Dr D A Ware · Dr G V Price · Dr J A Crane · Dr G A Preest· Dr O Thomas
There are two main types of pill - The combined oral contraceptive ("The Pill") and the progesterone only pill ("The Mini Pill"). This information applies only to the combined oral contraceptive. The information given here does not apply to the progesterone only pill (or "Mini Pill").
This page is meant to supplement the information given with your packet of pills. You are strongly advised to read the information leaflet provided with your packet of pills. If you have any concerns or doubts about taking the pill, you should discuss these with your doctor before starting the pill. You should be aware of, and be prepared to accept, all the benefits and risks of taking the pill - if you are not, then you should consider a different means of contraception.
Advantages Disadvantages How to start After having a baby Reduced effectiveness Review Stopping the pill Forgotten pills
What are the
advantages of the pill?
It’s a very effective means of
contraception! Your monthly bleed should be lighter, less painful and very
regular. Certain tumours (e.g. ovary) are less common in pill takers. It
may help some women who are prone to cysts on the ovary. If you want to postpone
your monthly bleed (e.g. going on holidays) then you could take one packet
immediately after another - without the usual 7 day break - and you can avoid
having a bleed (in other words, by taking 2 packets in a row without a break in
the middle). This can only be done with a "monophasic" pill such as
"Microgynon". It may not work with "triphasic" pills (e.g.Logynon) and
does not work with "ED" formulations (see below). There are
ways of postponing periods with triphasic and ED formulations but it is a little
more complicated and involves substituting certain tablets with others in the
packet. If you would like to postpone a period, then it would be wise to discuss
the matter with your Doctor beforehand.
What are the
disadvantages?
Smoking is even more dangerous
if you are taking the pill. Blood clots (thrombosis) are very rare but they
occur more often in pill taking women than those who do not take the pill (but
the highest risk of thrombosis is for pregnant women). For a full list of side
effects, please read the leaflet that comes with your pill. The approximate risk
of DVT for non-pill taking women is around 5 per 100,000 (i.e. 5 women out of
100,000 will have a clot). If you take the pill, your risk is between 15 and 30
per 100,000. However, the highest risk is in pregnancy when it is 70 per
100,000. In other words, if you are sexually active and either not using
contraception or using ineffective contraception you may find yourself pregnant
and subsequently at a higher risk of blood clots than if you were on the pill!
If you are going to be inactive (either by going on a long car journey, flight
abroad or recovering from an operation etc.), then being on the pill does
slightly increase your risk of DVT or "Deep Vein Thrombosis". You may wish to
discuss this with your Doctor beforehand. You may reduce this risk by drinking
plenty of water to avoid dehydration, wearing compression stockings, taking
aspirin and exercising your calf muscles regularly during the flight. You may be
advised by your Surgeon to stop the pill several weeks before an operation.
How and when do I start?
Your packet of pills will contain 21
tablets. You can start the pill on any day of your monthly cycle. It is
better to start your pill on the first day of your cycle (i.e. the day you start
your period) because it will provide immediate contraceptive cover if you start
your pill then. If you start your pill at any other time of your cycle, it will
take a week for the contraceptive action to take effect - so you should abstain
or use alternative contraception (e.g. condoms) for that first week.
Whatever day you decide to start your packet, you will then take a pill every day for 21 days. After that 21 days, you will have 7 days without taking any pills, before starting the next packet. You should start the next packet 28 days to the day after starting the previous packet. For example, if you start your pill on a Thursday you will then have 21 days of taking the pill followed by a pill free week. You would start the next packet on the Thursday that is exactly 4 weeks after you started the previous packet. You will bleed during the pill free days.
Some women find it confusing to take a pill for 21 days followed by a week off. For this reason, doctors may prescribe a type of pill packet that contains 21 active tablets followed by 7 blank tablets. These women still have a "week off" in between packets, although they don’t realise it because the last 7 tablets are blanks - they simply take a pill every day. This type of pill packet is called an "ED" pill and contains the letters "ED" after the name of the pill e.g. "Logynon ED" (but there is also a "non-ED" form of Logynon!).
After having
a baby.....
If you’re breast-feeding, you should not
take the combined oral contraceptive pill (but you can take the "mini pill").
Providing you are not breast-feeding and you have discussed the matter with your
doctor, it is usually safe to start after the 21st day following
birth. You do not need to wait for a period before you start.
Are there any circumstances when the pill
might not work?
Your pill is absorbed from the stomach. If
you have a bout of diarrhoea or vomiting, your pill will not have time to be
absorbed and may not work (but you must continue to take your pills all the
same). Any new medicines, especially antibiotics, may stop the pill from
working. You should not stop taking your pill during these instances, but you
should take extra precautions (e.g. not having intercourse or using condoms in
addition to your pill).
How often do I need to
see my doctor?
The first time you are given the pill,
you will usually be given 3 months supply to try. When you return for review
after 3 months your doctor will check your blood pressure and suggest you have a
smear test (if you are due to have one or if you have not had one in the past).
If all is well, you will be given 6 months supply and you should return every 6
months for a fresh supply and blood pressure check - but please don’t wait until
you have run out before booking an appointment! It is not appropriate to
use up an emergency appointment to renew your supply. You will only need a
"smear test" if you are over 20yrs old. Normal smears are repeated every 3 years
(sooner if there is any abnormality or if closer monitoring is required).
How long will it take to get pregnant if I
stop my pill?
Taking the pill does not affect future
fertility. Your ovaries will normally "wake up" and start releasing
eggs again ("Ovulation") within seven days of stopping the
pill. All other factors being normal, you can become pregnant as soon as you
stop taking the pill. There are many factors that can lead to infertility, but
"having been on the pill in the past" does not seem to be one of them!
What happens if I forget
to take one of my pills?
The golden rule is this - take it as soon
as you remember and do not stop taking the rest of your pills, even if
that means taking the forgotten pill and the next scheduled pill at the
same time. It takes seven continuous days of pill taking to put your ovaries
back to sleep again.
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Less than 12 hours late: Provided you remember, and take, your forgotten pill within 12 hours of the scheduled time you will be safe. |
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More than 12 hours late: If you are more than 12 hours late, consider yourself at high risk of becoming pregnant. Take the forgotten pill as soon as you remember and don’t stop taking the rest of your pills, even if this means taking your forgotten pill and the next pill at the same time. However, it will take seven continuous days of pill taking for the pill to regain its contraceptive effect. If you are at the end of your packet (e.g. only 2 pills left in the packet) and unable to take seven continuous days of pill taking, start your next packet immediately (without the usual 7 day break). That way, you can take 7 days of continuous pill taking and should regain contraceptive cover a week after your forgotten pill. Of course, if you take 2 packets in a row, you may not have a period in the middle. Don’t worry, this will cause no harm (in fact, your doctor may advise you to do this if ever you wish to postpone a period e.g. going on holidays). |
What happens if I forget an "ED" pill?
Women taking the "ED" type of pill need to
take a pill every day without a break. The last 7 pills in each packet are
inactive, so if you forget one of these, it doesn’t matter! If you forget any of
the other pills in the packet you should use additional contraception (e.g.
condoms) until you can discuss the matter with your doctor by booking to see him
during the next routine surgery.
If in doubt, you must use another means of contraception (e.g. condoms) and book a routine appointment to see your doctor during normal daytime surgery opening hours.
This page has been amended and information added by Dr G A Preest in June 2001 in response to e-mail enquiries and questions from patients. Thank you for all your helpful comments and feedback.
We will add to this page, depending on feedback from our patients. We regret that we cannot answer individual or personal questions online.
The information contained on this site is general information which is not in any way intended to replace the specific advice that patients may obtain from their own doctor about individual care.