In this Article:
01: Progesterone Only Pill (POP)02: Combined Oral Contraceptive (COC) 03: Long-Acting Reversible ContraceptionProgesterone Only Pill (POP)
How it prevents pregnancy
The traditional progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg.
The desogestrel progestogen-only pill can also stop ovulation.
The progestogen-only pill needs to be taken every day to work.
Side effects
The progestogen-only pill is generally well tolerated and side effects are rare.
Side effects may include:
acne
breast tenderness and breast enlargement
an increased or decreased sex drive
mood changes
headache and migraine
nausea or vomiting
small fluid-filled sacs (cysts) on your ovaries – these are usually harmless and disappear without treatment
These side effects are most likely to occur during the first few months of taking the progestogen-only pill, but they generally improve over time and should stop within a few months.
What to do if you miss a pill
If you forget to take a progestogen-only pill, what you should do depends on:
the type of pill you're taking
how long ago you missed the pill
how many pills you've forgotten to take
whether you've had sex without using another type of contraception in the previous 7 days
If you're less than 3 or less than 12 hours late taking the pill
If you're taking a 3-hour progestogen-only pill and are less than 3 hours late taking it, or if you're taking the 12-hour progestogen-only pill and are less than 12 hours late:
take the late pill as soon as you remember, and
take the remaining pills as normal, even if that means taking 2 pills on the same day
The pill will still work, and you'll be protected against pregnancy – you do not need to use additional contraception.
Do not worry if you've had sex without using another form of contraception. You do not need emergency contraception.
If you're more than 3 or more than 12 hours late taking the pill
If you're taking a 3-hour progestogen-only pill and are more than 3 hours late taking it, or you're taking the 12-hour progestogen-only pill and are more than 12 hours late, you will not be protected against pregnancy.
What you should do:
take a pill as soon as you remember – only take 1, even if you've missed more than 1 pill
take the next pill at the usual time – this may mean taking 2 pills on the same day (1 when you remember and 1 at the usual time); this is not harmful
carry on taking your remaining pills each day at the usual time
use extra contraception such as condoms for the next 2 days (48 hours) after you remember to take your missed pill, or do not have sex
if you have unprotected sex from the time that you miss your pill until 2 days after you start taking it reliably again, you may need emergency contraception – get advice from your contraception clinic or GP
tell them that you've been taking the progestogen-only pill as this can affect which emergency contraception is best for you to take
It takes 2 days for the progestogen-only pill to thicken cervical mucus so sperm cannot get through or survive.
The Faculty of Sexual Health and Reproductive Healthcare recommends using extra contraception for 2 days after you remember to take your pill.
The patient information leaflet that comes with your pill might say to use condoms for the next 7 days after you remember to take your pill. This is because it takes 7 days for the pill to stop you ovulating.
You can also read the patient information inside your box of medication for guidance.
Advantages and disadvantages
Advantages:
it does not interrupt sex
you can use it when breastfeeding
it's useful if you cannot take the hormone oestrogen, which is in the combined pill, contraceptive patch and vaginal ring
you can use it at any age
Disadvantages:
you may not have regular periods while taking it – your periods may be lighter, more frequent, or may stop altogether, and you may get spotting between periods
it does not protect you against STIs
you need to remember to take it at or around the same time every day
some medicines, including some (uncommon) antibiotics, can make it less effective
If taken correctly, it's more than 99% effective. This means fewer than 1 in 100 who uses the progestogen-only pill as contraception will get pregnant in 1 year.
Sickness and diarrhoea
If you're sick (vomit) within 2 hours of taking a progestogen-only pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time.
If you do not take another pill within 3 (or 12 hours) of your normal time, use additional contraception, such as condoms, for 2 days (7 days for the 12-hour pill).
If you continue to be sick, keep using another form of contraception, such as condoms, while you're ill and for 2 days after recovering.
Very severe diarrhoea – 6 to 8 watery poos in 24 hours – may also mean that the pill does not work properly.
Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea and for 2 days after recovering, or 7 days if you're taking a 12-hour pill.
Speak to a pharmacist, nurse or GP, or call NHS 111 or the national sexual health helpline free on 0300 123 7123, if you're unsure whether you're protected against pregnancy, or if your sickness or diarrhoea continues.
Risks of taking the progesterone only pill
Ovarian cysts
There is a chance you could develop fluid-filled cysts on your ovaries. These are not dangerous and do not usually need to be removed.
The cysts usually disappear without treatment. In many cases, the cysts do not cause symptoms, although you may experience pelvic pain.
Breast cancer
Research is continuing into the link between breast cancer and the progestogen-only pill.
There is not enough evidence to say for certain that the progestogen-only pill does not increase the risk of breast cancer.
But if there is any increased risk, it's likely to be very small and disappear with time after you stop taking the progestogen-only pill.
Ectopic pregnancies
The risk of any pregnancy is low during use of effective contraception. Of pregnancies that occur during use of the traditional POP, 1 in 10 may be ectopic.
More information can be found here:
https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/
Combined Oral Contraceptive (COC)
How it prevents pregnancy
The pill prevents the ovaries from releasing an egg each month (ovulation). It also:
thickens the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
thins the lining of the womb, so there is less chance of a fertilised egg implanting into the womb and being able to grow
Side effects
Minor side effects include
Mood swings
Nausea
Breast tenderness
Headaches
These usually settle down in a few months.
What to do if you miss a pill
If you miss a pill or pills, or you start a pack late, this can make the pill less effective at preventing pregnancy. The chance of getting pregnant after missing a pill or pills depends on:
when the pills are missed
how many pills are missed
Find out what to do if you miss a combined pill.
https://www.nhs.uk/conditions/contraception/miss-combined-pill/
You can also read the patient information inside your box of medication for guidance.
Advantages and disadvantages
Some advantages of the pill include:
it does not interrupt sex
it usually makes your bleeds regular, lighter and less painful
it reduces your risk of cancer of the ovaries, womb and colon
it can reduce symptoms of PMS (premenstrual syndrome)
it can sometimes reduce acne
it may protect against pelvic inflammatory disease
it may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease
Some disadvantages of the pill include:
it can cause temporary side effects at first, such as headaches, nausea, breast tenderness and mood swings – if these do not go after a few months, it may help to change to a different pill
it can increase your blood pressure
it does not protect you against sexually transmitted infections
breakthrough bleeding and spotting is common in the first few months of using the pill
it has been linked to an increased risk of some serious health conditions, such as blood clots and breast cancer
When taken correctly, the pill is over 99% effective at preventing pregnancy. This means that fewer than 1 in 100 who use the combined pill as contraception will get pregnant in 1 year.
Serious symptoms:
You should stop taking the COC and seek medical help urgently if you experience:
calf swelling
heat or pain in the calf
shortness of breath
chest pain
haemoptysis (coughing up blood from the lungs or bronchial tubes)
You should seek advice if you experience your first ever migraine or develop an aura if you normally suffer from migraines.
Risks of taking the combined pill
There are some risks associated with using the combined contraceptive pill. However, these risks are small.
Blood clots
The oestrogen in the pill may cause your blood to clot more readily. If a blood clot develops, it could cause:
deep vein thrombosis (clot in your leg)
pulmonary embolus (clot in your lung)
stroke
heart attack
The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors before prescribing the pill.
Cancer
The pill can slightly increase the risk of developing breast cancer and cervical cancer. It can also decrease the risk of developing womb (uterus) cancer, ovarian cancer and bowel cancer.
However, 10 years after you stop taking the pill, your risk of breast cancer and cervical cancer goes back to normal.
Additional information
If you are immobile or have restricted mobility for an extended period of time (due to travel, surgery or other reasons) you are at increased risk of blood clots. This risk may be further increased with the use of a COC. You should be advised to stop the COC and to switch to an alternative contraceptive method at least 4 weeks prior to planned major surgery or expected period of limited mobility.
If you are trekking to high altitudes (above 4500m or 14500 feet) for periods of more than 1 week you may be advised to consider switching to a safer alternative contraceptive method.
Sickness and diarrhoea
The general advice for people using oral contraceptives is to follow the instructions for missed pills if vomiting occurs within 3 hours of taking your COC or if severe diarrhoea occurs for more than 24 hours. It is advised to consider non-oral contraceptive if diarrhoea or vomiting persist.
If you vomit within 3 hours of taking the combined pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time.
If you continue to be sick, keep using another form of contraception until you've taken the pill again for 7 days without vomiting.
Very severe diarrhoea (6 to 8 watery poos in 24 hours) may also mean that the pill does not work properly. Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea and for 2 days after recovering.
Speak to a GP or nurse or call NHS 111 for more information, if your sickness or diarrhoea continues.
Antibiotics
The antibiotics rifampicin and rifabutin (which can be used to treat illnesses including tuberculosis and meningitis) can reduce the effectiveness of the combined pill. Other antibiotics do not have this effect.
If you are prescribed rifampicin or rifabutin, you may be advised to change to an alternative contraceptive. If not, you will need to use additional contraception (such as condoms) while taking the antibiotic and for a short time after. Speak to a doctor or nurse for advice.
More information can be found here:
https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
Long-Acting Reversible Contraception
Long-acting reversible contraception (LARC) is the term used for birth control that helps prevent pregnancy after just one treatment.
There are a few different options to choose from, so you can make sure you use the one that's right for you and your lifestyle. And because they can be reversed at any time, changing your mind about using them isn’t a worry either. This method of contraception is better at preventing pregnancy than oral contraception.
But remember – while LARC will protect you against pregnancy it will not protect you against sexually transmitted infections (STIs). So it would be sensible to keep using condoms to protect yourself against STIs.
There are four different types of LARC:
Contraceptive injection
This is a simple injection into a muscle on the top part of your bottom. Once done, you don't have to worry about getting pregnant for around 13 weeks.
Contraceptive implant
The implant is a small, flexible rod that’s placed under the skin in your upper arm and can be left for up to four years. It works by releasing the hormone progestogen which stops the ovary from releasing an egg and thickens the cervical mucus to make it difficult for sperm to enter the womb.
Coil with hormones (IUS or LNG-IUD)
This is a small, T-shaped device that’s placed inside the womb. Once in place, you don’t have to worry about getting pregnant for five years.
Coil without hormones (Cu-IUD)
This is a small device that’s inserted into the womb. Once in place you don’t need to worry about getting pregnant for five to 10 years, depending on the type used. The coil stops sperm reaching an egg and can also stop a fertilised egg from implanting.
Contact your doctor’s surgery or local sexual health clinic to find out more.
Where to find your local Sexual Health Clinic
Your nearest sexual health clinic can be found here:
https://www.nhs.uk/service-search/find-a-sexual-health-clinic
Using condoms alongside all forms of contraception is recommended for STI prevention. Further information on how to get free condoms can be found here:
https://www.nhs.uk/service-search/other-health-services/free-condoms
For information and advice about sexual health, including contraception and sexually transmitted infections (STIs) please check out this page: