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Can women who smoke take birth control pills?

Women who smoke may have heard that they shouldn’t be taking birth control pills that contain estrogen. But while doctors recommend that women either find different pregnancy prevention alternatives (i.e. pills/ birth control methods not containing estrogen) or quit smoking before taking estrogen- containing birth control pills, studies find that 80% of women will still continue to smoke while taking the pill.

Can smokers take a combined birth control pill containing estrogen?

Doctors strongly recommend against taking combined oral contraceptives containing estrogen especially in women 35 years of age and older when continuing to smoke due to the increased risk of serious side effects which we will explore below.

Why aren’t combined oral contraceptives recommended for smokers?

Smoking and the use of oral contraceptives featuring estrogen each have their own side effects, both relating to blood flow.

While normal blood vessels are softer and more pliable, smoking causes blood vessels to constrict, which overtime results in blood vessel walls becoming weaker and harder. Smoking also increases the development of plaque formations which further contributes to the restriction of blood flow.

On the other hand, birth control pills containing estrogen thicken the consistency of blood, making it easier for blood to clot.2 Combined, the effects of smoking and taking combined birth control pills may significantly increase the risk of serious heart and blood vessel problems, including death from heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes smoked.

For this reason, all birth control pills containing estrogen carry a boxed warning especially for women over the age of 35 who smoke (see below).


Do not use combined oral contraceptives if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects from hormonal birth control methods, including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke.

What are the side effects for smokers when taking combined oral contraceptives?

The synergistic effect of smoking and taking combined pills may lead to an increased risk of adverse effects on a woman’s heart and blood vessels, leading to cardiovascular complications such as a heart attack, blood clots, and stroke.

Who is at risk of developing complications?

Women who smoke and are over 35 years old have the highest risk of experiencing cardiovascular side effects when also taking birth control pills with estrogen.3 They should speak to their doctor about alternative birth control methods.

What are some birth control alternatives for women who smoke?

For women who smoke over 15 cigarettes a day, in addition to the combined pill, doctors also do not recommend the patch or ring as these options all contain estrogen. Instead, ask about progestin-only pills or other birth control methods that are estrogen-free, like a copper IUD. Neither of these options contains estrogen.

Why are progestin-only birth control pills safer for smokers?

Progestin-only pills (or POPs) do not contain any estrogen and therefore may have a lower risk of side effects when compared to combined pills in women who smoke. Doctors typically recommend estrogen-free contraceptives for women who are smokers, have high blood pressure, are overweight, suffer from migraine headaches, or have a history of blood clots.


What is Slynd® birth control and how can it help women who smoke?

As a progestin-only (estrogen-free) oral contraceptive, Slynd® is a safer alternative to combined pills containing estrogen. It does not have a boxed warning pertaining female smokers 35 years of age and older, and in clinical studies there were no reports of blood clots while taking Slynd.

What makes Slynd® a unique progestin-only pill? It’s currently the only estrogen-free birth control pill available that features a 24-hour missed pill window. Other progestin-only pills feature a much tighter 3-hour window, which places more pressure on women to take their pill at the right time. In addition, with Slynd®, women can expect a more predicted and tolerable bleeding pattern with the 24 days of active hormone and 4 days of placebo dosing regimen.

Learn more about Slynd, by clicking here.

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Dr. Darya Blednova, M.D. is a board-certified internal medicine physician. Dr. Darya grew up in Krasnoyarsk, Russia; she graduated from medical school at Krasnoyarsk State Medical University and completed her internal medicine residency at Nassau University Medical Center. She is a first-generation immigrant and understands the struggles that others face when moving to the other side of the world. She uses real-life examples to make it easy for her patients to understand the root causes of their problems, which encourages them to stick with their new, healthy behaviors. Dr. Darya is greatly interested in optimizing women’s somatic and reproductive health during their reproductive cycles.

Josh Emdur D.O. is a board-certified family medicine physician and Chief Medical Officer at SteadyMD with a passion for providing personal, high-value medical care that embraces the use of technology. His friends and family have texted him their medical questions on a daily basis for years (despite having their own respective doctors). It is this concept that launched the idea to start a virtual primary care practice. With the ubiquity of smartphones, fitness trackers, and connected health devices he can gather important data to help coach his patients to live healthy lives.

Dr. Amanda Sadler was born in Enid, Oklahoma and fell in love with sports and medicine at a young age. She swam at Texas Christian University and then returned to Oklahoma for medical school. While in medical school, she found the sport of triathlon and had immediate success. She raced as a professional athlete on the ITU and Ironman World Circuit for 15 years. Throughout her journey as a professional athlete, she discovered functional medicine. Now she gets to combine all that she loves (functional, sports, and performance medicine) into her job. Her approach to helping patients optimize their health and performance is through root cause analysis and encouraging a healthy balanced lifestyle.

Dr. Lynn Buchanan is a family medicine physician who has years of experience in conventional and integrative medicine. She was born and raised in the inner city of Paterson, NJ. After growing up poor and quitting high school, Dr. Buchanan worked in a hospital as a pharmacy tech. There, the oncologist pushed her to attend college. She went on to graduate Summa Cum Laude from William Paterson University. Then, she attended the UMDNJ School of Osteopathic Medicine and Nova Southeastern COM. Dr. Buchanan believes in aligning her medical approach with the needs and preferences of the patient. She takes cultural and individual needs into consideration, taking time with each individual patient to determine the best treatment method.

Dr. Leah Roberts is a board-certified physician who specializes in Emergency Medicine. Prior to medical school, she practiced as a personal trainer and nutritionist. Dr. Roberts completed her Emergency Medicine residency at Cooper Medical School of Rowan University in Camden, NJ. She earned her Doctorate of Medicine at Temple University School of Medicine and M.S. Nutrition at Columbia University.  Additionally, Dr. Roberts proudly serves as a Commissioned Officer in the US Army Reserves. She has an interest in preventative medicine and helping patients find a balanced, healthy lifestyle.

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You can request your Vitafol® prescription to be filled at the pharmacy of your choice — whether it’s your local pharmacy or an online option.

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Fill out a health questionnaire to tell us more about yourself, and book a virtual appointment to speak with a doctor over video or live chat*.

*Each video or chat consultation is $0.


Connect with our doctors

At your virtual appointment, you can connect with a doctor to learn more about your oral contraceptive options and whether Slynd® is the right fit for you.

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Select a local or online pharmacy to fill your prescription, all from the comfort of your own home. Getting birth control has never been easier.


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Tips for remembering to take your pill

Whether you’ve started taking new medication or you’re naturally a forgetful person, it can be hard to remember to take your pills. Thankfully, there are a variety of different methods you can use to help you keep yourself organized.

Keep reading to learn our top seven tips for how you can remember to take your pills on time.

1. Use an app on your smartphone

Is your phone glued to your hand? For those of you who have your phone with you wherever you go, consider using an app with the notifications turned on. Some examples include a reminders app or a dedicated alarm for your birth control pill.

Of course, a secondary tip is to keep your phone charged so that you get your alert in the first place!

2. Where you keep your pills is important

Have you heard of the phrase, “out of sight, out of mind”? This saying applies to your pills as well. Are they stuffed at the bottom of your purse or hidden away in a bathroom cabinet? If so, it’s much easier to forget about them if they’re not visible.

Be sure to keep your medication next to items you use every day. Some ideas include:

  • Your night table or near your alarm clock
  • Next to your toothbrush
  • Near your phone

While you want to store your pills in a safe and dry location, hiding them in a cabinet makes it more likely to forget they are there.

3. Get a friendly reminder

If a friend, family member, or partner is also taking medication at the same time, consider asking them to help remind you to take your pill. If both of you take your respective medication at the same time, it’s much easier to have you or the other person remind each other.

However, this method may be less effective if both of you forget!


4. Develop a routine and stick to it

One way to help you to remember to take your pill is to establish a step-by-step routine that you go through every day. By sticking to the steps in order, taking your pill becomes a natural part of your process. Here’s a sample routine:

  • Wake up in the morning
  • Go through your skincare routine
  • Take your pill
  • Brush your teeth


5. Tangible reminders can help you stay on track

Sometimes when we get into the habit of doing something over and over again, we may forget if we actually did it. Developing a visual system may help!

For example, if you have a calendar, consider adding a checkmark to it if you’ve taken your pill for the day. That way when you’re wondering whether or not you actually did take your pill that morning, you can look at your calendar to check.


6. A “sticky” reminder

On a colorful sticky note, write a reminder to yourself to take your pill. Make sure that it’s in a noticeable area that you’ll pass by every day, such as your bed or kitchen. While a plain beige or yellow sticky note might not stand out, try a bright pink or hot orange sticky note instead.


7. A high-tech cap

If your medication comes in a bottle, it could be used with an electronic cap. These reminder caps typically feature a small electronic display that keeps track of the last time you opened the bottle. Talk about fancy!


8. Reward yourself

In an article by the American Academy of Family Physicians, they found that patients are much more motivated by an immediate reward compared to long-term benefits, which are often harder to quantify. When it comes to taking your birth control pill, pair it with a small treat. Be sure to keep it on the healthy side such as your favorite fruit or a small piece of dark chocolate.


What type of reminders are best for you?

Ultimately, the most effective method to remind yourself to take your medication will depend on your preferences. If you don’t often have your phone on hand around the house, using a reminders app may be less effective. Try a few different methods and see which one works best for you.


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How to prepare for a video call with a doctor

With the COVID-19 pandemic accelerating the use of telemedicine, virtual calls with a doctor are becoming increasingly more popular. It’s a safer alternative to in-person visits and patients can connect to a healthcare provider right from the comfort of their own homes—talk about convenience! Depending on your location and laws applicable to your state, doctors may prescribe certain medications through video calls.

For many people who are new to online appointments with a doctor or have been accustomed to visiting in person, a video call may seem daunting. In this article, we provide tips on how you can prepare effectively for a video appointment with your doctor.

Are you nervous about your virtual appointment with your doctor?

Some people may feel more anxious when speaking over the phone or through a video call. This is perfectly normal. Here are some things to remember when preparing to speak to a doctor online:

  • Understand that your doctor is there to listen and help you.
  • While you and your doctor may not be physically in the same space, using a camera and being able to see each other can make the experience feel more personal.
  • Preparing what you want to say ahead of time can help mitigate stress.
  • Keep a glass of water beside you.

What equipment will you need for a video call with a doctor?

For many virtual appointments, you’ll need a way to view your doctor on screen with a smartphone, tablet, laptop, or computer. If you’d like to be on-screen as well so your doctor can see you, make sure your device has a usable webcam and microphone.

Here’s our pro tip! Be sure to test your webcam and microphone before heading into your virtual doctor’s appointment. After all, your online time with your doctor should be about you and your health—not troubleshooting technical issues.

For privacy reasons, you may also want to consider using headphones or earbuds to keep the conversation more private.

On the day of your appointment, check to see if your device has a full battery. We recommend keeping your device plugged in if possible.

Where should I have my video call with my doctor?

For your doctor’s appointment, choose a location that is quiet and private. This allows you to speak freely and hear what your doctor is saying.

If you’ll be on camera, choose a well-lit location with a strong Wi-Fi signal so that you don’t run into any issues with your internet connection.

In terms of your internet, connect to a secure Wi-Fi channel to ensure that your data is protected.

Here’s our pro tip! While a virtual call can technically be held anywhere, we wouldn’t recommend going to a public space like a library or cafe. You may need to rely on public Wi-Fi, which is not as secure.

Preparing for your virtual call with your doctor

Before heading into your appointment, we highly recommend writing down questions or topics you want to cover with your doctor. This can help steer the conversation and ensure you’re getting the information you need.

Here’s our pro tip! Add an open-ended question at the end, such as “Is there anything else I need to know?” Your doctor might bring up topics you missed on your own list.

If you are taking any medication or are using any medical devices, have these next to you in case you want to show your doctor. On a similar note, have any information related to your medical history and health or insurance nearby in case you or your doctor needs to refer to it.

For video calls that deal with external or skin-related issues, take a high-resolution photo and send these to your doctor ahead of time. Holding your arm up to your webcam, for example, will be less effective since the video may appear blurry.

Whether you’re using a phone or a laptop, shut down other programs you may be using. Having these run in the background of your virtual doctor’s appointment may hinder the speed and quality of your video.

During your virtual call with your doctor

Don’t be afraid to take notes or ask your doctor to repeat themselves. If you need your doctor to slow down, let them know. A less stable internet connection means you or your doctor may cut out at times, making it harder to follow the conversation.

If someone else is in the room who will be listening to the conversation, let your doctor know beforehand. In most cases, having another person with you during your doctor’s appointment is perfectly fine.

Make the most out of your virtual doctor’s appointment

As a service, telemedicine has been around for decades, but in recent years, innovations in technology have improved the accessibility and quality of online healthcare.

Are you ready to connect to a doctor online about birth control pills or prenatal vitamins? Click here to get started!

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