THE PILL

by Royal College of General Practitioners

The combined oestrogen and progestogen contraceptive pill

1. Start your first packet of pills on the first day of your cycle (the day your period starts) or within the first 3 days. If you do this you are immediately safe. Alternatively, you can start your pills on day 5 of your cycle and you will be safe when you have taken 7 pills.
2. Take one pill daily for 21 days (3 weeks). Then stop the pills for 7 days (1 week). Your period usually starts a few days after stopping the pills. It is usually shorter and lighter than your normal period and occasionally there is no bleeding. You are still safe in your pill free week.
3. Missed Periods - Providing you have taken all your pills correctly and have not had any vomiting or diarrhoea or taken any other medicines (especially antibiotics), this does not matter. Start your next packet of pills as usual after your pill free week.
4. Missed Pills - If you forget a pill, take it as soon as you remember and take your next pill at your usual time. You are safe providing you do not take a pill more than 12 hours late. If you are more than 12 hours late you should use another method of birth control or not have intercourse for the next 7 days, and at the same time continue to take your pills. If the 7 unsafe days following a forgotten pill run beyond the end of your packet, start your next packet immediately after finishing your present packet, ie miss out your pill free week and have your period at the end of your next packet (see diagram over the page). Missed pills may cause bleeding sometimes when taken only a few hours late. Continue to take your pills.
5. Spotting or Bleeding - This is common during your first one or two packets and may occur at other times. Providing you have taken all your pills correctly and not had vomiting or diarrhoea or taken any other medicines spotting is a nuisance but you are not unsafe. Report any irregular bleeding at your next clinic visit.
6. Vomiting and Diarrhoea - This may prevent the absorption of the pill from your stomach into your bloodstream. It is like missing a pill, and there may be some bleeding. You should use another method of birth control or not have intercourse for the next 7 days. Continue to take your pills. If the 7 unsafe days run beyond the end of your packet, start your next packet immediately after finishing your present packet, ie miss out your pill free week and have your period at the end of your next packet (see diagram below).
7. Antibiotics - Some antibiotics reduce the effect of the pill in some people. You should use another method of birth control or not have intercourse during your course of antibiotics and for 7 days afterwards. If these 7 days run beyond the end of your packet, start your next packet immediately after finishing your present packet, ie miss out your pill free week and have your period at the end of your next packet (see diagram below).
8. Other Medicines - There are some other medicines which might make the pill less effective so always tell your doctor when you are taking other medicines, or ask your pharmacist.
9. Do not stop taking the pill without first seeking advice from the Health Centre.

What to do if you have forgotton to take the pills at the right time

If you left more than 12 hours please also see the table below