Cramps while on the pill

Hi,
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She can experience usual period like symptoms and spotting during her expected period time (if she has skipped the placebo pills in her first pill pack use) as the body needs to get adjusted to the hormonal changes caused by the pill use. Since most of the hormonal contraceptives start giving effective protection after 2-3 weeks, she would be at risk for pregnancy if having unprotected intercourse during first 2-3 weeks of getting started on the hormonal birth control pills. Wait and watch for her periods. If she has already started her next pill pack use, the periods/withdrawal bleeding would occur around the placebo pill use or end of the pill pack (if she is not pregnant). Look out for development of any new symptoms if pregnancy is suspected. She should visit her gynecologist for further evaluation and assistance if she does not get her periods within 10 days of expected period dates, or gets abnormal bleeding. If pregnancy gets ruled out and if you are not ready for pregnancy, but intend to remain sexually active, you should consider getting her started on suitable regular birth control measures to be protected (after her periods). She should be regular with birth control use as instructed. Avoid having unprotected sexual contact if you are not ready for pregnancy. She should stop the use of hormonal contraceptive if pregnancy is suspected, or if pregnancy gets confirmed.
Take care.