Contraceptive Pill

You should take contraceptive pills at the same time every day, but the specific instructions vary depending on the type and brand of the pill. For example:

• If you are using a combined pill with 21 active pills per pack, you should take a 7-day break between packs unless you are taking it continuously without a break.
• If you are using a combined pill with 21 active pills and 7 dummy pills, you should not take a break between packs.
• If you are using a mini pill (progestogen-only), you should not take a break between packs.

Some pills require strict adherence to the exact time of day every day, while others offer more flexibility. You should consult your doctor to choose the method that best fits your lifestyle.

What to Do If You Forget to Take a Pill?

If you forget to take a pill, take it as soon as you remember and then continue taking the next pill at the usual time, even if it means taking two pills at once. Depending on the type of pill (combined or mini) and the timing within your menstrual cycle when you missed the pill, contraceptive effectiveness may be reduced, and you should use additional contraception methods. Please read our doctor’s advice on what to do if you miss a contraceptive pill.

When Do Contraceptive Pills Start to Work?

Generally, contraceptive pills become effective after 7 consecutive days of use, regardless of the day of your menstrual cycle when you start.

• For both combined and mini pills, if you start taking them on days 1-5 of your cycle, the pill is effective immediately without the need for additional contraception.
• If you start outside this window, you should use additional contraception methods, such as condoms, for the first 7 days for combined pills or the first 2 days for mini pills.

When taken correctly and consistently at the same time every day, contraceptive pills are over 99% effective at preventing pregnancy. This means that only about 1 in 100 women per year may become pregnant. Therefore, even with strict adherence to instructions, there remains a small risk of pregnancy.

However, in reality, users may not always take the pill perfectly, which reduces the actual effectiveness to about 91%. The main reasons for this include:

• Forgetting to take the pill
• Taking the pill at different times each day
• Experiencing severe vomiting or diarrhea
• Taking other medications that may reduce the effectiveness of contraceptive pills

The main mechanisms by which contraceptive pills prevent pregnancy include:

• Inhibiting ovulation: Preventing the body from releasing an egg from the ovary into the uterus each month.
• Thickening cervical mucus: When the mucus at the cervix becomes thicker, it makes it harder for sperm to move through and fertilize the egg.
• Thinning the uterine lining: Thinning the lining of the uterus reduces the chance of a fertilized egg implanting and developing in the uterus.

Hormones in contraceptive pills may cause various side effects, but they also offer other benefits such as improving acne, reducing menstrual flow, and alleviating menstrual cramps. For these reasons, some people choose to take contraceptive pills specifically for these benefits rather than solely for pregnancy prevention.

However, you should consult and discuss your options with a doctor before starting the pill to help you choose the type of contraceptive that best suits your body and lifestyle.

The side effects of different types of contraceptive pills are generally similar regardless of brand, but the severity and symptoms experienced can vary from person to person.

Side effects of combined pills:

• Spotting or breakthrough bleeding — commonly occurs with continuous or extended-cycle use
• Breast tenderness
• Increased blood pressure
• Headaches
• Nausea
• Bloating

Side effects of mini pills:

• Irregular menstrual periods
• Acne
• Breast tenderness
• Reduced libido
• Depression
• Headaches
• Nausea
• Ovarian cysts

When it comes to contraception, contraceptive pills are not your only option. There are many other methods, each with its own advantages and disadvantages, as follows:

• Hormonal Implant: A small rod implanted under the skin of the upper arm that gradually releases progestogen hormone to prevent pregnancy.
• Copper Intrauterine Device (IUD): A small device inserted by a doctor through the vagina and cervix into the uterus to prevent fertilization.
• Hormonal Intrauterine System (IUS): Similar to the copper IUD but releases hormones to prevent pregnancy and also reduces menstrual flow, cramps, and duration.
• Contraceptive Injection (Depo-Provera): Hormone injections given every 8 or 13 weeks (depending on the type) to prevent pregnancy.
• Hormone Patch: A small patch applied to the skin that releases hormones similar to combined contraceptive pills through the skin. When used correctly, it is up to 99% effective.
• Vaginal Hormonal Ring: A small ring inserted into the vagina that releases estrogen and progestogen hormones, the same as those in combined contraceptive pills.
• Diaphragm: A hormone-free silicone dome inserted into the vagina to block sperm from entering the cervix.
• Cervical Cap: A silicone cup inserted into the vagina to cover the cervix and block sperm, usually used with spermicide for maximum effectiveness.
• Male Condom: A sheath worn over the penis during intercourse to prevent sperm from entering the vagina. It is an affordable and effective method to prevent both pregnancy and sexually transmitted infections (STIs).
• Female Condom: Also known as an internal condom, it is a lubricated sheath inserted into the vagina before intercourse to prevent sperm from reaching the cervix.
• Withdrawal Method: A contraceptive method where the male withdraws the penis before ejaculation. This method is unreliable and carries a high risk of pregnancy due to sperm present in pre-ejaculate fluid. It also does not protect against STIs.

Can contraceptive pills cause bleeding between periods?

Bleeding between periods is a possible side effect of some contraceptive pills, especially the mini pill. Although it can be inconvenient, this bleeding is usually not a sign of a serious problem and is not harmful to your health. Most cases are temporary and improve within 2-3 months as your body adjusts to the medication. However, if bleeding persists beyond 3 months or is unusually heavy, you should see a doctor to rule out other causes.

If my period doesn’t come while taking contraceptive pills, am I pregnant?

Contraceptive pills are over 99% effective when taken correctly, so the chance of pregnancy is very low. Missing a period does not always mean you are pregnant. Some pills, especially the mini pill, can cause delayed, skipped, or missed periods.

Can I switch to a different type of contraceptive pill?

There are many types of contraceptive pills available. If you feel your current pill is not suitable, there are other options. However, you should consult your doctor before switching to ensure you choose the right pill and learn how to switch safely.

Do contraceptive pills cause weight gain?

Some women report weight gain while taking contraceptive pills, but there is no clinical evidence that contraceptive pills directly cause weight gain. However, estrogen can cause the body to retain water, and progestogen may increase appetite, both of which can contribute to weight gain.

How long after stopping contraceptive pills can I get pregnant?

Taking contraceptive pills does not have a long-term effect on fertility. Fertility usually returns to normal shortly after stopping the pill. You can become pregnant immediately after stopping, although some women may take 2-3 months for their menstrual cycle to normalize.

Can contraceptive pills stop your period?

You can delay your period if you are taking combined contraceptive pills by taking two packs consecutively, which can delay your period by about 3 weeks. Most combined pills can be used this way.

If you are not using combined pills or are on the mini pill, you may use other progesterone-based period delay pills, which can delay your period for up to 17 days.

Can I take antibiotics with contraceptive pills?

Most antibiotics do not interact with contraceptive pills or reduce their effectiveness. However, some rare antibiotics may have an effect, so always inform your doctor if you are taking contraceptive pills when prescribed antibiotics.

Additionally, some antibiotics may indirectly affect contraceptive effectiveness by causing vomiting or diarrhea. If you take antibiotics regularly or plan to, consult your doctor to ensure there are no interactions.