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COMBINED CONTRACEPTIVE PILL

PROGESTOGEN ONLY PILL

Anyone with a womb. Not suitable if you are pregnant, smoke (or stopped smoking less than one year ago) and are 35 or older, or are over a certain weight. There are certain medical conditions, e.g. blood clots and breast cancer, that mean the pill may not be suitable for you, please check these with your doctor.

who?

Anyone with a womb. May not be suitable if you think you may be pregnant, don’t want your period to change, experience bleeding between periods or after sex, have heart, liver or an arterial disease, have had a stroke or have (or have had) breast cancer, severe cirrhosis or liver tumours. There are also medicines which can affect the pill so discuss any with your doctor beforehand.

who?

One pill, taken every day for 21 days, with a seven day break where you have a period-like bleed. It prevents pregnancy by stopping the release of an egg (ovulation), and is sometimes prescribed if you have heavy or painful periods, PMS or endometriosis. Often referred to as “the pill” or the “combined pill”

what?

One pill, taken daily, which prevents pregnancy by thickening the cervical mucus to stop sperm reaching an egg. It can cause changes in your period.

It may be an option for people who cannot take the combined pill.

what?

The combined pill is usually taken every day for 21 days, with a seven day gap in between packs of pills, where you will experience a bleed like a period. Most come in packs of 21, however some are Every day (ED) pills. These have 21 active pills and 7 inactive pills in a pack, and you take one pill daily. All combination pills must be taken around the same time every day. 
You can start taking the combined pill at any time in your menstrual cycle. If you start on day 1 to 5 (the first five days of your period) it will work straight away and you will not need additional contraception. On any other day of your cycle you will need additional contraception, e.g. condoms, until you’ve taken the pill for seven days.
If you miss or forget to take a pill, follow the instructions for your specific type of pill in your pack. Always check with your doctor if you are unsure.

when?

The progestogen-only pill is taken every day, with no breaks between packs of pills. It must be taken at the same time every day. If taken more than three hours late it may not be effective.
You can start taking the progestogen-only pill at any time in your menstrual cycle. If you start on day 1 to 5 (the first five days of your period) it will work straight away and you will not need additional contraception. On any other day of your cycle, or if you have a short menstrual cycle, you will need additional contraception, e.g. condoms, until you’ve taken the pill for two days.
If you miss or forget to take a pill, follow the instructions for your specific type of pill in your pack. Always check with your doctor if you are unsure.

when?

If taken correctly it is more than 99% effective at preventing pregnancy. It doesn’t interrupt sex, usually makes your bleeds regular lighter and less painful and reduces the risk of ovarian, womb and colon cancer. It can reduce PMS symptoms and acne, may protect against pelvic inflammatory disease and reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease.

why?

If taken correctly it is more than 99% effective at preventing pregnancy. It can be taken by people who cannot use contraception that contains oestrogen, if you are breastfeeding and if you are over 35 and smoke. It doesn’t interrupt sex and can be used at any age.

why?

At first it can cause temporary side effects like headaches, nausea, breast tenderness and mood swings - if these do not disappear after a few months you may need to change to a different pill. It can increase your blood pressure and does not protect against STIs. If you are sick (vomit) or have severe diarrhoea it may cause the pill to not work. Breakthrough bleeding and spotting is common in the first few months. It has been linked to an increased risk of some serious health conditions, such as blood clots and breast cancer.

why

not?

It does not protect against STIs. If you are sick (vomit) or have severe diarrhoea it may cause the pill to not work. You must take it at the same time every day, and it can cause your period to become lighter, more frequent, and in some cases stop altogether. Some medicines and (uncommon) antibiotics can make it less effective.

why

not?

how?

In the UK, contraception services are free and confidential. You can get a free prescription for the combined contraception pill from your GP, or from contraception clinics, sexual health clinics and some young people’s services, even if you are under 16.
During your appointment you will be asked some personal questions, e.g. if you are sexually active, some family history to see how at risk you are from certain side effects, and you may have your blood pressure checked. Your appointment will take about 15-20 minutes.
On your first appointment you are generally given three month’s worth, which come in three packs of either 21 or 28 pills. You will need to schedule an appointment for three months’ time to check how you got on and get your next prescription, at which point you can sometimes ask for a larger prescription. In this appointment you can also ask to change to a different pill - there are many to choose from - if this one didn’t feel right. If at any time you experience side effects or symptoms that you are not comfortable with, schedule an appointment with your doctor.

how?

In the UK, contraception services are free and confidential. You can get a free prescription for the progestogen-only pill from your GP, or from contraception clinics, sexual health clinics and some young people’s services, even if you are under 16.
During your appointment you will be asked some personal questions, e.g. if you are sexually active, some family history to see how at risk you are from certain side effects, and you may have your blood pressure checked. Your appointment will take about 15-20 minutes.
On your first appointment you are generally given three month’s worth, which come in three packs of 28 pills. You will need to schedule an appointment for three months’ time to check how you got on and get your next prescription, at which point you can sometimes ask for a larger prescription. In this appointment you can also ask to change to a different pill - there are many to choose from - if this one didn’t feel right. If at any time you experience side effects or symptoms that you are not comfortable with, schedule an appointment with your doctor.

real life experiences

I was offered the pill at 12 years old primarily for my acne at the time, as for many people this can help. As it goes, this didn't help for me at all, but I stayed on it because I liked having control over my irregular periods and being able to know when they were coming. As time when on my periods started becoming really painful and I cycled the pill so that I would only have 4 periods a year which suits me down to the ground.

When I was 18 I switched to the implant because somehow after 6 years of taking a pill everyday I was still rubbish at remembering, and now I don't get any periods at all which suits me even better.

My experience has been overwhelmingly positive, however for my girlfriend, being on the pill killed her sex drive, she took it over her A levels and was very productive at that time but found that she really didn't feel like herself at all.

My advice would be for anyone thinking about the pill is give it a go, it affects us all differently and you won't know until you try. When they first give it to you, it is suggested that you ride the wave for 6 months because that is how long it takes for the body to settle into new hormones and you wont know what your experience will be like until then, so it does take a little perseverance.

If it is something you want purely for contraceptive reasons and you're as much of a scatter brain as me, I would suggest going for another option. My GP was happy to give the pill to me because it was for my acne, but other medical practitioners that I asked for my medications did sometimes question me on my use of the pill because I was a child. To me this was just water off a ducks back, I know they are just looking out for me and checking for abuse, but I know it may make others uncomfortable. Just bear in mind that most of them are just looking out for you if you are a minor on the pill!!" Olivia 

real life experiences

"It can take a while to find a pill that works for you, and some people never do. I have had some horror stories, but I did also find a progestogen-only pill that worked perfectly for me after a few trials with other, less ideal ones. My periods stopped (which wasn’t a problem for me), my skin reacted well and most importantly my mood wasn’t affected at all. I now refuse to use anything else. In the past I’ve had doctors switch me to “the same pill, it’s just made by a different company”, or “the same pill, it’s just cheaper”, and spoiler, it has not gone well. I’m talking ‘having to call in sick to work because you can’t stop crying’, not gone well. Now, I don’t think any of these doctors were lying to me or deliberately trying to switch my contraception, but at the end of the day you know your own body, and what works for it, better than anyone else. I have been ignored and made to feel silly for insisting on a specific brand, but insist I do. Anyone who has experienced a pill that does not agree with you knows how great it is when you find one that works. Always remember that you are entitled to contraception, and medical care, that is right for you, and speak up if it isn’t.​" Chloe, she/her

"I had heard at least one horror stories about nearly every type of contraception so I booked an appointment with a sexual health nurse to discuss my options instead. I chose to use the pill as contraception as I was not ready to commit to something permanently implanted but wanted something reliable. I suffer from regular  migraines and so I was too high risk to have the combined pill, hence my decision for the single-hormone pill. 

I’ve been taking Desogestrel for nearly 3 years. To begin with I had really bad headaches but these subsided in a couple of weeks and since then I’ve had very few side effects. I also haven’t had a period or any bleeding since starting! The most important thing is remembering to take it on time!! I have a reminder everyday on my phone to remind me to take it everyday and I keep the sheet of pills in my purse so I always have it to hand. Another factor is if you’re prone to being sick on a night out, if you vomit then the pill may not be fully absorbed and therefore may not be effective. Like all contraception it’s not 100% but it give me peace of mind without having any objects in my body. 

I only told my mum about taking the pill about 6 months ago when she found it in my room. She’s a practicing catholic so I never felt comfortable talking to her about sex or contraception so I made these decisions without my parents. Now she knows she has made an effort to try and understand my way of thinking but it’s still a topic we avoid unfortunately." Lisa, she/her