There are a few important things that you should know about using The Pill if you are currently or thinking about taking it for contraception to prevent pregnancy. It’s 99% effective when it is used correctly, but only 91% effective if you don’t use it properly – if you forget to take it at the right time, for example.
In this guide, we’re going to cover how to take the oral contraceptive pill and what you should do if you accidentally forget to take a dose.
How does The Pill work?
The Pill contains synthetic oestrogen and progesterone hormone to manipulate the natural menstrual cycle of a woman.
The dose of the hormones in The Pill works to prevent pregnancy by stopping ovulation so that an egg is not released from the ovaries. Additionally, the hormones increase the thickness of the fluid at the opening of the uterus, so that it is more difficult for sperm to pass through and fertilize the egg.
Types of Oral Contraceptive Pills
There are two different types of oral contraception that are used in Australia:
- “The pill” or combined oral contraceptive pill contains both oestrogen and progesterone hormones. (The most common type)
- The mini pill contains only progesterone hormone. (This is the best option for women who are breastfeeding.)
You’ll need to see your doctor for a prescription to get access to either type of oral contraceptive pill.
If you’d more information about the differences between the different types of oral contraceptive pills to help you choose the best option, feel free to ask us at Inverell Pharmacy.
Are there side effects?
Many of the unintended effects of the pill can actually be beneficial for the women. It can cause periods to be lighter, premenstrual syndrome to be less severe and help to improve acne or other skin problems. However, some women may notice side effects such as:
- Mood swings
- Headaches
- Sore or tender breasts
- Nausea or stomach pain
- Weight gain
Some research has found that women who take the oral contraceptive pill may have a slightly increased risk of developing breast or cervical cancer. On the hand, some studies have found that the oral contraceptive pill has a protective effect for other types of cancer and women who take The Pill are less likely to develop ovarian, uterus or bowel cancer.
How to take The Pill
It is important to take the Pill every day for it to work effectively. This helps to make sure that you keep the dose of the hormones in your body at the right level to prevent you from becoming pregnant.
You can take the pill at any time of the day, with or without food. The most important thing is for you to fit it into your daily routine so that you remember to take it. Many women find it easier to remember to take the pill in the morning, and they can catch up the dose later on in the day if they happen to forget occasionally.
Depending on which brand of oral contraceptive pill you are taking, it will be available in ether a 21-day or 28-day pack. Both packs have 21 days of active pills that contain hormones, and the 28-day pack has 7 extra “sugar pills” to help you continue the habit of taking the pill each day during the withdrawal bleed period.
During the sugar pill or break period, depending on which type of pack you have, you may have a “withdrawal bleed.” This is similar to a period in that you will have bloody discharge, but it isn’t a true menstrual period because you haven’t ovulated.
- If you miss a pill.
- If you have been being sick (vomiting).
The following gives a general guide.
Most brands of pill come in packs of 21. To start, it is best to take the first pill on the first day of your next period. You will be protected against pregnancy from then on. If you start the pill on any other day, you need an additional contraceptive method (such as condoms) for the first seven days. You should take your pill at about the same time each day for the 21 days.
You then have a break of seven days before starting your next pack. You will usually have some bleeding in the seven-day break, although it may happen later. This is called a withdrawal bleed and is like a period, although strictly speaking it is not a menstrual period. You will be protected from pregnancy during the seven-day break provided you have taken your pills correctly and you start the next pack on time. Start the next pack after the seven-day break whether you are still bleeding or not. If you take the pill correctly, you will start the first pill of each pack on the same day of the week. (It is only when you start the pill for the first time that you take the first pill on the first day of your period. After this, you should ignore your period and start each packet on the same day of the week as the month before. Write down the day of the week you start your first pack, and start all your packets after that on that day.)
Most 21-day pills have the same amount of oestrogen and progestogen in each pill. Some brands, called phasic pills, vary the dose in two or three steps throughout the 21 days. The pills in these packets have to be taken in the correct order as directed on the packet. One type of pill called Qlaira® has a changing dose throughout the cycle, and also needs to be taken in the correct order.
Brands with pills for every day
Most of these contain 21 active and seven dummy pills. There are 28 pills in a packet. Instead of a seven-day break, you carry on taking the dummy pills. As soon as you finish one packet, you go on to the next. The idea is that you don’t have to remember to restart the pill after a seven-day break and you develop a routine of taking a pill every day. The pills have to be taken in the correct order. Read the instructions carefully, particularly on when to start, which pill to start with, and how long it takes for the contraceptive effect to begin.
What should you do if you forget a dose of The Pill?
There are two important rules to remember for you to be sure that The Pill is working correctly. Firstly, it takes a week of hormone pills taken every day to be sure that your body is covered. Secondly, the hormone levels in your body can drop enough for you to be able to become pregnant if you don’t take a hormone pill for more than two days.
So what does this mean for you?
If you miss one hormone pill, you are not likely to become pregnant. If you remember later on in the day, simply take the pill then and the next dose, as usual, the following day.
If you miss two or more hormone pills, the hormone levels in your body can drop, and it is possible for you to become pregnant. You may need to take extra precautions to avoid pregnancy for the next week. Additionally, if you’ve recently had the sugar pills or break period, you may need to take the emergency contraceptive pill to prevent pregnancy.
If you’ve missed one or more pills and would like to double check about what you should do, feel free to ask for personalized and professional advice at Inverell Pharmacy.
Do other medicines interfere with the pill?
Yes, some do but most do not. Therefore, before you take any other medicines, including those available to buy without a prescription, herbal and complementary medicines, ask your doctor or pharmacist if they stop the pill from working properly. He or she will advise you on what to do.
For example, some medicines that are used to treat epilepsy and tuberculosis (TB) can stop the pill from working properly. St John’s wort is an example of a commonly used herbal remedy that can affect the pill.
Antibiotic medicines
Antibiotics (other than one called rifampicin) do not interfere with the effectiveness of the pill. In the past it was recommended that, if you were taking antibiotics and were also taking the pill, you should use additional contraception. This is no longer the current recommendation after more recent evidence has been reviewed. You should continue taking your pill as normal if you also need to take any antibiotics.
What if I am sick (vomit) or have diarrhoea?
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, you will remain protected from pregnancy. If you continue to vomit, the advice is the same as missing pills (see above). Mild diarrhoea does not affect the absorption of the pill. Severe diarrhoea may affect it and if you have severe diarrhoea, consider this as the same as missing pills (see above).
Bleeding whilst on the pill (breakthrough bleeding)
During the first few months, while your body is adjusting to the pill, you may have some vaginal bleeding in addition to the usual bleeding between packs. This is not serious but more of a nuisance. It may vary from spotting to a heavier loss like a light period. Do not stop taking your pill. This usually settles after the first 2-3 months. If it continues (persists), see your doctor or nurse. Another brand of pill may be more suitable for you.
Can I delay or skip a withdrawal bleed (period)?
There are times when it is useful not to have a period – for example, during exams or holidays. Check with your doctor or nurse about the best way to do this with your particular brand of pill. For the commonly used pill types (that is, not bi-phasic or tri-phasic or the pills that are taken every day with 28 pills in the packet) you can go straight into your next pack without a break. Have the usual seven-day break at the end of the second packet.
Want to find out more?
If you’d like to find out more the oral contraceptive pill and what to do if you accidentally miss a pill, we’ll be happy to help you at Inverell Pharmacy. Simply stop by at 132 Byron Street (next to Telstra) for a chat with one of our pharmacists for more information, or give us a call on 0267 22 3146.
Inverell Pharmacy – your locally owned and operated pharmacy with 5 pharmacists to Assist and Advise you.