Changing Your Contraceptive Pill – What You Need to Know

It’s easy to change to a different contraceptive pill. Many women switch their main method of contraception multiple times in their lifetime. It’s a good way of finding out which method works best for you, and may be necessary depending on your personal situation or circumstances. However it is important to follow the correct instructions when changing to prevent unwanted pregnancy.

Both your new and old pill packets will have instructions for what to do when you are changing from one pill to another. Check these instructions first to see whether there are any precautions to take during the changeover.

Otherwise, there’s generally a difference in how your body reacts to changing between different types of pill. There are two main types:

• the combined pill
• the progestogen-only, or ‘minipill’ of which there are 2 types: traditional mini pills (e.g. noriday, norgeston) or desogestrel minipills (e.g. cerazette, cerelle)

The combined pill contains two types of hormones (oestrogen and progestogen), whereas the ‘minipill’ contains only one (progestogen).

The combined pill packet will contain 21 or 28 pills, depending on the brand. After 21 days of taking the pill, you’ll usually have either a 7-day break of no pills, or 7 days of ‘placebo’ pills, which are pills that don’t contain any hormones. This is when you get your ‘withdrawal’ bleed.

The progestogen-only, or mini pill packet will contain 28 pills. All of these pills contain a progesterone hormone only. You should take one of these pills at the same time every day, without a break between packs.

When changing pills (combined pill to mini pill), it’s best to go straight from one type to the other, without taking a gap in between. Start your new pill the day after taking the last active pill in your last pill packet.

This also applies with ‘placebo’ pills. Switch pills when you’re taking your ‘active’ ones (with hormones), so that your hormone levels don’t have the chance to drop. You don’t need to wait for your withdrawal bleed before switching 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 to 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, 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 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 when starting a combined pill (9 days for Qlaira) or 2 days when starting a mini pill. If you are in week one of your combined pill pack or in your 7 day pill free break and have had unprotected sex in the last 7 days please continue to use your existing combined pill for at least 7 days 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.
• 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.
• 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.

Changing from another hormonal method (like the IUS progesterone only Mirena coil, progesterone-only implant or progesterone-only injection) to the contraceptive pill isn’t difficult, but might need a bit of forward planning.

Once the IUS or the implant leaves your body or has expired (or your injection has run out), you can return to full fertility straight away. This means that you can get pregnant as soon as it’s taken out of your body.

Instructions for switching will depend on which pill you are starting on and changing from:

• If you change to a combined pill or mini pill from the progesterone-only implant (less than 3 years since insertion) or progesterone-only injection (less than 14 weeks since your last injection) then you are protected from pregnancy immediately (unless changing to Qlaira in which case condoms are recommended for 9 days). If it has been more than 3 years since your implant was inserted or more than 14 weeks since your last injection condoms would be needed for the first 7 days if changing to the combined pill (9 days for Qlaira) or 2 days for the mini pill.
• If you change from an IUS you should make sure that you have not had unprotected sex in the 7 days before changing and should use condoms for the first 7 days if changing to a combined pill (9 days for Qlaira) or 2 days for the mini pill.

Non-hormonal contraceptives, like the copper contraceptive coil (IUD), only protect you against pregnancy while they’re still in your body. As soon as they are removed, you are at risk of getting pregnant.

Because of this, we recommend that you use a barrier method of contraception (like condoms) for the first 7 days after the IUD has been removed if you are changing to a combined pill (9 days for Qlaira) or 2 days if changing to a mini pill. The only time condoms would not be required to prevent pregnancy would be if you have regular periods on the IUD and change to a contraceptive pill on day 1–5 of your cycle. You should not have unprotected sex for 7 days before having your coil removed.

There’s little risk of getting pregnant when changing your pill, if you follow the right instructions and take all your pills correctly.

If you’re worried you haven’t done this, or if you’ve missed any pills, take a pregnancy test at least 3 weeks after having unprotected sex or visit your doctor to make sure.