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Going on the pill – what you need to know

Going on the pill – what you need to know

The pill is both convenient and offers reliable protection from pregnancy. Find out what you need to do to go on the pill and what to expect.

Last reviewed: 18/06/2020 by Dr Simran Deo

Contents

When can I start taking the pill?

Before you can go on the pill, a doctor or nurse has to assess whether you can take it. You can get assessed in person or through an online assessment.

You give information about your medical history during your assessment and your doctor will talk to you about the most appropriate pill for you to start on. This depends on your medical history and lifestyle. For example, women who are breastfeeding and gave birth over 6 weeks ago can use a mini pill but won’t be prescribed a combined pill. The same goes for women who are over the age of 35 and who smoke.

You can get your pill from your GP or sexual health clinic or place an order with Superdrug Online Doctor.

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How to start taking the pill

When you start taking the pill for the first time, you should take the first pill on the first day of your period (though you will be fully protected if you start it within the first 5 days of your period). This way, you will be protected immediately and you won’t need to use any additional contraception to prevent pregnancy. Though you should use a condom too for protection against STIs as the pill will not protect against these. 

You then need to take one pill every day at the same time. If you are on a mini pill, each pack will contain 28 pills. If you are on a combined pill, each pack will most likely contain 21 pills and you can take a maximum seven day break between each pack. Some combined pill packs contain 28 pills in which case no break should be taken between packs. 

It is also possible to start using the pill at a different point during your menstrual cycle. However, if you don’t start taking it on day 1 to 5 of your period you will need to use additional contraception for 7 days if using a combined pill, or 2 days if using a mini pill.

Can I take my combined pill without a 7 day break between packs?
The answer is yes, there are a few methods to choose from when taking a combined pill which you can discuss with your prescriber as to which will suit you:
  • Standard use
  • Tailored use
Standard use
Traditionally you take your pill for 3 weeks and then have a 7-day break. This is because the pill was designed to mimic your monthly cycle. However, there is no biological need to have the 7-day break. In fact, if things go wrong with pill taking, it’s quite common for women to start their next pack late, and this is where an error might take place. Getting rid of the 7-day break may help maintain some of the non-contraceptive benefits of combined pill, like reducing acne.

Tailored use
These can be more convenient without any additional risks.

The extended tricycling regime involves:
  • Take the pill every day for 3 packs (9 weeks)
  • Then have a pill free break – often this is a 4- to 7-day break
  • Then restart the next pack
  • You may have a withdrawal bleed in the pill free break
  • There is no need to use additional contraception after restarting
The shortened hormone-free interval regime involves:
  • You take the pill every day for 3 weeks then have a 4-day break before starting the next pack
  • You may have a withdrawal bleed in the pill free break
  • There is no need to use additional contraception after restarting
The flexible extended use regime involves:
  • You take the pill every day continuously until breakthrough bleeding occurs for 3 to 4 days, then have a 4-day break before starting the next pack
  • There is no need to use additional contraception after restarting
The continuous use regime involves:
  • You take the pill every day continuously without any breaks (if a bleed occurs, you continue to take your pill)

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Changing contraceptive pills

If your GP, nurse or online doctor has advised you to change your pill and prescribed a new brand, the instructions for how to change between these pills vary depending on the type of pill you are changing from and to: 

Combined pill to combined pill or a mini pill: 
  • Start the first pill of the new pack the day after taking the last pill of your last pack. If you do not have a break between packs, or are in week 2 or 3 of your pack and have not missed or taken any pills more than 24 hours late then additional contraception such as condoms is not needed. 
  • If you are in the first week of your combined pill pack or in your 7-day pill free break and have not had unprotected sex in the last 7 days you should use condoms for the first 7 days (9 days for Qlaira) when starting a combined pill or 2 days when starting a mini pill. 
  • If you are in week 1 of your combined pill pack or in your 7-day pill free break and have had unprotected sex in the last 7 days, continue to use your existing combined pill for at least 7 days in a row before switching to another pill and then follow the instructions above as if you were in weeks 2 to 3 of your pack. 
  • If you take a combined pill that has 28 pills in the packet usually the last 7 pills are inactive pills and you should therefore consider the last 7 pills as being on your pill free break. 
Changing from desogestrel mini pill (e.g. Cerelle, Cerazette) to another mini pill or combined pill: 
  • Start the new mini pill or combined pill the day after taking your final mini pill in your current packet and you will be protected from pregnancy immediately, provided you have not taken any pills more than 12 hours late or missed any pills in the last 2 days. 
  • If changing to Qlaira condoms are recommended for the first 9 days regardless.
Changing from a traditional mini pill (e.g. Noriday, Norgeston) to another mini pill or a combined pill:
  • Start the new mini pill or combined pill the day after taking your final mini pill in your current packet. 
  • If changing to a combined pill you need to use additional contraception for the first 7 days (9 days for Qlaira). 
  • If changing to another mini pill you will be protected from pregnancy immediately providing you have not taken any pills more than 3 hours late or missed any pills in the last 2 days. 
If you are changing to the pill from the progesterone only implant, progesterone only injection, IUS or IUD you can talk to your GP or nurse about how best to do so or read our advice on changing your pill.

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Can starting the pill give you thrush?

The pill contains either one or two hormones. When you start taking it, your body needs to get used to these hormones. During the first three months you may experience side effects which improve as you continue your treatment.

Thrush is a possible side effect of the pill and some women get thrush while using a pill. If this happens, you can use a thrush treatment from the pharmacy to treat your fungal infection.

If you notice any side effects which bother you or which persist, you should speak to your GP who may be able to recommend a more suitable pill. Your prescribing doctor or nurse should talk to you about common side effects before starting the pill. 

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Starting the pill after giving birth

Most women have their first period within six weeks to three months after giving birth. How soon you are fertile again can also depend on whether you are breastfeeding or not. Women who breastfeed exclusively tend to take longer to experience their first period after birth. 

However, your fertile days are about two weeks before your first period. If you are ready to have sex again, you should consult your doctor before having sex (or using condoms). If you are breastfeeding, you may be able to use a mini pill. If you are not breastfeeding then the combined pill may also be an option.

The mini pill can be started anytime after giving birth. If you are not breastfeeding, you can start taking the combined pill 21 days after giving birth providing you have no risk factors for blood clots. If you begin using the pill more than 21 days after birth, you need to use an additional contraceptive such as a condom for seven days for the combined pill or 2 days for the minipill. If you are breastfeeding you may still be able to use a combined pill but this would not be recommended until at least 6 weeks after giving birth. 

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Is going on the pill bad for you?

The pill is prescription medication and it is not suitable for everyone. Before you start taking it, your doctor or nurse will assess whether the pill is safe for you to take. Most women can take the pill but women who suffer from certain medical conditions may need to use a different contraceptive. When you get assessed for the pill, they will ask you a number of questions about your health and medical history to check which contraceptive is best for you.

If your doctor or nurse prescribes you a pill they will also tell you about any side effects and health risks associated with this. If you take a combined pill there is a slightly higher risk of blood clots, breast and cervical cancer (but a lower risk of some other cancers). Any link between the mini pill and breast cancer has not been proven. 

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From which age can I take the pill?

The pill is usually prescribed to women over the age of 16. However, in some cases doctors and nurses can prescribe the pill to women under the age of 16, if they feel that it is appropriate. NHS sexual health services are free and confidential and your doctor or nurse can help you choose a contraceptive.

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Sources

Cerazette (2020) EMC [accessed 30 March 2020]

Combined hormonal contraception (2019) FSRH [accessed 30 March 2020]

Progesterone-only pills (2019) FSRH [accessed 30 March 2020]

Switching or starting methods of contraception (2017) FSRH [accessed 30 March 2020]

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