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The Oral Contraceptive Pill - buy on prescription

The oral contraceptive pill is used by approximately 100 million women worldwide. ‘The Pill’ or oral contraceptive pill is the most popular form of contraception in the UK. In the UK, 3.5 million women, about one third of all women of reproductive age nationwide, take the pill.

There are two different types of Pill: the combined oral contraceptive pill (COCP), which contains an estrogen and a progestin compound, and the mini-pill or progestin only pill (POP).

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How does the pill work?

The synthetic hormones in the pill override the menstrual cycle by altering the naturally changing hormone balance. The pill suppresses the monthly release of an egg (ovulation), causes the womb lining to think making it more difficult for a fertilised egg to nest, and thickens the cervical mucus which makes it harder for sperm to enter the womb.

How effective is the pill?

Taken correctly, the pill offers 99% protection against unwanted pregnancy. Statistically, this means that each year less than 1 out of 100 women will become pregnant whilst taking the pill.

If you start taking the combined Pill on the first day of your period, protection is immediate. If you start the Pill at any other day during your cycle, it will take 7 days before its effect kicks in, so you should use an additional form of contraception during this time.

How do I take the pill?

How you take your pill will vary according to the type of COPD or POP prescribed.

The minipill is taken without any breaks and comes in packs of 28 tablets which you will need to take back to back. You will most likely experience light withdrawal bleeding after about 21 days, however many women do not get any ‘periods’ while on the minipill. As the hormone dose is very low, it is crucial that you take your pill at exactly the same time everyday, or within a 3 hour window (or 12 hour window for Cerazette) to achieve maximum effectiveness.

The combined pill is taken for either 21 days or 28 days. Speak to your doctor or check your patient information leaflet for details.

If your pill blister contains 21 tablets, take one pill each day for 3 weeks. After finishing all the pills in the blister, you will have a pill-free break of 7 days during which you will experience a withdrawal bleed. Start a new pack after the 7-day break. Most pill packs have the days of the week printed on the blister to make it easy for you to remember when to take your tablet.

If your pill blister contains 28 tablets, take one tablet each day, everyday on a continuous basis. 21 pills in your pack will be "active" or pills containing hormones, and the other 7 tablets will be "inactive" placebo or sugar pills. Make sure you take your pills in the correct order.

Regardless of whether you follow a 21 scheme followed by a 7 day break or a 28 tablet dosaging regime, you will be protected from unwanted pregnancy throughout your cycle provided that you have taken your medication correctly.

What if I miss a pill?

It is essential that you take your Pill religiously every day at the same time. Try to adopt a routine that will make it easy for you to remember to take your Pill, such as a reminder on your mobile set to go off daily at the same hour.

If you forget to take your Pill you will still be protected against pregnancy if you take the mini-pill within 3 hours or the combined pill within 12 hours of your usual time. If you miss the window, follow the instructions on your patient information leaflet.

If you vomit or have diarrhoea within 2 to 3 hours after taking your Pill, take another one. Then continue your dosaging regime as normal bearing in mind that your cycle will be shortened by one day.

Can I delay my period with the Pill?

When you take the pill you will not have a real period, but instead will experience a break-through bleed during your 7-day pill-free break.

The following information refers to the most common type of Pill, the COCP, so if you wish to delay withdrawal bleeding with any other type of pill, please read the patient leaflet or consult your doctor or family planning nurse.

You may choose to delay your break-through bleed for a holiday or a special event. You can do this by running your pill packs back-to-back. If you take the 30 day pill or the mini-pill speak to your doctor or carefully follow the instructions on the patient information leaflet.

In some women, tricycling might be indicated, which means that you will use 3 blisters in a row without any breaks. This can be beneficial to women suffering from a particular type of migraine or endiometriosis. For further information or if you would like to consider this option and reduce the number of withdrawal bleeds per year, please consult your prescribing doctor for advice on whether this is suitable for you and if it is feasible with the Pill you take. It is possible to tricycle both with monophasic and multiphasic pills.

Benefits of the Pill

Millions of women in the UK opt for the pill and find it a very convenient, easy and reversible means of contraception. It is highly effective and does not interfere with sex. While the Pill alters your hormonal balance for as long as you take it, it does not impair your fertility and if you are planning on having children, your fertility should be back to normal within a few months of stopping the Pill.

The Pill

Risks of the Pill

The contraceptive Pill has a very well established safety profile and the majority of women do not experience any problems while taking it. Like every medication, the Pill can cause side effects, and certain patient groups are more at risk than others. It is essential that you provide your prescriber with full details about your past and present medical condition before you obtain a prescription for the Pill.

Taking the pill can increase the risk of Deep Vein Thrombosis (DVT) or blood clotting, which can be potentially fatal. You should not take the pill if DVT, stroke or heart attack run in your family.

The pill is considered to be cancer neutral - this means that although pill takers may be at greater risk of developing some types of cancer, they are more protected from others whilst on the pill.

Side effects

The Pill is generally well tolerated and the most women taking it do not experience any adverse side effects. In the first few weeks after starting a pill some women complain of nausea, headaches or tender breasts. These symptoms usually subside once your body gets used to the new medication. For full information about side effects, please refer to your pill patient information leaflet.

The contraceptive Pill may cause:

  • Fatigue
  • Change in sex drive (increased or decreased libido)
  • Hypertension
  • Headaches
  • Weight gain/water retention
  • Depression/Mood swings
  • Migraine

Please note that this list is not exhaustive. As the Pill can alter blood pressure, it is important that you have your blood pressure monitored regularly while you take the Pill. It is recommended you have a check-up every 6 months to spot any changes.

Which medications interact with the Pill?

Some medicines interact with the Pill which is why you need to tell your doctor about all medications you take before going on the Pill. Some broad spectrm antibiotics can make the Pill less effective. These are:

  • amoxicillin
  • ampicillin
  • azithromycin
  • cefadroxil
  • cefixime
  • cefradine
  • cefalexin
  • cefpodoxime
  • clarithromycin
  • co-amoxiclav
  • co-fluampicil
  • doxycycline
  • erythromycin
  • metronidazole
  • minocycline
  • oxytetracycline
  • tetracycline
  • tinidazole

If you are required to complete a course of any of these drugs, tell your doctor that you are on the Pill. You will need to use additional contraception during your antibiotic treatment and for 7 days thereafter.

Certain medicines affect how quickly estrogens and progestogens are broken down by the liver, which again makes the Pill less effective. These medicines include:

  • aprepitant
  • bosentan
  • carbamazepine
  • griseofulvin
  • modafinil
  • nelfinavir
  • nevirapine
  • oxcarbazepine
  • phenytoin
  • phenobarbital
  • primidone
  • rifabutin
  • rifampicin
  • ritonavir
  • rufinamide
  • St John's Wort (Hypericum)
  • topiramate

If you need to take any of these medicines at the long term, you might have to consider switching to a different method of contraception.

Who should not take the Pill/Precautions

The Pill increases the risk of a blood clot such as in the legs (Deep Vein Thrombosis), lungs (Pulmonary Embolism), a stroke or heart attack.

Your risk for this kind of potentially fatal complication is increased if you:

  • Smoke
  • Are overweight with a BMI above 35
  • Are over 35 years of age
  • Suffer from migraines with aura
  • Have high blood pressure
  • Have had a blood clot in the past or if the condition runs within your family
  • You are unable to move for an extended period of time, for example following an accident or if you are otherwise bedbound

The Pill does not offer any protection against sexually transmitted infections such as Chlamydia, Gonorrhoea, HIV or Syphilis. Especially if you have several or frequently changing sexual partners, you should use an effective barrier method such as male condoms. If you think you are pregnant, stop taking the Pill and consult a doctor or family planning nurse to arrange for a test and further advice.

Further information

Apart from offering a very high protection against unwanted pregnancy, the Pill is sometimes prescribed to treat a number of other medical conditions. Women affected by acne often find that the Pill clears up their condition. Acne is due to an excess of male sex hormones which is balanced out by the synthetic hormones in the Pill. Furthermore, scientific research suggests that the contraceptive Pill protects against certain types of cancer such as ovarian, uterine or colon cancer.

One particular combined pill, sold under the brand name Dianette (active ingredient co-cyprindiol) can be prescribed to women suffering from severe acne or hirsutism (excessive hair growth in women) seeking contraception at the same time. It should not be given merely for contraception.

The Pill can also potentially improve the following conditions or make them less painful:

  • Endiometriosis
  • Painful, heavy periods
  • Prementrual Syndrome
  • Anaemia
  • Polycystic Ovary Syndrome (PCOS)

The Pill

Reviews for The Pill

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Reviewed by Mellissa on .

I was brought up to think the pill was bad. It was only after a new female doctor finally conviced me that I should try it to reduce my period pains. So I did not start taking it till I was 25. One year on I am now a much happier person and really feel much more steady.

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