How to take the combined pill

There are different types of combined oral contraceptive pills such as Microgynon, Rigevidon, Loestrin 20, Mercilon, Femodette, Cilest, Yasmin, Brevinor.

How does it work?

The pill works by stopping the ovaries from releasing an egg. The mucus (discharge) made by the cervix becomes thicker to make it harder for sperm to get through. The lining of the uterus (womb) becomes thinner which makes it harder for a sperm and egg to stick.

There are different types of the pill  including 21 day pills, every day pills and 21 day pills with different coloured pills in the packet. It is important to take the pill in the way the doctor prescribing it tells you to.

There are 3 ways to take the combined pill:

• Traditional – where you take the pill for 21 days before having a 7 day break. Usually during these 7 days you will bleed but not always.
• Tricyclic – where you take the pill for 3 consecutive pill packets and then have a 4 to 7 day break. Usually you will bleed during the break.
• Continuous – where you take the pill packets back to back with no break. When you have a bleed you can then take a 4 to 7 day break.

How do I take the pill?

Choose a convenient time in the day to take your 1st pill. 1st thing in the morning is the best time for most people. It may be less effective if not taken at the same time everyday. You have up to 12 hours to take the pill if you do forget.

If you are starting the pill on the 5th day of your period or before, you will be protected from pregnancy straight away (unless your period is every 23 days or less). If you start after the 5th day of your period you will need to use extra contraception for 7 days, such as condoms.

If you miss 1 pill, take it as soon as you remember. You will still be protected from pregnancy if you don’t miss any other pills and continue to take your packet as normal.

If you have missed 2 or more pills, take the a pill as soon as you remember and use barrier contraception (such as condoms) for 7 days and continue to take your packet as normal.

If you are sick 2 to 3 hours after taking your pill, take another 1. If you continue to vomit or have severe diarrhoea (6 to 8 watery stools in 24 hours) use another form of contraception (such as condoms) for 48 hours after recovering.

Some medicines, including some (uncommon) antibiotics, can make the pill less effective and you may need additional contraception (such as condoms) while taking the antibiotic. Speak to your doctor or nurse for advice.

Are there any side effects?

Some people may experience side effects whilst taking the pill, these can include:

• feeling sick
• headaches
• sore breasts

These usually go away in a few days or weeks, but you can try using a different pill if they don’t.

More uncommon side effects are:

• Tiredness
• Oily or spotty skin
• Mood swings

Tell your doctor or nurse if you experience any of these for longer than 3 months.

Blood clots

Although very rare, the combined pill can increase the risk of blood clots. You can get these in your legs or lungs. If you experience:

• chest pain
• breathlessness
• swollen legs

Seek immediate medical attention.

How effective is it as contraception?

When taken correctly, the pill is over 99 percent effective. This means that fewer than 1 women in 100 will get pregnant in 1 year.

What are the pros and cons of the combined oral contraceptive pill?

Sexually transmitted infection

Remember, only a condom will protect you against sexually transmitted infections.