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Things to consider
Using contraception effectively
Missed pills and extra pills
The combined oral contraceptive pill is often just called "the pill". It contains artificial versions of female hormones oestrogen and progesterone, which are produced naturally in the ovaries. If sperm reaches an egg (ovum), pregnancy can happen. Contraception tries to stop this happening usually by keeping the egg and sperm apart or by stopping the release of an egg (ovulation). Credit: Kumar Sriskandan / Alamy Stock Photo https://www.alamy.com/stock-photo-a-selection-of-contraceptive-pills-for-female-contraception-uk-17868589.html?pv=1&stamp=2&imageid=E45CED51-AEF3-414B-9C55-89B37D1D3FD5&p=11411&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3Dbar%26st%3D0%26sortby%3D2%26qt%3DB11YFW%26qt_raw%3DB11YFW%26qn%3D%26lic%3D3%26edrf%3D0%26mr%3D0%26pr%3D0%26aoa%3D1%26creative%3D%26videos%3D%26nu%3D%26ccc%3D%26bespoke%3D%26apalib%3D%26ag%3D0%26hc%3D0%26et%3D0x000000000000000000000%26vp%3D0%26loc%3D0%26ot%3D0%26imgt%3D0%26dtfr%3D%26dtto%3D%26size%3D0xFF%26blackwhite%3D%26cutout%3D%26archive%3D1%26name%3D%26groupid%3D%26pseudoid%3D%7BA883FDE5-7F3D-4472-81F5-B61111916852%7D%26userid%3D%26id%3D%26a%3D%26xstx%3D0%26cbstore%3D1%26resultview%3DsortbyPopular%26lightbox%3D%26gname%3D%26gtype%3D%26apalic%3D%26tbar%3D1%26pc%3D%26simid%3D%26cap%3D1%26customgeoip%3D%26vd%3D0%26cid%3D%26pe%3D%26so%3D%26lb%3D%26pl%3D0%26plno%3D%26fi%3D0%26langcode%3Den%26upl%3D0%26cufr%3D%26cuto%3D%26howler%3D%26cvrem%3D0%26cvtype%3D0%26cvloc%3D0%26cl%3D0%26upfr%3D%26upto%3D%26primcat%3D%26seccat%3D%26cvcategory%3D*%26restriction%3D%26random%3D%26ispremium%3D1%26flip%3D0%26contributorqt%3D%26plgalleryno%3D%26plpublic%3D0%26viewaspublic%3D0%26isplcurate%3D0%26imageurl%3D%26saveQry%3D%26editorial%3D1%26t%3D0%26edoptin%3D At a glance: the combined pill
How the combined pill worksHow it prevents pregnancyThe pill prevents the ovaries from releasing an egg each month (ovulation). It also:
The pill is over 99% effective if used correctly. Other methods of contraception are better at preventing pregnancy, such as the IUD, IUS, implant and injection. There are many different brands of pill, made up of 3 main types: Monophasic 21-day pillsThis is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then no pills are taken for the next 7 days. Microgynon, Marvelon and Yasmin are examples of this type of pill. Phasic 21-day pillsPhasic pills contain 2 or 3 sections of different coloured pills in a pack. Each section contains a different amount of hormones. One pill is taken each day for 21 days and then no pills are taken for the next 7 days. Phasic pills need to be taken in the right order. Logynon is an example of this type of pill. Every day (ED) pillsThere are 21 active pills and 7 inactive (dummy) pills in a pack. The two types of pill look different. One pill is taken each day for 28 days with no break between packets of pills. Every day pills need to be taken in the right order. Microgynon ED is an example of this type of pill. Follow the instructions that come with your packet. If you have any questions, ask a doctor, nurse or pharmacist. It's important to take the pills as instructed, because missing pills or taking them at the same time as certain medicines may make them less effective. How to take 21-day pills - standard regime
How to take every day pills
Tailored regimesYou can also take the combined pill as a tailored regime. This may include taking the pill for 21 days and stopping for 4, or taking the pill continuously without a break. For more information speak to a doctor or nurse. Starting the combined pillYou can normally start taking the pill at any point in your menstrual cycle. There is special guidance if you have just had a baby, abortion or miscarriage. The guidance may also be different if you have a short menstrual cycle. Get advice from a doctor or nurse if you need it. You may need to use additional contraception during your 1st days on the pill – this depends on when in your menstrual cycle you start taking it. Starting on the 1st day of your periodIf you start the combined pill on the 1st day of your period (day 1 of your menstrual cycle) you will be protected from pregnancy straight away. You will not need additional contraception. Starting on the 5th day of your cycle or beforeIf you start the pill on the 5th day of your period or before, you will still be protected from pregnancy straight away. Starting after the 5th day of your cycleYou will not be protected from pregnancy straight away and will need additional contraception until you have taken the pill for 7 days. If you start the pill after the 5th day of your cycle, make sure you have not put yourself at risk of pregnancy since your last period. If you're worried you're pregnant when you start the pill, take a pregnancy test 3 weeks after the last time you had unprotected sex. What to do if you miss a pillIf you miss a pill or pills, or you start a pack late, this can make the pill less effective at preventing pregnancy. The chance of getting pregnant after missing a pill or pills depends on:
Find out what to do if you miss a combined pill. Vomiting and diarrhoeaIf you vomit within 3 hours of taking the combined pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time. If you continue to be sick, keep using another form of contraception until you've taken the pill again for 7 days without vomiting. Very severe diarrhoea (6 to 8 watery poos in 24 hours) may also mean that the pill does not work properly. Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea and for 2 days after recovering. Speak to a GP or nurse or call NHS 111 for more information, if your sickness or diarrhoea continues. Who can use the combined pillIf there are no medical reasons why you cannot take the pill, and you do not smoke, you can take the pill until your menopause. However, the pill is not suitable for everyone. To find out whether the pill is right for you, talk to a GP, nurse or pharmacist. The pill may not be right for you if you:
The pill may also not be right for you if you have (or have had):
After having a babyIf you have just had a baby and are not breastfeeding, you can most likely start the pill on day 21 after the birth but you will need to check with a doctor. You will be protected against pregnancy straight away. If you start the pill later than 21 days after giving birth, you will need additional contraception (such as condoms) for the next 7 days. If you are breastfeeding, you're not advised to take the combined pill until 6 weeks after the birth. After a miscarriage or abortionIf you have had a miscarriage or abortion, you can start the pill up to 5 days after this and you will be protected from pregnancy straight away. If you start the pill more than 5 days after the miscarriage or abortion, you'll need to use additional contraception until you have taken the pill for 7 days. Advantages and disadvantagesSome advantages of the pill include:
Some disadvantages of the pill include:
The combined pill with other medicinesSome medicines interact with the combined pill and it does not work properly. Some interactions are listed on this page, but it is not a complete list. If you want to check your medicines are safe to take with the combined pill, you can:
AntibioticsThe antibiotics rifampicin and rifabutin (which can be used to treat illnesses including tuberculosis and meningitis) can reduce the effectiveness of the combined pill. Other antibiotics do not have this effect. If you are prescribed rifampicin or rifabutin, you may be advised to change to an alternative contraceptive. If not, you will need to use additional contraception (such as condoms) while taking the antibiotic and for a short time after. Speak to a doctor or nurse for advice. Epilepsy and HIV medicines, and St John's wortThe combined pill can interact with medicines called enzyme inducers. These speed up the breakdown of hormones by your liver, reducing the effectiveness of the pill. Examples of enzyme inducers are:
A GP or nurse may advise you to use an alternative or additional form of contraception while taking any of these medicines. Risks of taking the combined pillThere are some risks associated with using the combined contraceptive pill. However, these risks are small. Blood clotsThe oestrogen in the pill may cause your blood to clot more readily. If a blood clot develops, it could cause:
The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors before prescribing the pill. CancerThe pill can slightly increase the risk of developing breast cancer and cervical cancer. It can also decrease the risk of developing womb (uterus) cancer, ovarian cancer and bowel cancer. However, 10 years after you stop taking the pill, your risk of breast cancer and cervical cancer goes back to normal. Where you can get the combined pillContraception is free to everyone through the NHS. Places where you can get contraception include:
Find a sexual health clinic How do I change to a different pill?If you want advice about changing your contraceptive pill, you can visit a GP, contraceptive nurse (sometimes called a family planning nurse), or sexual health clinic. You should not have a break between different packs, so you will usually be advised to start the new pill immediately or wait until the day after you take the last of your old pills. You may also be advised to use alternative methods of contraception during the changeover, as the new pill may take a short time to take effect. If you're under 16 years oldContraception services are free and confidential, including for people under the age of 16. If you're under 16 and want contraception, the doctor, nurse or pharmacist will not tell your parents (or carer) as long as they believe you fully understand the information you're given and your decisions. Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they will not make you. The only time that a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first. |