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Combined Pill

Combined Pill

The combined oral contraceptive is often referred to as ‘the pill’.  It contains a combination of the two hormones oestrogen and progesterone similar to those produced by the body. 

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Key Facts

  • It is over 99% effective if taken correctly
  • It can help with acne
  • You need to take the pill around the same time every day. If you don’t or you miss a pill you could get pregnant
  • The combined pill is not suitable for women over 35 who smoke, or women with certain medical conditions
  • It does not protect against sexually transmitted infections (STIs) so use a condom as well 

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Who can use the combined pill?

If there are no medical reasons why you cannot take the pill, and you don't smoke, you can take the pill until menopause. However, the pill is not suitable for all women. To find out whether the pill is right for you, always talk to your GP, practice nurse or pharmacist.


You should not take the pill if you:

  • are pregnant 
  • smoke and are 35 or older 
  • stopped smoking less than a year ago and are 35 or older 
  • are very overweight 
  • take certain medicines (ask your GP or a health professional at a contraception clinic about this) 

 

You should also not take the pill if you have (or have had):

  • thrombosis (a blood clot) in a vein, for example in your leg or lungs 
  • stroke or any other disease that narrows the arteries 
  • anyone in your close family having a blood clot under the age of 45 
  • a heart abnormality or heart disease, including high blood pressure 
  • severe migraines, especially with aura (warning symptoms) 
  • breast cancer 
  • disease of the gallbladder or liver 
  • diabetes with complications or diabetes for the past 20 years

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After having a baby

If you have just had a baby and are not breastfeeding, you can start the pill on day 21 after giving birth but you need to check with your doctor. If you are starting the pill after this then you will need to use condoms for 7 days. 

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After a miscarriage or abortion

If you have had a miscarriage or an abortion you can start the pill up to 5 days after this and you will be protected from pregnancy straight away.  If you start the pill after 5 days you will need to use condoms for 7 days. 

Advantages

  • It doesn’t interrupt sex
  • It may help reduce the premenstrual symptoms (PMS )
  • The pill can have additional  health benefits such as reducing the risk of cancer of the ovaries, womb and colon
  • It can help reduce acne

 

Disadvantages

  • It can increase your blood pressure
  • It can cause temporary side effects at first, such as headaches, breast tenderness and mood swings
  • It does not protect you STIs
  • Breakthrough bleeding or spotting is common when you first start taking it

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If you miss a pill

One pill missed:

If you have missed one pill, or if you have started the new pack one day late:

  • Take the last pill you missed, now
  • Continue taking the rest of the pack as usual
  • Emergency contraception is not usually required but may need to be considered if pills have been missed earlier in the pack or in the last week of the previous pack

 

Two or more pills missed:

If you have missed two or more pills or if you have started the new pack two or more days late:

  • Take the last pill you missed, now
  • Continue taking the rest of the pack as usual
  • Leave any earlier missed pills
  • Use an additional method of contraception for the next seven days
  • If you have had unprotected sex in the previous seven days, you may need emergency contraception. 

 

If seven or more pills are left in the pack after the missed pill:

  • Finish the pack
  • Have the usual seven day break or take the placebo tablets

 

If fewer than seven pills are left in the pack after the missed pill:

  • Finish the pack and begin a new one the next day (this means missing out the break or not taking the placebo tablets)

 

Please note if you have missed a pill and need to take two, this is not the same as taking emergency contraception. If you have missed a pill and are worried talk to a nurse of doctor.

This information does not apply to the combined pill Qlaira. If you use this pill you should contact the doctor or nurse who prescribed it if you are not sure how to take it or read the manufacturer’s instructions.
 

Free and confidential advice and support

Contact a sexual health adviser


The Passionate about Sexual Health (PaSH) Partnership) is a collaboration between BHA for Equality, George House Trust and the LGBT Foundation. The PaSH Partnership will deliver a comprehensive programme of interventions to meet the changing needs of people newly diagnosed with HIV, living longer term with HIV or at greatest risk of acquiring HIV.

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