How to take contraceptive pills correctly

There are many different types of contraceptive options. This section will cover the most common options and how they are taken.

The combined oral contraceptive pill (COCP)

The COCP (often called “the pill”) should typically be taken at the same time every day, no more than 24 hours after your normal time. Depending on the pill you’re on, these instructions may vary slightly:

Monophasic 21-day pills:

This is the most common type of contraceptive pill. Each pill contains the same amount of hormones in it. You take 1 pill daily for 21 days, followed by a pill-free period of 7 days. This is where you will get a withdrawal bleed.

Everyday (ED) pills:

These packs contain 21 active pills and 7 sugar pills (inactive pills). You take 1 pill daily for 28 days and during the 7 days of taking the sugar pills, you will get a withdrawal bleed.

Some contraceptive packs may contain 24 active pills and 4 inactive pills (24/4 regimes). This means that you will have a shorter break in between packs. This reduces the chance of contraceptive failure and breakthrough ovulation.

Multiphasic pills:

These contain multiple sections within a pack, where each section contains a different amount of hormones. They try to mimic the way your own hormones would fluctuate and change during your cycle. The varying hormone levels in each section mean you have to take these pills in the correct order. Multiphasic pills are available in packs of 21 and 28 pills.

Progesterone-only pill (POP)

The POP (“mini-pill”) only contains the hormone progesterone in them. Most minipills are taken daily, at the same time, for 28 days with no pill-free break between packs. You start the next blister immediately after finishing the current one.

Desogestrel minipills can be taken up to 12 hours after your normal pill-taking time, while traditional minipills should not be taken more than 3 hours after your normal time.

The contraceptive patch

This is a small adhesive patch that releases hormones through your skin into the bloodstream daily to prevent pregnancy.

Apply your first patch onto an area of clean, dry, hairless skin and wear it for 7 days (each patch lasts 1 week). On the eighth day, remove the old patch and apply a new one. Change this every week for 3 weeks, and then have a patch-free week. Then, repeat this cycle.

The vaginal ring

This is a small soft plastic ring that is placed inside the vagina. It prevents pregnancy by releasing oestrogen and progestogen into the bloodstream continuously.

You can insert the ring into your vagina and leave it there for 21 days before removing it and taking a 7-day break. After this break, insert a new ring.

You can also choose to have a shorter ring-free break or to skip the break altogether. Each ring provides contraception for 1 month.

Long-acting reversible contraception (LARC)

These provide contraception that lasts from months to years after insertion and includes:

• Intrauterine device (IUD)
• Intrauterine system (IUS)
• Contraceptive implant
• Contraceptive injection

For your contraception to be effective, it is important to take it at the same time every day, as there is a small "window" for error. It may be helpful to coordinate taking the pill at the same time as an activity you do each day.

For instance, if you wake up or sleep at the same time every day, consider incorporating the pill into your morning or bedtime routine. You could take the pill just before bed or after you brush your teeth. You could also set a daily reminder on your phone.

There are multiple ways you can start taking the pill according to where you are in your menstrual cycle. How and when you start taking it will determine how quickly you will be protected from pregnancy.

Starting on the first day of your period: Taking one pill daily starting from day 1 of your period provides immediate pregnancy protection. You will not need to use any additional methods of contraception.

Starting within 5 days of your cycle: Starting the pill within 5 days of your period and taking one tablet daily, will protect you from pregnancy immediately.

Starting after 5 days of your cycle: This means that you won't be protected from pregnancy until you have taken the pill 7 days in a row. You should also use additional contraceptive methods during this time.

Switching to the contraceptive pill from other contraceptive methods

In most cases, switching to the contraceptive pill from other contraceptive methods is an easy process.

These instructions may vary depending on the brand of contraception you are using. It is best to contact your doctor for further advice.

You can become pregnant again very soon after giving birth so it's important to plan contraception in advance.

Depending on your health condition, and whether or not you will be breastfeeding, there are several options for contraceptive methods to use after giving birth.

Read more

Vomiting/diarrhoea

If you vomit within 3 hours of taking the pill, it may prevent the full absorption into your bloodstream and might not be effective. If this happens, treat this event as a ‘missed pill’ and take another pill straight away and the next pill at your usual time.

If you continue to vomit, you will need to use another form of contraception until you've taken the pill for 7 days in a row without vomiting.

In the case of severe diarrhoea, there is a chance that the pill won't work properly. If this occurs, continue taking your pill as normal, and use additional contraception while you have diarrhoea and for 2 days after this stops.

Taking certain medications

Some medicines may interact with the pill and make it less effective. This includes some antibiotics, epilepsy drugs, herbal remedies (e.g. St John's wort) and more.

Always tell your healthcare professional all the medicines you take. If there is an interaction, you may need to change to a different contraceptive or use additional contraception.

If you miss 1 pill take it as soon as you remember, and take your next pill at your regular time (even if this means taking 2 pills together). If you miss 1 pill, you are still protected from pregnancy.

If you miss 2 or more pills, follow the same instructions as mentioned above. Depending on how you are taking the pill, you might need to use other contraceptive methods to protect yourself from pregnancy. You can read our article about what to do if you miss a pill.

If you miss a pill and are worried, you can consider taking the emergency contraceptive pill, also known as 'the morning after pill'. This can prevent pregnancy after unprotected sex or if the contraception you have used has failed. These are available through your doctor or sexual health clinics.

If you've taken one extra contraceptive pill by mistake you should not experience any unusual symptoms. You can seek medical advice if you are worried.

If you have taken a few extra pills you may experience side effects such as nausea, vomiting, or vaginal bleeding. These symptoms will pass, however, if you are concerned it is best to speak to a healthcare professional.

Most people who take the pill do not develop any side effects. However, a small number of people do.

Taking the pill just before bed may help to avoid side effects such as nausea or headaches.

Experiencing mood changes is common among women taking the pill. If you experience this, consider keeping a journal to track your mood or talking to a healthcare professional.

Certain oral contraceptives can worsen skin issues for some people, while others are prescribed them specifically to address skin conditions, such as acne. If your skin becomes worse, your doctor may recommend trialling a different COCP.

Taking the pill is also associated with a small increased risk of developing a blood clot. However, the risk is not the same for everyone.

If you’ve been taking birth control for some time and have had no side effects, it’s likely that you can continue using it for as long as your doctor considers it a safe choice for you.

It is important to understand the risks and benefits associated with hormonal contraception.

It’s important to have regular checkups with your doctor or nurse when taking contraceptives. At these appointments, your doctor or nurse will check your blood pressure and body mass index (BMI).

They may also ask about any new medical conditions or medications you take to see if your chosen contraceptive method remains suitable for you.

It can be hard to remember to take your medication, even when you are at home. Travelling can disrupt your routine, especially when you are crossing time zones.

Here are some tips for taking the pill safely when travelling:

• set up an alarm reminder on your phone or a 24-hour countdown
• keep a watch on ‘home time’ and continue to take your tablets at the normal time you would take them back home
• before leaving, adjust your usual pill time based on your destination
• take enough supply of the pill to cover your trip and any delays

• For contraceptives to be effective, they need to be used consistently and correctly. This is particularly important for methods like contraceptive pills, which must be taken daily at the same time.
• Some side effects of oral contraceptives such as nausea or headaches are common when you first start taking the pill. These usually subside with time.
• You should ensure you have enough supply of your contraceptives to avoid running out and putting yourself at risk of pregnancy.