same time every day. But if you’re sensitive to estrogen, or the other combination pill isn’t working out this is a great alternative!”

She also adds, “BOTH of these pills have the potential to cause these extra scary but RARE side effects:

Rare side effects:
  • Blood clots
  • Heart attack
  • Thrombosis or Eye problems
  • Allergic reaction
  • Gallbladder disease
  • Embolism or stroke

The person looks taken aback as they read the list of side effects. “Jesus Christ,” they say.

Erika puts her hands up to reassure them as they listen. “Scary, I know, but a TON of people take this stuff because it’s so effective and it’s one of the most thoroughly studied medications in history, so don’t get frightened off yet.”

They say, “Ok. I’m still interested. So how do I get it?”

Erika says, “Cool! Well, to get on the pill you gotta go see your sexual healthcare provider (That can be your regular doc) and pick up a prescription from them!” She shows a doctor holding up an RX prescription. “It tends to cost between $15 to $50 a month in the USA.”

The person jumps for joy and clicks their heels together as they cheer, “And then it’s a one way ticket to Bone Town!

They start running off again. “I can have sex whenever I want and I’ll be TOTALLY PROTECTED!!!”

Erika quickly grabs them by the hem of their shirt to stop them again. “Ha! Whoah Tiger, before you go jumpin’ on any dicks, here’s a few other things to keep in mind! It’s recommended you keep using other kinds of contraception for a FULL menstrual cycle when starting either pill to make sure it has time to become fully effective.

“And these pills only protect you from becoming preggers, but do nothing to stop STI transmissions.

She holds an umbrella up over them. Sperm are shown bouncing off the top of the umbrella, but the person can see viruses, bacteria, and/or parasites surrounding them are not necessarily also blocked by it.

“You’re still gonna wanna practice safer sex with barriers (condoms and dental dams) to avoid STIs.”

“FINALLY, there are some medications and substances that can impair the pill’s effectiveness, so always warn your doctor before taking new meds! No joke, my cousin got knocked up while she was on the pill because her doctor gave her flu medication when she was sick and didn’t warn her it could negate her birth control!”

A cartoon prescription bottle full of meds is shown stomping on a birth control pill like a schoolyard bully.

“Some people luck out and find their perfect birth control on their first try, but for others (like me!) finding the right contraception for your body can take a lot of trial and error before you find your match. If the pill doesn’t cut it with you, there are many other options, including non-hormonal, that you can try out too! Stuff like -”

Options like the shot, the sponge, cervical caps, spermicides, the ring, the implant, condoms, and IUDs surround Erika as she says this.

She ends the comic by saying, “Taking a new, body-altering drug can be intimidating, but when you find the right contraception for you it’s so incredibly freeing!” She waves goodbye to the person. “Good luck, friend!”

The person waves back as they run off for real this time. They call back, saying, “Thanks, bud!”

This comic was drawn June 20, 2017 by Erika Moen and Matthew Nolan, then transcribed Feb 15, 2022, by Dennie Park, who can be found at linktr.ee/DeepBeeps