Q2A

Got a question about......

Whether you are protected in the 7 days when you dont take the contraceptive pill while you have a period.  Are you still protected til your period starts and also, if you forget to take the pill one day but then take two the next, does that affect it?

This is our reply.......

Many thanks for your enquiry. We understand that you are concerned about how protected you are during the 7 contraception pill free days and when you miss pills.

There are two types of contraceptive pill and you don't tell us which one you are prescribed. It does make a difference so we will outline briefly information about both below, with some brand examples. Hopefully you will recognise your own.

A combined pill is the most common which contains two hormones - oestrogen and progestogen. Examples of this kind of pill are:

Standard Strength Oestrogen - 21 days:

BiNovum / Brebinor / Cilest / Dianette / Femodene / Katya 30/75 / Loestrin 30 / Logynon / Microgynon 30 / Norimin / Noriny1 - 1 / Ovysmen / Ovranette / Synphase / Triadene / Trinordial / TriNocum / Yasmin
Standard Strength oestrogen - 28 day or Every Day (ED):Femodene ED / Logynon ED / Microgynon ED

Low Strength Oestrogen - 21 day
Femodette / Loestrin 20 / Mercion / Sunya 20 / 75

A progestogen - only pill contains the hormone progestogen. Examples of this kind of pill are:

Fenulen / Micronor / Norgeston / Noriday / Cerazette

The combined pill is where you take it for 21 days and then have a 7 day break whereas the progestogen only pill you take every day even when on your period. Therefore we think you are on a combined pill if you are having a 7 day break in between pill packets.

The combined pill is over 99% effective if used correctly. This means that less than 1 woman in 100 using the pill correctly will become pregnant each year so its effectiveness is high. Correct use means not missing any pills, and taking extra contraceptive precautions when necessary such as if you are taking antibiotics.

Your doctor will normally advise on what to do if you are prescribed an antibiotic. Generally, when prescribed a short course of antibiotics (up to three weeks) you should carry on taking your pill. However, in addition, you should use another method of contraception (usually condoms) whilst you are on the antibiotics and also for a further seven days after you have finished the course of antibiotics.

If, when you stop the course of antibiotics, you have less than seven pills left in the packet, you should not have the usual seven day break from taking the pill. You should start the next packet straight away. If you are in the first week of your pill packet and you start some antibiotics and you have had sex in the last few days, then seek advice from your doctor or nurse. You may need emergency contraception.

If you vomit within 2-3 hours of taking a pill, the pill will not have been absorbed. If you are well enough, take another pill as soon as possible. Provided that you do not vomit this second pill and it is taken on the same day, then you will remain protected from pregnancy. If you continue to vomit, then it is the same as 'missing pills'.

Mild diarrhoea does not affect the absorption of the pill. Severe diarrhoea may affect it, so if you have severe diarrhoea, consider this as the same as 'missing pills'.

With the combined pill, taken as prescribed, you are protected from pregnancy during the 7 day break.

In terms of when you start bleeding during your 7 day pill break then it varies with each person. Generally you should start bleeding 2-4 days in the 7 days break period but even if you are still on your period when you need to start the pill again after the 7 day break don't worry just start the next pack as normal.

Generally it is a good idea to take the combined period at the same time each day whether that's when you get up, or go to bed, or lunch time. It's best to choose a suitable time and one that you won't forget; many women choose to take it first thing in the morning or last thing at night. If you do forget to take a pill on one day then you need to take it as soon as you remember. You are allowed up to 12 hours after you should have taken it to take it. As long as you take the pill you should be okay, however if it is longer than 12 hours you are at a greater risk of the pill not being as effective especially if the missed pills are at the beginning or at the end of the cycle.

It also depends on how many pills you have missed. Taking 2 pills at once won't mean you are at a lesser risk of getting pregnant either. As a general rule if you have missed taking a pill or taken it after the 12 hours then you should remember to take the pill as soon as you can and use other forms of contraception alongside the pill as well such as condoms for 7 days.

If you are having a problem remembering to take your pill then try and think of places where you can put the pack, put the pack in a visible place where you will see it when you need to but obviously discreet enough so others in your family don't see it all the time - perhaps your knickers drawer that you go into every day or jewellery box if you wear jewellery every day or possibly your handbag.

If it still is becoming a problem and you are forgetting a lot then maybe you could consider going onto another form of contraception where you don't need to remember all the time. For instance you could go on the contraception injection.

The contraception injection is also over 99% effective. It lasts for 12 weeks (Depo - Provera) or 8 weeks (Noristerat). As with any form of contraception there are advantages and disadvantages. Some of which are:

Advantages:

- You do not have to remember to take a pill every day.
- You only have to think about contraception every 2-3 months.
- It does not interfere with sex.
-It may help some of the problems of periods, such as pre-menstrual tension, heavy periods and pain.

Disadvantages:

-The injection cannot be removed once given, so any side effects last for more than 2-3 months until the progesterone goes from your body.

-As the injection is long acting, it takes some time after the last injection for its effect on fertility to wear off. This time varies from woman to woman. Some women take 6-8 months after the last injection before fertility returns. Rarely, it can take up to two years before fertility returns. This delay is not related to the length of time you use this method of contraception.

-Your periods are likely to change. During the first few months some women have irregular bleeding which can be heavier and longer than normal. However, it is unusual for heavy periods to persist. After the first few months it is more common for the periods to become lighter than usual, although they may be irregular. Many women have no periods at all. The longer it is used, the more likely periods will stop. Periods stop for about 7 in 10 women after they have had the injection for a year

Another form of contraception you could consider using is the implant. This is also over 99% effective. A contraceptive implant is a small tube that is put under the skin. It contains a progestogen hormone.

Advantages and disadvantages include:

Advantages:

-You don't have to remember to take a pill each day
-You only have to remember to think about contraception every three years
-It does not interfere with sex

Disadvantages:

-Periods can become irregular during the first year after having the implant and can become heavy but they do tend to settle down after a period of time.
-Some women do experience less bleeding or no bleeding at all

There are now many different forms of contraception to choose from, if you require further information about contraception you could go to your local GP or nurse. Alternatively you could go to:

Family Planning Clinic
The Bridge Sexual Health Clinic
Braille St
Health Centre
Rochdale
OL16 1XS
Tel: 01706 517633 (Opening hrs for appointments are Mon - Fri 9.30am - 4.30pm), appointments are necessary.

Further information on the combined pill can be found at:
www.bbc.co.uk/health/sexual_health/contr_combpill.shtml
www.fpa.org.uk/Information/.../combined
www.patient.co.uk/.../Combined-Oral-Contraceptive-Pill.htm

Further information on contraception methods can be found at:

www.brook.org.uk/content/M2_1_Contraception.asp
hcd2.bupa.co.uk/fact_sheets/Mosby.../contraception.html
www.netdoctor.co.uk/sex.../facts/contraception_which.htm

So to summarise in order for the pill to be effective you need to take it preferably at the same time each day but no longer than 12 hours after you were supposed to take it and not miss a pill. If you do miss the pill or take it after 12 hours then you need to use further protection for 7 days whilst still taking the pill as normal. Taking two pills after one another due to forgetting to take the first one the day before will not protect you from pregnancy.

We hope that you find this information useful, if you need any more information on this or anything else please come back to us.

 

Expert advice and every precaution has been taken to ensure that the information in this answer is trustworthy and reliable, but the publishers do not hold themselves responsible for any inaccuracy as information can go out of date very quickly.  This page gives general guidance only and should not be treated as a complete and authoritative statement of the law.  With regard to suggested weblinks given in this reply please note that Lancashire County Council is not responsible for the content of external internet sites.

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