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The combined pill, often just called ‘the pill’, contains two hormones similar to those produced naturally by the body, progestogen and oestrogen, which work to prevent pregnancy.
Contains oestrogen and progestogen
Usually helps with feeling low or anxious
No protection against STIs
Possible that others may see you take the pill
Can control when you have periods (which are likely to be lighter) and choose to stop them altogether
Lasts as long as you take it
Can reduce acne
More than 99% effective if used without mistakes
Requires a prescription from a doctor or nurse. You may have to use additional contraception for the first seven days depending where you are in your cycle.
Remembering to take a pill every day
ImportantMedical or family history, as well as certain lifestyle factors, might mean the pill isn’t suitable for some people.
The combined pill works to prevent pregnancy in three ways:
During your pill-free week, or when you are taking the placebo (dummy) pills, you may get a bleed. This isn’t a proper period, but is called a ‘withdrawal bleed’ and is caused by not taking hormones during this week. This can happen at any point during this week, and you should start your next pack on time whether or not you are still bleeding.There is also no harm in taking the pill back-to-back to avoid getting a withdrawal bleed. More about how to take the pillYou may experience bleeding when you first start taking the pill. This is very common, isn’t usually anything to worry about and should settle down within three months. If you are worried, talk to a doctor or nurse for advice.
As of December 2023, you may also be able to get the pill from a pharmacy without needing to see a doctor or nurse. You will need to have a consultation with a pharmacist before you can be prescribed the pill.
The combined pill is available free of charge from a range of services including contraceptive clinics, your GP, Brook and some pharmacies.
Contraception and sexual health services such as Brook are free and confidential, including for people under the age of 16. Health professionals work to strict guidelines and won’t tell anyone else about your visit unless they believe you’re at serious risk of immediate harm. Find out more about Brook’s confidentiality policy.
Before you can start on the combined pill you will usually be assessed by a nurse, doctor or in some cases a pharmacist. An appointment will typically include:
When you first start the combined pill you will usually be given a three month supply. Follow up appointments and reviews are then usually every 6-12 months providing there are no issues. You can return to the clinic at any time if you are worried about anything.
You will not be required to have an internal or breast examination for the combined pill.
If you start taking the combined pill in the first five days of your period, you will be protected against pregnancy straight away.
If you have a short menstrual cycle, where your period is normally 23 days or less, you will need to start taking the pill in the first four days to be immediately protected (because you might ovulate early).
If you start the pill at any other time in your menstrual cycle you will need to use additional contraception, such as condoms, for the first seven pill taking days.
This information does not apply to the combined pill Qlaira. If you use this pill you should contact a doctor or nurse if you are not sure how to take it or read the manufacturer’s instructions.
It’s possible to start on the combined pill after giving birth, a miscarriage or abortion but when it is safe to start on this method does vary.
You can become pregnant from as little as three weeks after giving birth. If you are not breastfeeding, it’s likely you can start the pill on day 21 after the birth (check with a doctor). If you start after week three (21 days), you will need to use alternative contraception for the first seven days.If you are breastfeeding, you’re not advised to take the combined pill until six weeks after the birth. After six weeks it is safe to do so.
You can become pregnant from two weeks after an abortion or miscarriage.If you start on the pill within five days of the abortion or miscarriage you are protected from pregnancy straight away Any later than day five and you will need to use additional contraception for the first seven days.
Always speak to your midwife, GP or nurse at a sexual health clinic to check this is the right method for you
How to take the combined pill:
Although there are many different brands of pill, there are three main types:
Always follow the instructions that come with the packet, paying careful attention to which medicines and antibiotics might affect it.
Factors impacting its effectiveness• Taking it more than 24 hours late• Vomiting within two hours of taking it • Very severe diarrhoea that lasts for more than 24 hours• Some medicines such as those used to treat epilepsy, HIV and TB and the complementary medicine St John’s Wort (If you are prescribed medication always say you are taking the combined pill)• Antibiotics used to treat STIs and antidepressants (Commonly used antibiotics do not reduce the effectiveness of the pill, but it is always best to check with the doctor, nurse or pharmacist first)Talk to a pharmacist, doctor or nurse and use additional contraception such as condoms until you know for sure your contraception is working to protect you from pregnancy.
If you have missed one pill, or if you have started the new pack one day late:
If you have missed two or more pills or if you have started the new pack two or more days late:
Finish the pack and begin a new one the next day (this means missing out the break or not taking the placebo tablets)
There is no evidence of weight gain with the combined pill.
Different contraceptive methods affect people differently. It is possible that contraception may increase or decrease your libido.
If this happens and you don’t like it, you can always stop and try another method. It’s all about finding the method that works for you.
For some, being on contraception in itself helps increase their libido as they have reduced anxiety around having sex knowing that they are protected from pregnancy.
You may experience some side effects of taking the pill in the first couple of months but these tend to be short-term. This is why, if you can, it’s best to trial a contraception method for at least three months before deciding it’s not for you.
There are different types of combined pill so you might find that another type of combined pill will suit you better. It’s a good idea to talk to a medical professional to discuss your options.
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