If You Miss a Pill How Long Does It Take to Work Again

The combined oral contraceptive pill is often simply chosen "the pill". It contains artificial versions of female person hormones oestrogen and progesterone, which are produced naturally in the ovaries.

If sperm reaches an egg (ovum), pregnancy can happen. Contraception tries to stop this happening usually by keeping the egg and sperm autonomously or by stopping the release of an egg (ovulation).

At a glance: the combined pill

When taken correctly, the pill is over 99% effective at preventing pregnancy. This ways that fewer than 1 in 100 who utilize the combined pill as contraception will get pregnant in ane year.
The standard way to take the pill is to take 1 every 24-hour interval for 21 days, then have a break for 7 days, and during this week you accept a bleed similar a period. You start taking the pill again after 7 days.
You may be able to take some types of pill with no or shorter breaks (a tailored regime), which may reduce some side effects. Speak to a medico or nurse about your options.
You need to take the pill at effectually the same time every day. Yous could get meaning if you do not practise this, or if you lot miss a pill, or vomit or have astringent diarrhoea.
Some medicines may make the pill less effective. Check with your doc if yous're taking any other tablets.
If you have heavy periods or painful periods, PMS (premenstrual syndrome) or endometriosis the combined pill may assist.
Small-scale side effects include mood swings, nausea, breast tenderness and headaches – these usually settle down in a few months.
There is no prove that the pill will make you gain weight.
There's a very low chance of serious side effects, such as blood clots and cervical cancer.
The combined pill is not suitable if you are over 35 and smoke, or if you have certain medical conditions.
The pill does not protect against sexually transmitted infections (STIs), so apply a safe also.
In that location may be a link between the pill and depression just evidence is mixed and further research is needed.

How the combined pill works

How information technology prevents pregnancy

The pill prevents the ovaries from releasing an egg each month (ovulation). It likewise:

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, then at that place is less gamble of a fertilised egg implanting into the womb and being able to grow

The pill is over 99% effective if used correctly. Other methods of contraception are improve at preventing pregnancy, such every bit the IUD, IUS, implant and injection.

There are many different brands of pill, made upward of three main types:

Monophasic 21-day pills

This is the almost common type. Each pill has the aforementioned amount of hormone in it. One pill is taken each twenty-four hour period for 21 days and and then no pills are taken for the adjacent 7 days. Microgynon, Marvelon and Yasmin are examples of this type of pill.

Phasic 21-day pills

Phasic pills incorporate 2 or 3 sections of different coloured pills in a pack. Each department contains a unlike corporeality of hormones. One pill is taken each day for 21 days and so no pills are taken for the next 7 days. Phasic pills need to be taken in the right lodge. Logynon is an case of this type of pill.

Every solar day (ED) pills

There are 21 active pills and seven inactive (dummy) pills in a pack. The 2 types of pill expect different. One pill is taken each mean solar day for 28 days with no intermission between packets of pills. Every 24-hour interval pills demand to exist taken in the right gild. Microgynon ED is an example of this type of pill.

Follow the instructions that come up with your packet. If you take any questions, ask a doctor, nurse or pharmacist.

It'due south important to have the pills equally instructed, because missing pills or taking them at the aforementioned fourth dimension equally certain medicines may make them less effective.

How to take 21-day pills - standard regime

Take your 1st pill from the packet marked with the right day of the week, or the 1st pill of the 1st color (phasic pills).
Proceed to take a pill at the same time each day until the pack is finished.
Stop taking pills for 7 days (during these seven days you will get a drain).
Start your next pack of pills on the eighth day, whether you are still bleeding or non. This should exist the same day of the calendar week as when you took your 1st pill.

How to take every day pills

Take the 1st pill from the section of the packet marked "outset". This will be an active pill.
Continue to accept a pill every mean solar day, in the correct order and preferably at the same time each 24-hour interval, until the pack is finished (28 days).
During the 7 days of taking the inactive pills, you lot will get a bleed.
Start your next pack of pills after you have finished the 1st pack, whether you are still bleeding or not.

Tailored regimes

You tin also have the combined pill every bit a tailored regime. This may include taking the pill for 21 days and stopping for 4, or taking the pill continuously without a break. For more data speak to a md or nurse.

Starting the combined pill

Yous can normally showtime taking the pill at any indicate in your menstrual cycle. There is special guidance if y'all have just had a baby, abortion or miscarriage. The guidance may also be different if y'all have a short menstrual cycle. Go communication from a dr. or nurse if you demand it. You may need to apply additional contraception during your 1st days on the pill – this depends on when in your menstrual bicycle you start taking it.

Starting on the 1st day of your menstruation

If yous start the combined pill on the 1st day of your period (mean solar day 1 of your menstrual bicycle) y'all will be protected from pregnancy direct away. You will not need additional contraception.

Starting on the 5th day of your cycle or before

If y'all start the pill on the fifth twenty-four hours of your period or before, yous will still be protected from pregnancy straight abroad.

Starting after the fifth 24-hour interval of your cycle

You lot will non be protected from pregnancy straight abroad and will demand additional contraception until you have taken the pill for vii days.

If you lot first the pill afterwards the 5th day of your cycle, make sure you have not put yourself at risk of pregnancy since your final period. If you lot're worried you're pregnant when y'all start the pill, take a pregnancy test three weeks later the last fourth dimension you had unprotected sex.

What to do if you miss a pill

If you miss a pill or pills, or you lot start a pack late, this can make the pill less constructive at preventing pregnancy. The chance of getting pregnant afterward 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.

Vomiting and diarrhoea

If you vomit within iii hours of taking the combined pill, it may non have been fully absorbed into your bloodstream. Have some other pill straight away and the next pill at your usual fourth dimension.

If you lot continue to be sick, keep using another form of contraception until y'all've taken the pill again for 7 days without vomiting.

Very severe diarrhoea (half dozen to 8 watery poos in 24 hours) may as well mean that the pill does non work properly. Keep taking your pill every bit normal, but use additional contraception, such as condoms, while you lot have diarrhoea and for 2 days after recovering.

Speak to a GP or nurse or call NHS 111 for more than information, if your sickness or diarrhoea continues.

Who can use the combined pill

If there are no medical reasons why yous cannot take the pill, and you lot do non smoke, y'all can take the pill until your menopause. However, the pill is not suitable for anybody. To find out whether the pill is right for you, talk to a GP, nurse or chemist.

The pill may not be correct for yous if you lot:

are significant
smoke and are 35 or older
stopped smoking less than a year agone and are 35 or older
are very overweight
take sure medicines

The pill may also not be right for yous if you take (or have had):

blood clots in a vein, for example in your leg or lungs
stroke or any other disease that narrows the arteries
anyone in your shut family having a blood clot under the historic period of 45
a eye abnormality or heart illness, including high blood pressure
severe migraines, peculiarly with aureola (warning symptoms)
breast cancer
affliction of the gallbladder or liver
diabetes with complications or diabetes for the by 20 years

After having a baby

If you accept just had a baby and are non breastfeeding, you tin nigh likely beginning the pill on twenty-four hour period 21 after the birth only you volition need to check with a doctor. You volition exist protected confronting pregnancy straight abroad.

If you lot outset the pill subsequently than 21 days afterward giving nativity, y'all volition need boosted contraception (such as condoms) for the next vii days.

If you are breastfeeding, you're not brash to take the combined pill until 6 weeks after the birth.

After a miscarriage or ballgame

If yous have had a miscarriage or abortion, y'all can first the pill upwards to 5 days afterwards this and you will be protected from pregnancy straight away. If you start the pill more than 5 days later the miscarriage or abortion, yous'll need to use additional contraception until you lot have taken the pill for 7 days.

Advantages and disadvantages

Some advantages of the pill include:

information technology does non interrupt sexual activity
it normally makes your bleeds regular, lighter and less painful
it reduces your risk of cancer of the ovaries, womb and colon
information technology can reduce symptoms of PMS (premenstrual syndrome)
information technology can sometimes reduce acne
it may protect against pelvic inflammatory affliction
it may reduce the gamble of fibroids, ovarian cysts and non-cancerous breast affliction

Some disadvantages of the pill include:

it can cause temporary side effects at first, such as headaches, nausea, chest tenderness and mood swings – if these do not get after a few months, it may help to alter to a different pill
it tin increase your claret pressure
it does not protect you confronting sexually transmitted infections
breakthrough bleeding and spotting is common in the outset few months of using the pill
it has been linked to an increased take chances of some serious health weather condition, such as blood clots and breast cancer

The combined pill with other medicines

Some medicines interact with the combined pill and it does not work properly. Some interactions are listed on this page, simply it is not a complete list. If yous want to cheque your medicines are safe to accept with the combined pill, you can:

ask a GP, exercise nurse or pharmacist
read the patient information leaflet that comes with your medicine

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 exist advised to change to an alternative contraceptive. If not, y'all will need to use additional contraception (such as condoms) while taking the antibiotic and for a brusque time after. Speak to a doctor or nurse for advice.

Epilepsy and HIV medicines, and St John's wort

The combined pill can interact with medicines called enzyme inducers. These speed up the breakdown of hormones by your liver, reducing the effectiveness of the pill.

Examples of enzyme inducers are:

the epilepsy drugs carbamazepine, oxcarbazepine, phenytoin, phenobarbital, primidone and topiramate
St John'due south wort (a herbal remedy)
antiretroviral medicines used to care for HIV (research suggests that interactions betwixt these medicines and the progestogen-only pill can bear on the safety and effectiveness of both)

A GP or nurse may advise you to use an alternative or boosted grade of contraception while taking whatsoever of these medicines.

Risks of taking the combined pill

In that location are some risks associated with using the combined contraceptive pill. All the same, 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 (jell in your leg)
pulmonary embolus (clot in your lung)
stroke
heart attack

The gamble of getting a blood jell is very minor, merely your medico will check if you take 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 subtract the risk of developing womb (uterus) cancer, ovarian cancer and bowel cancer.

However, 10 years later you terminate taking the pill, your risk of breast cancer and cervical cancer goes back to normal.

Where yous can go the combined pill

Contraception is free to everyone through the NHS. Places where you can get contraception include:

community contraception clinics
some genitourinary medicine (Mucilage) clinics
sexual health clinics – they also offer contraceptive and STI testing services
GP surgeries – talk to a GP or nurse
some young people'southward services (call the Sexual Health Line on 0300 123 7123 for more information)

Observe a sexual health dispensary

Getting contraception during coronavirus

If yous need contraception, phone call your GP surgery or a sexual wellness clinic every bit shortly as possible. But go in person if y'all're told to.

It can accept longer to get contraception at the moment and some types are not widely available.

You may only exist able to get the combined pill if y'all've had your blood pressure and weight checked in the final 12 months.

If you cannot go the combined pill, you may be advised to utilize the progestogen-only pill or condoms for at present.

How do I change to a different pill?

If you want advice about irresolute your contraceptive pill, you tin visit a GP, contraceptive nurse (sometimes called a family planning nurse), or sexual health dispensary.

You should non have a pause betwixt different packs, so you will usually be advised to offset the new pill immediately or look until the day after y'all take the last of your former pills.

You may likewise be advised to utilise alternative methods of contraception during the changeover, as the new pill may take a brusk time to have effect.

If you're nether 16 years old

Contraception services are free and confidential, including for people nether the age of 16.

If you're nether xvi and desire contraception, the md, nurse or pharmacist will not tell your parents (or carer) as long equally they believe you fully sympathise the information you're given and your decisions.

Doctors and nurses piece of work nether strict guidelines when dealing with people under xvi. They'll encourage you to consider telling your parents, but they will non make you.

The only fourth dimension that a professional might want to tell someone else is if they believe you're at risk of harm, such every bit abuse. The hazard would demand to be serious, and they would commonly discuss this with you kickoff.

More information

For more information nigh the pill visit:

Sexwise's folio about the combined pill
Contraception Choices' page about the combined pill

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Page last reviewed: ane July 2020
Next review due: one July 2023

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Source: https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/