The combined oral contraceptive pill, commonly referred to as ‘the pill’, is an extremely efficient method of contraception, and one of the most popular types of contraceptives in the UK. It is popular not only due to its success rate at preventing conception, but it also regulates periods, makes menstrual cramps less painful, minimises ovarian cysts and provides symptomatic relief from endometriosis.
At euroClinix, we offer 16 different brands of the combined pill ranging from all three types; monophasic, phasic and every day (ED). If you are already taking your preferred method of contraception, simply start your consultation. We offer next day delivery free of charge without the need for a face-to-face appointment with your doctor, saving you time and effort spent booking and attending appointments in person.
'The pill' is a common term for the combined oral contraceptive (COC) pill. It may also be used to describe the mini pill, however this is a different contraceptive pill.
'The pill' is the most common form of contraception in the world. In fact, there are currently about 100 million women who use one type of combined oral contraceptive including roughly 3.5 million in the UK alone. That works out as roughly 1 in 3 of all women of reproductive age who are using the combined pill as their method of pregnancy prevention.
Each combined contraceptive tablet contains a combination of oestrogen and progestogen with the individual names of hormones varying from each pill, and there are multiple brands available in the UK. Whilst they can be split into monophasic, phasic and every day (ED) pills, ultimately they all work in the same way - by altering the environment of your reproductive system in such a way that it's almost impossible for you to conceive.
When used correctly, all brands of the combined pill are over 99% effective at preventing pregnancy, as well as having a whole host of other benefits.
The main benefit of 'the pill' is to prevent pregnancy. When used correctly – e.g. not missing a couple of pills and starting the new pack at the correct time – all combined pill brands are nearly 100% effective at preventing conception.
Depending on the type of combined pill, there are a number of other advantages to taking 'the pill', which may ellipse this primary aim. In fact you can be prescribed certain types of combined pill without needing to use it as a form of pregnancy prevention.
These additional advantages will depend on the brand of combined pill you are taking, and will be advised by a medical professional. For example, Dianette can be taken to help reduce bouts of acne without needing to be a contraceptive. Certain brands of the pill can do all or some of the following:
All combined pills can help to alleviate any symptoms associated with your period, however if you experience particularly painful or sporadic periods, there may be a certain type of combined oral contraceptive that is more suitable than others. If you would like to combat anything troublesome that is mentioned above such as acneor endometriosis, you should arrange an appointment with your doctor to discuss which brand of pill would be best for you.
It needs to be taken every day for 21 days of your cycle, with a seven-day break. During this break, women will usually experience a withdrawal bleed. The excess lining of the womb is shed, as with a normal period, and you may experience some cramps and discomfort.
There are nearly 30 different types of contraceptive pills available to women in the UK. Choosing a pill may seem like a daunting task. However when completing a consultation, which is necessary when ordering the combined pill, your doctor will be able to advise the correct pill for you.
The combined pill can be split into two different types: monophasic and multiphasic, which can then be categorised further in categories such as monophasic, phasic and every day (ED).
Monophasic versions contain the same dose of hormones in each pill, and are usually the first kind of ones that women are prescribed. They allow you to regulate your period and can be taken in any order.
Every day pills (ED pills) are different in that they contain 21 active pills which contain hormones and 7 inactive placebo pills which act as a break for a withdrawal bleed. You take one pill each day in the correct order for 28 days with no breaks between blister packs.
Multiphasic versions have a varying hormone dosage across different pills for different phases of your cycle.
These types of pills mimic the natural fluctuation of hormones during your cycle, and administer a lower total dose of hormones to your body. These two benefits reduce the risk of experiencing side effects like spotting, however must be taken in the correct order.
The most common monophasic pills include:
The most common biphasic pills:
The most common triphasic pills:
The most common multiphasic pills:
If taking the combined contraceptive pill is not suitable for you, you can try another method of contraception.
To understand how this form of combined oral contraception will prevent pregnancy, it's important to understand the process of conception.
Once a month, your ovaries release a mature egg that travels down the fallopian tubes towards the uterus. While this happens, the lining of your womb begins to thicken as it prepares itself to host a fertilised egg. At the same time, the mucus in the cervix becomes thinner to make it easier for sperm to reach the womb.
|The hormones prevent the lining from thickening.
The fluid at the neck of the cervix is made
thicker to impede the movement of sperm.
The release of hormones from the pill prevents
ovulation, which is when an egg is
released from the ovaries.
The combined pill stops all of these activities, which in turn prevents you from conceiving. The oestrogen in the pill stops your ovaries from releasing a mature egg, whilst the progestogen stops the womb lining from thickening and actually makes the cervical mucus thicker meaning that, in the unlikely event an egg is released, it cannot attached to the wall of the womb, nor can the sperm reach it.
The pill regulates periods, makes them lighter and less painful and offers symptomatic relief from endometriosis. It is over 99% effective and you don't need to interrupt sex to use it. It can also help to improve spotty skin, reduce excessive body hair and treat polycystic ovary syndrome (PCOS). If used over a long period of time, the pill can cut your risk of developing ovarian, uterine or colon cancer.
It's important to note that the combined pill, as well as any hormonal contraception, is not a method of STI protection. The best method to significantly reduce the chance of contracting a sexually transmitted infection is to wear barrier contraception such as male or female condoms, which are easily available from pharmacies and shops around the UK. You can also get free condoms and other types of emergency contraception across the country in sexual health clinics, contraception clinics and some GPs. You can find your nearest access point through the NHS.
The combined pill is taken for 21 consecutive days of the menstrual cycle. Blister packs of the pill are clearly marked with the day of the week, meaning you can easily keep track, especially if you're taking a brand of the pill that requires you to take the tablets in the correct order.
Many women decide to take the pill either first thing in the morning or last thing at night, as there is a higher chance of you forgetting throughout the day when you're busy.
You can order either a three-month or six-month supply of the pill either from your doctor in person, or online from euroClinix. A six-month supply of the combined pill means you only need to arrange contraceptive cover twice a year.
When beginning your first combined pill, or starting a different type of combined pill from another form of hormonal contraception, starting the pill on the first scheduled day or before the fifth day of your period will offer immediate protection against pregnancy. When beginning the pill after the fifth day of your cycle, you will need to use additional contraception for seven days after, before the medication is 99% effective.
It is possible to use the combined pill to delay your period if needed by taking the following blister pack immediately after you've finished the first one. You can do this safely for three consecutive packs, however you may experience bloating during the third course.
The combined pill is the most effective version of contraception to delay your period and you may decide to do this for a number of reasons, the most popular being a holiday or sporting event.
Missing a contraceptive pill is a common occurrence. Whilst missing the odd one over time won't affect the 99% efficiency rate, frequently missing tablets can alter the effectiveness of the pill. It's important to use additional contraception if you have missed two or more tablets in your blister pack, and you may need to seek emergency contraception if you have had sex.
Missing one pill in one 21-day blister pack will not affect the combined pill; you will still be 99% protected against pregnancy. Simply take the missed pill as soon as you remember and continue taking the rest of your pack as normal. You won’t need to use additional protection.
This will affect the success rate of your combined pill so it is best practice to avoid sex until you start a new blister pack, or use additional contraception for 7 days after your missed pill. Always remember to take the last missed pill when you remember, even if it means taking two tablets in one day.
Once you get to the end of your blister pack, if there are more than 7 or more pills left in the pack after the last missed pill, you should finish the pack and take your 7-day break (or 7 inactive pills) as normal before you start your next pack. If there are less than 7 pills left in the pack after the last missed pill, you should finish the pack and start a new pack the next day. This will mean missing out the pill-free break (or inactive-pill break).
Falling sick can affect the effectiveness of any combined pill type as the latest tablet a woman digests might not have been absorbed into the system correctly. This includes whether you have vomited (been sick) or experienced diarrhoea.
If this is the case, you should take another pill straight away and then continue to take the rest of your pills as normal. If you continue to be sick, it is recommended that you use additional contraception for 7 days from when you were last sick. In the case of severe diarrhoea, you should continue to take your pill as normal but also use additional contraception.
If you’re ever unsure, it’s best to continue to take your pill and use other means of contraception. Then seek advice immediately.
If you're over 18 you may be able to buy these treatments online, if you are below 18 years, you can visit your doctors in person. However, there are a number of medical conditions that may mean that it is unsafe for you to use the combined pill. This varies according to each different combined pill, and involves only a small number of women. If you smoke, are severely overweight, have diabetes with complications, have high blood pressure, have or have had frequent migraines or a family history of thrombosis, you may not be able to use certain brands of this medication.
Additionally, some medications can interfere with the combined pill and prevent it from working properly including some antibiotics, epilepsy medication, HIV medication and St John’s wort (a herbal medicine).
In many cases women who can't use this treatment can still obtain oral contraception, usually in the form of the progestogen-only pill instead or other forms of contraception such as the patch orring.
The oestrogen in combined pills can cause a range of side effects for the first few months including nausea, 'spotting' (bleeding between periods), breakthrough bleeding (bleeding between cycles) mood swings and breast tenderness. The risk of developing blood clots is slightly increased when using this form of contraception which can lead to heart attacks and strokes. It is still relatively uncommon, but a doctor will outline any risk factors during an online consultation before prescribing the combined contraceptive.
There is an ongoing debate on whether the combined pill can cause an increased risk of breast and cervical cancer. However in 2010, the Royal College of General Practitioners created a significant report revealing that women who used the combined contraceptive pill have a 12% reduced risk of cancer. The study researchers looked at 46,000 women over a time span of 40 years and discovered that those who had taken the pill were less likely to die of stroke, cancer or heart disease. Findings also revealed that breast cancer rates are identical in women who have taken the pill and those who have not. This discovery – if it is definitely confirmed – goes a long way towards waning former fear about this treatment and breast carcinoma.
If you are not breastfeeding after you have had a baby, you will most likely be able to start taking your contraceptive again 21 days after the birth. However, it’s always best to check with your doctor before doing so. If you are not taking any combined contraceptive after 21 days of birth, you should use additional contraception for the next 7 days. If you are breastfeeding, it is advised that you should not take any combined contraceptive pill until at least 6 weeks after the birth.
You can start taking your combined contraceptive pill up to 5 days after your miscarriage or abortion and you will have immediate protection from pregnancy. If you start taking your combined contraceptive after 5 days you will need to use additional contraception until you have taken ‘the pill’ for 7 days.
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