Contraception is prescribed free of charge on the NHS and there are many different options.
Here are some websites with lots of information on the various options. They include videos on the open clinic website showing the longer acting reversible contraceptives (LARCs); these include the copper coil, hormonal coil and implant which are all offered at Marden Medical Practice.
Contraception – NHS
Contraception – Open Clinic
Please book an appointment with the GP or ANP if you would like to start a form of contraception. If this is a pill, we can issue you with 12 months supply.
Contraception – Patient Information Leaflets
The Combined Pill
There is a new way to take the combined pill (oestrogen and progesterone). Here is some information regarding this:
Continuous Pill Taking
- For many years the standard way of taking the combined oral contraceptive pill (eg Microgynon) has been to take this daily for 21 days then to have a 7 day break (pill free interval) when you would have a “period” or withdrawal bleed.
- If you take the pill in this way and then also by chance miss 1 or 2 further pills in your pack it can make it more likely for your ovaries to release an egg (ovulate) and increase the chance of you getting pregnant.
- New evidence has emerged saying that the pill is much safer as a contraceptive if you take this more flexibly, using 3 or 4 packs continuously and then have a shorter 4 day break (pill free interval).
What is an “off licence” prescription?
This new way of prescribing the pill is “off licence”, yet it is supported by medical authorities in the UK and by WHO.
All medicines have a product licence, which informs doctors which conditions the medicines can be prescribed for patients.
Sometimes guidance can change from the standard advice, and when this happens doctors are then allowed to prescribe “off-licence” if expert medical opinion says that a medicine can now be safely used in different ways or under different conditions.
Advantages of continuous pill taking
It’s a more effective way of using the contraceptive pill and you are less likely to become pregnant.
You don’t have to have regular monthly bleeds to know you are not pregnant.
By having fewer periods or bleeds you will get fewer related problems like period pain, PMT, migraine and other headaches.
It’s more flexible – You can choose when it’s convenient to take your 4 day break from pill taking, and when you want to continue to take the pill to avoid a bleed e.g. for holidays and special occasions.
How do I take the pill continuously?
Start your pill on the correct day of the week (as shown on the strip).
Take one pill at about the same time each day, at a time that is easy for you to remember.
Take all the pills in that strip, and then start the next strip without a break.
Keep taking the strips without a break.
How do I start this pill?
You can start any pill straight away if you are already on a safe method such as the Implant, Injection or the IUD or IUS.
If you are not using regular contraception, then you can start taking the pill on the 1st day of your next period.
If you start the pill at other times in the cycle after the 5th day of your last period, then you will also need to use extra precautions (condoms) for 7 days.
How long can I take the pill continuously?
Indefinitely – until either you choose another method or a clinician at the surgery advises this.
Alternatively you can take 3 or 4 packs continuously then to have a 4 day break (pill free interval).
Isn’t it better for me to have “periods” every month?
The “period” on the pill is completely artificial and is just your womb’s response to stopping your pill for a few days. It is called a “hormone withdrawal bleed”.
Many women prefer to have fewer bleeds, as it is not necessary to have bleeds every month.
What happens if I get bleeding while taking the pill continuously?
Irregular bleeding and/or ’spotting’ during the first months of continuous pill-taking can occur, but most women find this becomes acceptable as it lessens over time.
If at any stage the bleeding becomes unacceptable to you and lasts 3-4 days, you can simply have a pill free interval and stop taking the pill for 4 days. This is called flexible extended use.
Start taking the pill again on the 5th day, even if you’re still bleeding. This can help manage the bleeding. Restart with the pill marked with the correct day of the week and take at least 21 pills before taking your next break.
There is no need to contact the surgery first.
You will not need to use other contraceptive precautions (condoms) unless you have for any reason missed pills in the previous week.
Having this 4-day break usually works to stop or improve the bleeding, but if it carries on and does not resolve, you should seek advice from the surgery in case you need a check up to exclude other causes of bleeding e.g. Chlamydia.
Managing missed or late pills during continuous use
You can miss up to 7 pills and still be protected against pregnancy, even if you had sex in that week.
You will not need emergency contraception.
Restart your strip of pills straight away as soon as you remember and continue with the next strip without any more breaks in pill taking.
What if I’ve missed 7 or more pills?
Please contact or attend the surgery as you might need to discuss emergency contraception, as you may be at risk of being pregnant.
You should then restart the pill and use condoms or abstain from sex for seven days.
You should do a pregnancy test after 3 weeks.
What if I have vomiting and/or severe diarrhoea?
If you have had vomiting or diarrhoea in the last 7 days, you will need to use extra precautions (condoms) as this might affect your absorbing pills properly. Continue pill-taking.
Please contact or attend the surgery to discuss if you need emergency contraception.
How often should I come back for follow up?
Once you are settled on the pill you usually only need an annual check for any changes to your medical history, family history, drug history or allergies.
You will need to have your blood pressure and your weight and height measured at this check.
Any other questions?
- If at any other time you have any questions, or have a problem or want to switch methods, please make an appointment with a clinician at the practice for review.
Emergency Contraception
If you have unprotected sex or miss a pill then you can obtain emergency contraception from the GUM clinic, your local pharmacy or Marden Medical Practice. This can be effective up to 5 days from the unprotected episode of intercourse.
The emergency contraception can be given in tablet form or as a copper coil.
The copper coil is the most effective form of emergency contraception and is over 99% effective. Please call the practice and advise us that you require an emergency coil for contraception, and we will aim to fit it as soon as possible.
Further information on your options are available here: Emergency contraception
