Combined Oral Contraceptive Pills

Ways to take the pill

1. Traditional 21/7 ( 3 weeks on, 1 week off)

The usual way to take the pill is to take one every day for 21 days, then stop for seven days, and during this week you have a period-type bleed. You start taking the pill again after seven days. Start your next pack of pills on the eighth day, whether you are still bleeding or not. This should be the same day of the week as when you took your first pill.

2. 84/7 (3 months on, 1 week off)

Take 3 packets of the pill back to back, when you come to the last pill in the third pack, stop for 7 days, during this week you will have a period-type bleed. Start a new pack after 7 days whether you are still bleeding or not and this should be the same day of the week as when you took your first pill.

3. Continuous pill taking

This is a new way of taking the pill. This is ‘off licence’ (ie: different from the instructions on the pack) but it has been supported by medical authorities in the UK and the W.H.O.

Take the pill every single day at the same time each day and when you finish a pack just continue straight onto the next pack without a break. You will stop having periods but if you do get some irregular bleeding (this is not unusual) just stop the pill for 4 days to have a bleed and then restart the pill taking the correct one for that day and leaving out the 4 unused pills. If the bleeding continues for at least a month you should see your GP.

When do I start taking the pill?

Day 1 is the first day you start bleeding. If you start the pill any time within the first 5 days of your period, you will be covered immediately. If you start at any other day you will need to use extra precautions (condoms) for the first 7 days of taking the pill. If you have just had a baby, start the pill after 21 days and you will be covered immediately. If you have just had a miscarriage or abortion you will need to start the pill the day after to be covered immediately.

What do I do if I forget to take a pill?

• If you have missed 1 pill in a pack: Take it when you remember, this may result in taking 2 pills in one day (forgotten pill + that days pill) then carry on the rest of the pack as normal. There is no need for extra precautions. 
• If you have missed 2 pills or more in a pack: Your protection against pregnancy may be affected. You should take the last pill you missed now, even if this means taking 2 pills in 1 day. You should leave any earlier missed pills and carry on taking the rest of the pack as normal but you will need to use extra contraception, such as condoms, for the next 7 days.

You may also need emergency contraception if you have missed 2 or more pills in the first week of a pack and had unprotected sex in the previous 7 days. Please see your GP or contact the Sexual Health Services for information on Emergency Contraception.

Risks of taking the combined pill

There are some risks associated with using the combined contraceptive pill. However, these risks are small and, for most women, the benefits of the pill outweigh the risks.

Blood clots

The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors before prescribing the pill.

Sexually Transmitted Infections

The pill will not protect you from STI’s. You should use condoms if you are worried about this risk or at the start of any new relationship.

If you are concerned you may be at risk, contact the Sexual Health Service on 01656 644120 or 0300 5550279.

Headaches, skin changes and mood changes can all occur with the pill, if these become problematic after the first couple of months, return to your GP to discuss what can be done to help. There is no link to weight gain whilst on the pill – it is more likely due to increased intake of food.

Other medicines

Mostly they have no effect on the pill. However some very strong medicines (eg: used to treat HIV/Epilepsy/TB) and some over the counter medicines (eg: St John’s Wart) may interfere with your pill. Normal antibiotics should not affect the pill but if you are worried use condoms. If in doubt ask your GP.

Follow up

Initially you will be prescribed a 3 month supply. If getting on okay with this a yearly review is needed to check your height/weight and blood pressure unless there are significant changes to your medical history. Follow up appointments for pill reviews can be made with the practice nurse.