"Hormonal methods, including the pill, are among the most effective forms of contraception, but they won't stop you getting infections."
What are contraceptive pills and how do they work?
Contraceptive pills are a hormonal method of contraception. They add modified versions of natural female sex hormones to your monthly cycle of hormone release. If you take them properly they are very effective at preventing pregnancy. They won't stop you getting infections so it is a good idea to use a condom even if you are taking oral contraceptives or 'on the pill'.
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Where can I get 'the pill' from?
You can get contraceptive pills only from a doctor, who will take a medical history to make sure they will be safe for you. You can get them from:
You can also get contraceptive advice from shac, at Clinic 1A. At The Laurels - Contraception & Sexual Health Service in Cambridge City Centre, you can get contraceptive advice and supplies.
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What types of pills are there?
There are two main types of contraceptive pills, the combined pill and the progestogen-only pill. Your doctor will help you decide which one is best for you.
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What is the combined pill?
The combined pill contains two hormones, oestrogen and progestogen. You must always follow the instructions carefully. Most pills come in packets of 21. You take a pill a day for 21 days and then have a pill-free break of 7 days in between each packet. You should take the pills within 12 hours of the correct time. It stops the release of an egg every month but it doesn't stop your periods. This type of pill is very effective when the instructions are followed perfectly.
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What are the advantages of the combined pill?
Taking the combined pill might make your periods lighter, which can be advantageous if you get bad period pains or heavy bleeding. It also protects you against cancer of the ovary and womb. We don't usually advise women who are over the age of 50, or 35 if they smoke, to use a combined contraceptive pill. We also encourage girls and women taking this pill to stop smoking.
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What is the progestogen-only pill, POP?
This type of pill contains only progestogen. It works by altering the mucus in the cervix, at the neck of the womb, making it thicker, which stops sperm getting through to the egg. It can also make the womb lining unsuitable for fertilised eggs to attach to and sometimes it can also stop the release of eggs. You should follow the instructions for using this pill carefully, for example, this type of pill has to be taken at the same time every day, within three hours. It can be around 96% effective. Because it has to be taken very regularly it might not be the first choice for a young, very fertile woman, unless for medical reasons she cannot use the combined pill.
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Why might the pill not work?
For the pill to be effective you need to have small but regular amounts of the hormones circulating around your body. You must make sure that you are getting this dose of hormones regularly. If a contraceptive pill fails it is usually because the girl or women has missed pills out or not taken them regularly.
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How can illness or medications affect the pill?
If you have vomiting, severe diarrhoea or are taking some other medicines at the same time as a contraceptive pill, you might not absorb enough of the hormones in the pill. If you are worried, ask your doctor, family planning clinic or a doctor at Clinic 1A. You might need to use other additional types of contraception for that month, or even arrange for some emergency contraception. If in doubt, use a male or female condom as well as continuing the pill. The worst thing you can do is to lengthen your 7-day pill-free break or take extra breaks without checking first with your doctor.
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I have missed a combined pill, what should I do?
The advice we give at shac if you have missed pills from a 21-day pack of combined pills (Adapted from Contraception Today, 3rd Edition, by John Guilleband) is as follows:
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If you are less than 12 hours late taking a pill.
Don't worry, just take the delayed pill at once and further pills as usual.
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If you are more than 12 hours late in taking one pill or more.
Take the last missed pill straight away but leave the other missed pills in the pack. Take further pills as usual. Use extra precautions, for example condoms, for the next 7 days.
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If there are 7 or more pills left in your pack after the missed or delayed pills when you have finished the pack.
Leave the usual 7-day break before starting the next pack.
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If there are less than 7 pills left in the pack after the missed or delayed pills when you have finished the pack.
Start the next pack the next day without a break.
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If you have missed two or more pills AND they were all from the first seven in your pack AND if you have had unprotected sexual intercourse since the end of your last pack.
Go to seek advice promptly from your doctor because you might need emergency contraception. In addition follow the advice given above.
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I have missed taking a progestogen-only pill, what should I do?
If you are using a progestogen-only pill and you miss one out or are more than three hours late taking it, you might need emergency contraception and should talk to someone at the family planning clinic, or your GP or shac as soon as you can.
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Is the combined pill dangerous?
The contraceptive pill and other hormonal methods of contraception work well for millions of girls and women worldwide, and they are mostly very safe. Some people can have problems with it and your medical history will need to be checked before the combined pill is prescribed.
"Don't stop taking the pill before arranging other types of contraception."
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What are the risks with taking the pill?
You should discuss contraceptive choices with a doctor before deciding on which method is best for you. One of the risks of taking the pill is that it can increase the very rare chance of a girl or woman getting a thrombosis, a blood clot. You are at an extremely low risk of this happening if you are fit and well and don't smoke. The tendency to have blood clots is increased in some families which is why your medical history will need to be checked. Different types of pill have different levels of risk of causing thrombosis and you might be advised to change from one to another.
"A good way to reduce the risks of taking the pill is to stop smoking."
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