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nhsinform.scot, At a Glance The Combined Pill

Sep 09, 20245 min read

At a Glance: The Combined Pill

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Highlights

  • When taken correctly, the pill is over 99% effective at preventing pregnancy. This means that fewer than 1 woman in 100 who use the combined pill as contraception will get pregnant in a year. (View Highlight)
  • In real world use, about 8 in 100 women who use the combined pill a year become pregnant due to incorrect use such as forgetting to take pills (92% effective). (View Highlight)
  • You need to take the pill every day for 21 days, then stop for 7 days, and during this week you have a period-type bleed. You’ll still be protected against pregnancy during these 7 days. You start taking the pill again after 7 days. (View Highlight)
  • You need to take the pill at the same time every day. If you don’t, you could get pregnant. You can also get pregnant if you miss a pill, or vomit or have severe diarrhoea. (View Highlight)
  • How the combined pill works The pill prevents the ovaries from releasing an egg each month (ovulation). It also: • thickens the mucus in the neck of the womb, so it’s harder for sperm to reach an egg • thins the lining of the womb, so there’s less chance of a fertilised egg implanting into the womb and being able to grow (View Highlight)
  • Although there are many different brands of pill, there are 3 main types. (View Highlight)
  • Monophasic 21-day pills This is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then no pills are taken for the next 7 days. Microgynon, Rigevidon and Brevinor are examples of this type of pill. (View Highlight)
  • Phasic 21-day pills Phasic pills contain 2 or 3 sections of different coloured pills in a pack. Each section contains a different amount of hormones. One pill is taken each day for 21 days and then no pills are taken for the next 7 days. Phasic pills need to be taken in the right order. Synphase and Logynon are examples of this type of pill. (View Highlight)
  • Every day (ED) pills There are 21 active pills and 7 inactive (dummy) pills in a pack. The 2 types of pill look different. One pill is taken each day for 28 days with no break between packets of pills. Every day pills need to be taken in the right order. Microgynon ED and Logynon ED are examples of this type of pill. (View Highlight)
  • If you start the combined pill on the first day of your period (day 1 of your menstrual cycle) you’ll be protected from pregnancy straight away. You will not need any additional contraception. If you start the pill on the fifth day of your period or before, you’ll still be protected from pregnancy straight away, unless you have a short menstrual cycle (your period is every 23 days or less). If you have a short menstrual cycle, you’ll need additional contraception, such as condoms, until you have taken the pill for 7 days. If you start the pill on any other day of your cycle, you will not be protected from pregnancy straight away. You’ll need additional contraception until you have taken the pill for 7 days. (View Highlight)
  • If you miss a pill or pills, or you start a pack late, this can make the pill less effective at preventing pregnancy. The chance of getting pregnant after missing a pill or pills depends on: • when the pills are missed • how many pills are missed (View Highlight)
  • A pill is late when you have forgotten to take it at your usual time. You’ve missed a pill when it’s more than 24 hours since the time you should have taken it. Missing one pill anywhere in your pack or starting the new pack one day late isn’t a problem. You’ll still be protected against pregnancy (known as having contraceptive cover). (View Highlight)
  • However, missing 2 or more pills, or starting the pack 2 or more days late (more than 48 hours late) may affect your contraceptive cover. In particular, if you make the 7-day pill-free break longer by forgetting 2 or more pills, your ovaries might release an egg and there is a risk of getting pregnant. This is because your ovaries are not getting any effect from the pill during the 7-day break. (View Highlight)
  • If you have missed 1 pill, anywhere in the pack: • take the last pill you missed now, even if it means taking 2 pills in one day • continue taking the rest of the pack as usual • you don’t need to use additional contraception, such as condoms • take your 7-day pill-free break as normal (View Highlight)
  • If you have missed 2 or more pills (you are taking your pill more than 48 hours late) anywhere in the pack: • take the last pill you missed now, even if it means taking 2 pills in one day • leave any earlier missed pills • continue taking the rest of the pack as usual and use an extra method of contraception for the next 7 days • you may need emergency contraception • you may need to start the next pack of pills without a break (View Highlight)
  • You may need emergency contraception if you’ve had unprotected sex in the previous 7 days and have missed 2 or more pills (you are taking your pill more than 48 hours late) in the first week of a pack. (View Highlight)

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