Contraceptive Pill

You should take your contraceptive pill at the same time every day. But, exactly how you should take the pill will depend on its type and brand. For example:

• If you take the combined pill with 21 pills in the pack, you should take a 7-day break between each pack, unless you’re taking your pills in another way, such as continuously (without a break)
• If you take the combined pill with 21 active pills and 7 dummy pills, you should not take a break between packs
• If you take the mini pill, you should not take a break between packs

Some pills have a strict time frame of when you need to take them every day, while others have a more flexible way of taking them. When going on the pill, you should discuss with your doctor which option is best suited to your lifestyle.

What should I do if I miss a pill?

If you miss a pill, the first thing you should do is take it as soon as you remember and take your next pill as normal, even if it means taking two pills at the same time. Depending on the type of pill you are taking (combined or mini pill), or where in your cycle you missed a pill, you may not be protected from pregnancy any more and would need to use additional contraception. Read our doctors’ guide on what to do if you miss a pill.

How long does it take for the pill to start working?

Generally, the contraceptive pill should work effectively after taking it for 7 days, no matter which day of your period you start.

For most of the combined pills and the mini pill, if you start on days 1 to 5 of your period, the pill should start working immediately without the need for an additional form of contraception.

If you start outside these days, you should use another form of contraception, like condoms, for the first 7 days of taking the combined pill, or the first 2 days of taking the mini pill.

When taken correctly at the same time daily, the pill is over 99% effective at preventing pregnancy. This means about 1 in 100 people who use the pill will get pregnant in a year, so there is still a very small chance of getting pregnant even if you use the pill as instructed.

In reality, people do not always take the pill correctly, so its effectiveness is actually about 91%. Some of these reasons are:

• forgetting to take the pill
• taking it at the wrong time of day
• being sick or having diarrhoea
• taking other medicines that make the pill less effective

The main ways the contraceptive pill works to prevent pregnancy are by:

• stopping your body from releasing an egg from your ovary into the womb (ovulation) each month
• making the mucus in your cervix (the neck or entrance of your womb) thicker, so it becomes more difficult for a sperm to pass through and fertilise an egg
• making the inner lining of your womb thinner, so it's harder for any fertilised egg to attach to your womb and grow

The hormones in the contraceptive pill can cause many side effects but may also help with improving acne or making periods lighter and less painful. Some people take the pill for these reasons alone, and not for preventing pregnancy.

It’s always best to discuss your options with your doctor first before you start the pill, to help you choose the best contraceptive pill for you.

The possible side effects of each type of contraceptive pill are the same, no matter which brand you use. But the side effects each person may have will vary from person to person.

Side effects of combined contraceptive pills:

• Breakthrough bleeding or spotting — more common with continuous-dosing or extended-cycle pills
• Breast tenderness
• Elevated blood pressure
• Headaches
• Nausea
• Bloating

Side effects of the mini pill

• Irregular menstrual bleeding
• Acne
• Breast tenderness
• Decreased sex drive (libido)
• Depression
• Headaches
• Nausea
• Ovarian cysts

When it comes to contraceptives, the pill isn’t your only option. There are many different forms of contraceptives each with their own advantages and disadvantages.

• Hormonal Implant - A hormonal implant is a small tube placed under your upper arm's skin. It releases a hormone called progesterone to stop you getting pregnant.
• Intrauterine device (IUD or copper coil) - An intra-uterine device is a type of birth control that's inserted through the vagina and cervix into the uterus to prevent pregnancy.
• Hormonal Coil (IUS) - Like the copper coil, but the IUS releases hormones which prevent you getting pregnant, and can also make your periods less painful, lighter, and shorter.
• Depo-Provera Hormonal Injection - The hormonal injection is an injection of hormones you receive 8 or 13 weeks (depending on which type) to protect you from pregnancy.
• Hormone Patch - The hormone patch is a small square patch worn on the skin. It contains similar hormones to those used in combined contraceptive pills, except you absorb them through your skin. When used correctly, the hormonal patch is up to 99% effective in preventing pregnancy.
• Vaginal hormonal ring - The vaginal hormonal ring is a small ring that's inserted into your vagina. It contains the hormones oestrogen and progestogen, which are the same type of hormones used in combined contraceptive pills.
• Diaphragm - The contraceptive diaphragm is a form of birth control that doesn't contain any hormones. It is a soft latex-free dome with a flexible rim made from silicone that's inserted into the vagina to form a barrier that stops sperm from reaching the cervix to prevent pregnancy.
• Cervical cap - The cervical cap is a dome-shaped cup made of silicone you place inside your vagina with its rim fitted around the base of your cervix. This forms a barrier that stops sperm from reaching your uterus. However, you should always use it in combination with spermicide for it to be fully effective.
• Male condom - The male condom is a covering worn over the penis during sex to stop sperm from getting inside the vagina and fertilising an egg. It's an affordable and effective method for preventing STIs and pregnancy.
• Female condom - Also known as the "internal condom," the female condom is a lubricated "sheath" you insert into your vagina before having sex. It works by blocking sperm from reaching the cervix.
• Withdrawal (the "pull out" method) - This is an unreliable method of contraception, where the man will remove (pull out) his penis from the vagina before he ejaculates. Doing this is risky, and can still cause pregnancy, as some sperm may be released before the man ejaculates. The withdrawal method does not protect you against STIs.