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Contraception has the objective of preventing pregnancy.
Get all your information about the best contraceptive
A woman may become pregnant when one of her eggs (ova) reaches a man’s sperm.
Contraception attempts to avoid this, by:
Keep egg and sperm separate
Stop yielding eggs
Stopping the sperm and egg (fertilized egg) that are bound to the womb lining
You will find one that fits you best, with 15 methods to choose from.
Barrier methods, such as condoms, are a form of contraception that helps protect against both sexually transmitted and pregnancy infections.
No matter what other contraception you use to prevent pregnancy, you should use condoms to protect both your sexual health and your partner’s.
Don’t be put off if the first form you ‘re using isn’t quite correct: try another one.
Different contraception methods:
l condoms (female)
diaphragms intrauterine device (IUD)
intrauterine system (IUS)
natural family planning
There are 2 permanent methods of contraception:
male sterilisation (vasectomy)
This includes services for people under the age of 16, so long as they are mature enough to understand the information involved and the decisions.
There are specific requirements for workers in the healthcare sector who deal with people under 16
The oral contraceptive pill combined is commonly labelled “the pill” This includes artificial copies of oestrogen and progesterone female hormones which are naturally released by women in their ovaries.
A woman may become pregnant when one of her eggs (ova) reaches a man’s sperm. Contraception typically attempts to avoid this by holding the egg and sperm separate, or by preventing an egg (ovulation) from releasing.
Combined pill – A good contraceptive?
At a glance: The pill combined
The pill is more than 99 per cent effective in preventing pregnancy when taken correctly. This means that within one year, less than one woman in 100 who uses the combination pill as contraceptive would become pregnant. Other methods are more effective, such as the IUD, implant, and injection.
The normal way to take the pill is to take one for 21 days a day, then quit for seven days and you have a bleed-type period during this week. After seven days you start taking the pill once again.
Every day you need to take the pill roughly the same time. When you do not, or if you miss a pill, or cough, or get serious diarrhoea, you might get pregnant.
Some medicines may make the pill less effective. If you are taking any other tablets check with your doctor.
If you have long periods or painful periods, the combined pill can help with PMS (premenstrual syndrome), or endometriosis.
Mood swings, nausea, breast tenderness and headaches are minor side effects.
There’s no evidence that women are getting weight from the pill.
Severe side effects, such as blood clots and cervical cancer, are very small in risk.
The combined pill is not appropriate for women over 35 who smoke, or for women with other conditions of health.
The pill does not protect you from sexually transmitted infections ( STIs), and using a condom would also help protect you from STIs.
How the pill works together
How it hinders pregnancy
The pill stops the ovaries from releasing an egg (ovulation) every month. It also includes:
Thickens the mucus in the womb ‘s neck, making it more difficult for the sperm to penetrate the womb and reach an egg
Thin the womb ‘s lining, because there’s less risk of a fertilized egg being inserted into the womb and rising
If used correctly, the pill is more than 99 per cent effective. Many women find it hard to take the pill at the same time every day and if not done correctly it is less successful. Other forms of contraception, such as IUD, IUS, implant and injection, are ideal for avoiding pregnancy.
There are many different pill brands, composed of three main types:
21 Day Monophasic Pills is another type of contraceptive
This is the most common form. Every pill has the same hormone content in it. One pill is taken for 21 days each day and no pills are then taken for the next seven days. Sources of this type of pill include Microgynon, Marvelon, Yasmine, and Cilest.
21-day phasic pills
Phasic pills contain two or three sections of pills in a pack of different colours. Each segment has different hormone content. One pill is taken for 21 days each day and no pills are then taken for the next seven days. Phasic pills have to be taken in the correct order. Logynon is an example of such pill type.
Pills every single day (ED)
There are 21 active pills in a box and seven inactive (dummy) pills. The two-pill types are different in appearance. One pill is taken for 28 days each day, without any break between pill packets. Pills need to be taken in the correct order each day. Microgynon ED is one such example of pill type.
Follow the instructions the packet comes in with. Ask your GP, nurse practitioner or pharmacist if you have any questions.
Taking the pills as directed is important since missing pills or taking them at the same time as certain medicines can make them less effective.
How to take pills within 21 days
Take the first pill or the first pill of the first colour (phasic pills) from the package labelled with the right day of the week.
Continue taking a pill every day at the same time until the pack is finished.
Stop taking pills for seven days (you will get a bleed over these seven days).
The eighth day, start your next pack of pills, whether you are still bleeding or not. This should be the same weekday as when you were taking your first pill.
How to take pills every single day
Take the first pill from “start” section of the packet This is set to be an active pill.
Start taking a pill every day, in the appropriate order and ideally at the same time every day, until the pack is full (28 days).
You will get a bleed within seven days of taking the inactive pills.
Start your next pack of pills, whether you are still bleeding or not after you have finished the first.
Start the Combined Pill as a contraceptive
Many women, in their menstrual cycle, will start the pill at any time. If you have just had a pregnancy, an abortion or a miscarriage, there is special guidance.
During your first days on the pill you will need to use extra medication-this depends on when you start using it in your menstrual cycle.
Beginning from the first day of your time
If you start the combined pill on the first day of your period (one day of your menstrual cycle) you’ll be immediately protected from pregnancy. You won’t need supplementary contraception.
Begins on or before the fifth day of your cycle
If you start the pill on or before the fifth day of your period you will still be immediately protected from pregnancy, unless you have a short menstrual cycle (your period is every 23 days or less). When you have a short menstrual period, you will require extra contraceptives, such as condoms, within seven days after taking the pill.
Beginning after the 5th day of your cycle
You won’t be automatically safe from abortion and will require extra protection once you have taken the pill for seven days.
If you start the pill after the fifth day of your cycle make sure that since your last period you have not put yourself at risk of pregnancy. If you’re concerned about getting pregnant before you start the pill, take a three-week pregnancy test after the last time you’ve had unprotected sex.
Taking pill back and forth
Find out more on taking back-to-back pill packs.
What should you do if you miss a pill
This may make the pill less effective in preventing pregnancy if you miss a pill or pills, or you start a pack late. The chance to become pregnant after lacking a pill or pill depends on:
When you miss the pills
How many missing pills
Figure out what you can do if you miss a pill.
Diarrhoea, vomiting and contraceptive
If you vomit a combined pill within two hours of taking it, it might not have been completely absorbed into your bloodstream. Directly take another pill and the next one at your usual time.
If you happen to be sick, happen using another method of contraception until you have taken the pill once again without vomiting for seven days.
Very severe diarrhoea (six to eight watery stools within 24 hours) can also mean the pill is not working properly. Keep taking your pill as normal, but use additional contraception, such as condoms, when you have diarrhoea and after recovery, for two days.
Talk to your GP or contraceptive nurse for more information or call NHS 111 if your sickness or diarrhoea continues.
Who can use the Pill Combined
When you can’t take the pill for any medical reasons and you don’t smoke, you can take the pill before the menopause. The pill isn’t ideal for all women, however. To find out if the pill is right for you, talk to your GP, nurse practitioner or pharmacist.
If you don’t take the pill you should:
Are you pregnant
Smoke, and older than 35
Arrested smoking less than a year ago and older than 35
Was highly overweight
Take certain medicines (ask your GP or health care professional about that at a contraceptive clinic)
Remember, if you have (or had): you will not take the tablet.
Thrombosis (a blood clot) in the vein, e.g. in the leg or lungs
Stroke or any other disease that restricts the arteries
Anybody in your family who has a blood clot below 45 years of age
A heart defect or cardiac disease like elevated blood pressure
Severe migraines, particularly with aura (symptoms of warning)
Cancer of the breast
Gallbladder disease or liver disease
Complicated Diabetes or Diabetes for the past 20 years
Having had a newborn
If you’ve just had a baby and don’t breastfeed, you will most likely start the pill after birth on day 21 but you’ll have to check with your doctor. Immediately, you’ll be protected against pregnancy.
If you start the pill within 21 days of giving birth, you will need additional contraception for the next seven days (such as condoms).
If you are breastfeeding, it’s not recommended that you take the combined pill until six weeks after birth.
After abortion or miscarriage
If you have had an abortion or miscarriage, you will start the pill up to five days after that and you will be automatically safe from pregnancy. If you start the pill after the miscarriage or abortion longer than five days, you will continue to use extra contraceptives before you have taken the pill for seven days.
Benefits and Drawbacks
Some of the pill ‘s advantages include:
Not interrupting sex
The bleeds are normally normal, lighter and less painful
It lowers your risk of ovary, womb and colon cancer
It may reduce PMS (premenstrual syndrome) symptoms;
Sometimes, it can reduce acne
Can protect against inflammatory pelvic disease
It can reduce the risk of fibroids, ovarian cysts and breast cancer
Some of the pill’s downsides include:
It may initially cause temporary side effects, such as headaches, nausea, breast tenderness and mood swings – if these do not occur after a few months, it may help change to another pill
It will raise your blood pressure
This will not protect you from sexually transmitted infections
Breakthrough bleeding and spotting are common in the first few months after the pill is used
This has been associated with an increased risk of some serious healing
By thickening the mucus in the cervix, the “traditional” progestogen-only pill (POP) prevents pregnancy to avoid sperm from entering an embryo.
The progestogen-only desogestrel pill will avoid ovulation, too.
Progestogen-only pills contain the progestogenic hormone but do not contain oestrogen.
You need to consistently take the progestogen-only pill every day.
At a glance: Progestogen-only pill facts
When taken correctly, it is successful at more than 99 per cent. This means fewer than 1 in 100 women who use the progestogen-only pill as contraception will become pregnant in 1 year.
For “typical use” of the progestogen-only pill (the way many people take it in real life), it is effective by around 92 per cent.
Each day you take a pill, with no break between drug packs.
Women who can’t use contraception that contains oestrogen can use the progestogen-only pill.
If you are over 35, and you smoke, you can take the progestogen-only pill.
Every day you need to take the progestogen-only pill at the same time. It may not be effective if you take it more than 3 hours late (traditional progestogen-only pill)-or 12 hours late (desogestrel pill).
Whether you’re sick (vomit) or have serious diarrhoea, the pill alone in progestogen may not work.
Many medicines can affect the effectiveness of the progestogen-only pill-ask for specifics from your doctor.
Your cycles can stop or become more frequent, irregular or lighter.
Side effects can include spotty skin and tenderness to the breast – these will be evident in a few months ‘ time.
To protect against sexually transmitted infections (STIs), you’ll need to use both condoms and the progestogen-only pill.
How to take the pill just for progestogen
There are 2 different types of just progestogen pills:
3-hour prophylactic-only pill (traditional progestogen-only pill) – must be taken every day within 3 hours of the same time
Progestogen-only 12-hour pill (desogestrel progestogen-only pill) – must be taken every day within 12 hours of the same time
Follow the instructions that come with your packet of pills – missing pills or taking the pill with other drugs will minimize their effectiveness.
One box of progestogen-only pills contains 28 tablets. Each day you need to take 1 pill within either 3 or 12 hours of the same time , depending on which form you are taking.
There is no break between packs of pills-you start the next one the next day when you finish a pack.
Start the first pill-pack
Choose an ideal time in the day to take your first pill
Keep taking a pill at the same time every day before the pack is ready
Start your next pill pack the next day-there ‘s no break between pill packs
Within your menstrual cycle you can start the progestogen-only pill at any time.
If you start your menstrual cycle on day 1 to 5 (the first 5 days of your period), it will work straight away and you will be protected from pregnancy. You don’t need any contraceptives.
If you have a short menstrual cycle, additional contraception, such as condoms, will be needed until you have taken the pill for 2 days.
If you start the progestogen-only pill on any other day of your cycle you will not be immediately protected from pregnancy and need additional contraception until you have taken the pill for 2 days.
Having had a newborn
If you’ve just had a baby, you should start the progestogen-only after birth pill on day 21. You will be covered from pregnancy immediately.
If you start the progestogen-only pill after giving birth more than 21 days, use additional contraception such as condoms until you have taken the pill for 2 days.
During abortion or miscarriage
If you have had an abortion or miscarriage, you can start the progestogen-only pill up to 5 days later and you’ll be immediately protected from pregnancy.
If you start the pill more than 5 days after an abortion or miscarriage, use additional contraception until you have been taking the pill for 2 days.
How would you do if you lose a pill
Forgetting to take a progestogen-only pill depends on what you should do:
Form of pill that you take
How long have you missed this pill
How many pills did you forget to take
If you have had sex in the previous 7 days without using any form of contraceptive
If you take the pill in less than 3 or less than 12 hours late
Whether you take a 3-hour progestogen-only pill and are taking it less than 3 hours late, or if you take the only 12-hour progestogen pill and are less than 12 hours late:
Taking the pill late as soon as you recall and
Take the other pills as usual, even if it means taking 2 pills the same day
The pill will still work, and you’ll be protected from pregnancy – you don’t have to use extra contraception.
Do not worry if you have sex without having to use another form of contraception. You don’t need contraceptives for emergencies.
If you take the pill more than 3 hours late or more
You will not be protected from pregnancy if you are taking a 3-hour progestogen-only pill and are taking it more than 3 hours late, or you are taking the 12-hour progestogen-only pill and are more than 12 hours late.
What should you do:
Take a pill as soon as you remember-just take one, even if you missed more than one pill
Take the next pill at the usual time – this may mean taking 2 pills the same day (1 if you remember and 1 at the usual time);
Continue taking your remaining pills at the usual time each day
Use extra contraceptives such as condoms for the next 2 days (48 hours) after you remember or don’t have sex with your missed pill.
When you have unsafe sex from the moment you drop your pill until 2 days after you consistently start taking it again, you will need emergency contraception – get advice from your contraceptive clinic or GP
Tell them you took a progestogen-only pill as this can affect which emergency contraception is best for you
For the progestogen-only pill, it takes 2 days to thicken cervical mucus, so that sperm can not get through or survive.
The Faculty of Sexual Health and Reproductive Healthcare suggests 2 days after you decide to take the pill, use extra contraceptives.
After you remember taking your pill, the patient information leaflet that comes with your pill might tell you to use condoms for the next 7 days. This is because the pill takes 7 days to stop you from ovulating.
Malaise and diarrhoea
If, within 2 hours of taking a progestogen-only pill, you are sick (vomit), it may not have been fully absorbed into your bloodstream. Directly take another pill and the next one at the normal time.
Use additional contraception, such as condoms, for 2 days (7 days for the 12-hour pill) if you do not take another pill within 3 (or 12 hours) of your normal time.
If you continue to be sick, continue to use another form of contraception, such as condoms, while you are ill, and after recovery for 2 days.
Quite serious diarrhoea-6 to 8 watery stools in 24 hours-can also mean the medication is not working properly.
Continue to take your pill as usual, but use extra contraceptives such as condoms if you have diarrhoea and for 2 days after recovery, or 7 days if you are taking a 12-hour pill
Who would use the progesterone-only pill as a contraceptive?
Most women are required to use the progestogen-only pill, but if you do:
Think you could be pregnant
Don’t want to change your periods
Take other medicines which could affect the pill
See unexplained bleeding after sex or between cycles
Have arterial or heart disease developed, or had a stroke
Have liver illness
Was breast cancer, or in the past
Have serious liver tumours or cirrhosis
If you are safe and there are no medical reasons why the progestogen-only pill should not be taken, you will take it before your menopause or until you are 55 years old.
If you are breastfeeding the progestogen-only pill is safe to use. You may get small amounts of progestogen into your breast milk, but this is not harmful to your infant. It doesn’t affect the way you produce breast milk.
Although it is very unlikely, while taking the progestogen-only pill, there is a very small chance you could become pregnant.
If this occurs there is no proof that the unborn baby would be affected by the drug. When you think you may be pregnant, speak to your GP or go to your nearest abortion clinic.
If you have a sudden or unusual pain in your tummy or your period is much shorter or lighter than usual, get medical counseling.
It is likely, but this is uncommon, that these are warning signs of an ectopic pregnancy.
Benefits and Drawbacks
It’s not about interrupting sex
You can use that when you breastfeed
It’s helpful if you can’t take the combination pill, contraceptive patch and vaginal ring hormone oestrogen
You can use it at any age-even if you are over 35 years old and smoking
You may not have regular intervals while taking it – your intervals may be lighter, more frequent or may stop altogether and you may spot between intervals
That won’t stop you from STIs
You have to recall taking it at or around the same time every day
Some medicines may make this less effective, including some (uncommon) antibiotics
Generally, the progestogen-only pill is well tolerated, and the side effects are minimal.
There are some side effects which include:
Breast tenderness and enlarged breast
Greater or lower sex drive
Migraine and Headache
nausea or vomiting
Small bags (cysts) filled with fluid on your ovaries are usually harmless and dissolve without treatment.
These side effects are most likely to take the progestogen-only pi during the first few months