Combined Contraceptive Pill Patient Information
What is a combination contraceptive pill?
It is a combination of two female sex hormones that prevents pregnancy by changing the hormone balance in your body to stop ovulation (the monthly release of the egg from the ovary). There are 28-day and 21-day packets, the only difference being the 7 inactive ‘sugar’ pills in the 28-day packet.
How effective is a pill?
If taken according to instructions, it is at least 99% safe.
When are you safe?
The pill will prevent pregnancy after you have taken the first 7 active pills in a row.
How is it commenced?
This varies according to the type of pill prescribed, so follow the instructions that come with the pill packet. It is usual to start the 28-day pack on the 1st day of bleeding of your next period and the 21-day pack on the 5th day of your cycle or on a particular day (e.g. Saturday) after your next period starts.
When and how is it taken?
The tablet should be swallowed whole with a small amount of water. It does not matter what time of the day you take it, but once a time has been chosen it is important to get into the habit of taking the pill at the same time (e.g. after breakfast or at bedtime). To be effective to stop pregnancy, the pill must be taken at a regular time.
What if the pill is missed or taken late?
The tablet should be swallowed whole with a small amount of water. It does not matter what time of the day you take it, but once a time has been chosen it is important to get into the habit of taking the pill at the same time (e.g. after breakfast or at bedtime). To be effective to stop pregnancy, the pill must be taken at a regular time.
The 7 days rule:
- Take the forgotten pill as soon as possible, even if it means taking two pills in one day
- Take the next pill at the usual time and finish the course
- If you forget to take the missed pill for more than 12 hours after the usual time, there is an increased risk of pregnancy and so you should use another form of contraception (such as condoms) for 7 days
- If these 7 days run beyond the last hormone pill in the packet, miss out the inactive pills (or 7-day group) and proceed directly to the first hormone pill in the next pack
How does it affect periods?
Periods tend to become shorter, regular and lighter. The blood loss may be the brownish colour of old blood. The pill also tends to stop painful periods.
Is the break from the pill necessary?
There is no reason to take a break from the pill. It is best to continue on until pregnancy is contemplated.
What if a period is missed?
If you miss a period, you should continue taking the pill but check with your doctor to exclude pregnancy.
Is it safe during lactation?
The pill can interfere with the quantity and quality of breast milk, and so it is better to use other contraception during breastfeeding. If a pill is used, the most appropriate is a progestogen-only pill.
What are unwanted side effects of the pill?
The most common side effects are nausea (feeling sick), breast tenderness and breakthrough spotting (i.e. bleeding between your usual periods). These side effects tend to disappear after a couple of months on the pill. Other side effects include vaginal thrush (which causes itching), discolouration of the skin and feeling depressed. More serious (although uncommon) effects include migraine headaches, high blood pressure and a tendency to form clots in the veins. To check if you should not take the pill, refer to the instruction leaflet that comes with the pill, or consult your doctor. Some women feel better when taking the pill, and their skin and hair condition can improve. A special pill can be used if you have acne.
Can I drink alcohol or take other drugs while on pill?
Alcohol in moderation does not appear to interfere with the pill. Medications that can reduce the effectiveness of the pill include antibiotics, vitamin C and drugs to treat epilepsy and tuberculosis. The pill may affect blood-thinning and antidiabetic preparations. Check with your doctor. If you are taking antibiotics, continue the pill, use another contraceptive method during the course and follow the 7-day rule when the course is finished.
What are rules to follow while on contraceptive pill?
- Smoking creates a health risk with the pill, and so you should not smoke.
- Make sure you tell a doctor if you are taking the pill when other medicine is about to be prescribed.
- Diarrhoea and vomiting may reduce the effectiveness of the pill—use additional contraception until you finish that particular course. (Follow the 7-day rule.)
- Report persistent or heavy bleeding between periods.
- Report any onset of blurred vision, severe headache or pain in the chest or limbs.
- Return for a checkup every 12 months while you are on the pill.
- Perform breast self-examination regularly and have a smear test every 2 years.
- Remember that the pill is highly effective, but pregnancy can occur if the pill is taken at irregular times, if intercurrent illnesses such as fever and gastric upsets develop, or if you are taking some other drugs.
