Combined Hormonal Contraceptive Pill

What is the Combined Hormonal Contraceptive Pill?

Combined Hormonal Contraceptive Pill is a form of contraception, known as a combined pill. It contains synthetic versions of both the female hormones.

A box of Combined Hormonal Contraceptive Pill contains three strips of tablets each containing 21 tablets. Combined Hormonal Contraceptive Pill should be taken each month for 21 days followed by a 7-day pill-free week where most women will experience a withdrawal bleed, like a period. The contraceptive pill is one of the leading ways of preventing pregnancy.

What is Combined Hormonal Contraceptive Pill used for?

Like other oral contraceptive pills, Combined Hormonal Contraceptive Pill is used by women to prevent pregnancy. It will not, however, prevent the transmission of sexually transmitted infections (STIs).

Combined Hormonal Contraceptive Pill may also help some women reduce the symptoms of premenstrual syndrome (PMS), regulating periods to help lighten flow and make them less painful.

How does Combined Hormonal Contraceptive Pill work?

A combined contraceptive pill such as Combined Hormonal Contraceptive Pill works in three ways to protect you from getting pregnant:

1. It stops the ovaries from releasing an egg each month preventing ovulation.
2. It thickens the cervical fluid making it more difficult for sperm to reach the egg.
3. It alters the lining of the womb to make it harder for a fertilised egg to implant.

When Combined Hormonal Contraceptive Pill is taken as directed in the Patient Information Leaflet it is up to 99% effective.

Combined Hormonal Contraceptive Pill and acne

Combined Hormonal Contraceptive Pill, like other combined contraceptive pills, may improve the condition of some women’s skin, making them less likely to get spots as the hormones can make the skin less oily.

There are, however, some specific treatments, including contraceptive pills that are better at improving skin conditions such as acne. If you are struggling with acne you should discuss this with a doctor who will be able to advise you on the best treatment options.

If you would like more information about acne and treatments take a look at our acne advice page.

Combined Hormonal Contraceptive Pill dosage

Combined Hormonal Contraceptive Pills can be prescribed by The Independent Pharmacy to adults over the age of 18 years.

• Combined Hormonal Contraceptive Pill is for oral use only.
• Take 1 tablet, at the same time each day, for 21 days. Take your first tablet from the top row, marked with the correct day of the week and follow the directions of the arrows printed on the pack.
• After 21 days, have a 7-day pill-free break, where you should expect to have a bleed.
• Start your new pack, after your 7 days pill-free, on the same day of the week that you started your previous pack.

Please read the Patient Information Leaflet carefully before taking Combined Hormonal Contraceptive Pill.

Starting Combined Hormonal Contraceptive Pill

If you have not used any contraceptive with hormones in the previous month:

Start your first Combined Hormonal Contraceptive Pill tablet on day 1 of your period. You are immediately protected against pregnancy. If you start any day after day 1 of your period you should use additional contraception such as a condom for the next 7 days.

Switching from another combined hormonal contraceptive pill:

Start Combined Hormonal Contraceptive Pill the day after your last pill from your previous pill packet. Do not have a 7-day pill-free break. If you start Combined Hormonal Contraceptive Pill after your 7-day break you will need to use an additional barrier contraceptive such as condoms for 7 days.

Changing from a progestogen-only pill, injection, implant or a progesterone-releasing IUD:

You may switch to Combined Hormonal Contraceptive Pill on any convenient day from the progestogen-only pill, or the day of removal of an implant or an IUD and the due date of the injection. In all of these cases, you must use an additional barrier contraceptive such as condoms for 7 days.

After having a baby:

You can start taking Combined Hormonal Contraceptive Pill between 21 and 28 days after having a baby. If you start taking Combined Hormonal Contraceptive Pill later than day 28 you must use an additional barrier method of contraception such as condoms for the next 7 days.

Combined Hormonal Contraceptive Pill and missed pills

If you forget to take your daily Combined Hormonal Contraceptive Pill or you are sick or have diarrhoea within 3-4 hours after taking your tablet, take it as soon as you remember or when you feel better, even if this means taking 2 tablets on the same day.

If you are more than 12 hours late taking your Combined Hormonal Contraceptive Pill tablet:

• You will not be protected from getting pregnant and should use additional barrier contraception such as a condom for 7 days.

You are at more risk of becoming pregnant if you miss more than one pill within a single packet or if you miss one pill and it’s at the start or the end of your packet. If you think you are at risk of being pregnant while taking Combined Hormonal Contraceptive Pill you should speak to a doctor for advice as soon as possible.

If you are less than 12 hours late taking your Combined Hormonal Contraceptive Pill tablet:

• You will be protected from getting pregnant. You will not need to use additional contraception.

Side Effects

Some people will experience side effects when taking a combined oral contraceptive pill like Combined Hormonal Contraceptive Pill, such as Combined Hormonal Contraceptive Pill weight gain. Most people will find that their symptoms settle within the first 3 months. If you do not notice any improvement after this time or are concerned about any side effects you should speak to a doctor or pharmacist for advice.

If you experience any severe side effects such as yellowing skin, upper abdominal pain or convulsions or you have an allergic reaction while using Combined Hormonal Contraceptive Pill you should either call 999 or attend your nearest emergency department as soon as possible.

The most common Combined Hormonal Contraceptive Pill side effects are:

• Headaches or migraines
• Feeling or being sick or diarrhoea
• Bleeding between periods or no bleeding
• Mood changes
• Difficulty sleeping
• Acne
• Muscle spasms in arms and legs
• Painful breasts
• Urinary tract infections
• Vaginal thrush and discharge
• Weight gain.
• Hair thinning or excessive hair growth
• Changes in appetite
• Change in sex drive

Please read the Patient Information Leaflet contained within the medicine packaging carefully before taking Combined Hormonal Contraceptive Pill for full details of reported side effects.

Warnings

Before taking Combined Hormonal Contraceptive Pill please read and make sure you have understood all the warnings and precautions associated with taking combined oral contraceptives detailed in the Patient Information Leaflet.

Combined Hormonal Contraceptive Pill can make some existing conditions worse and increase your chances of certain health conditions. If you start taking Combined Hormonal Contraceptive Pill you will therefore need to continue to have your health monitored at least once a year.

• You should not take Combined Hormonal Contraceptive Pill if you have ever had a blood clot, problems with your heart or liver, or you are at risk of having a stroke or suffer from migraines.
• You also should not take Combined Hormonal Contraceptive Pill if you have high blood pressure, have high levels of fat in your blood or have ever had breast cancer or cancer of the genital organs.
• You should consult with your doctor before taking Combined Hormonal Contraceptive Pill if you have diabetes, inflammatory bowel disease, sickle cell anaemia, HUS or SLE or if you have a disease that first appeared during pregnancy.
• You should tell your doctor if you have recently been taking or are currently taking any other prescribed or non-prescribed medication including herbal remedies such as St. John’s Wort.

Combined Hormonal Contraceptive Pill and blood clots

The use of combined hormonal contraception, including Combined Hormonal Contraceptive Pill, can enhance a woman's risk of forming arterial and venous blood clots or venous thrombosis.

The risk of developing blood clots increases:

• Throughout the first year of taking a combination pill
• As you get older
• If you are overweight
• If someone in your family has suffered from blood clots
• After you have had an operation or had an extended period of immobilisation

Blood clots can be serious and even fatal when leading to heart attacks and strokes. If you think you are experiencing symptoms of a blood clot see a doctor immediately.

Combined Hormonal Contraceptive Pill and cancer

Taking combined pills for contraception, such as Combined Hormonal Contraceptive Pill, can very slightly increase the risk of developing breast cancer. This risk appears to reduce once you stop taking any form of contraception.

Women taking Combined Hormonal Contraceptive Pill must regularly check their breasts for any changes and you should contact your doctor if you are concerned.

Combined Hormonal Contraceptive Pill in pregnancy & breastfeeding

You should not take Combined Hormonal Contraceptive Pill during pregnancy and if you think you have become pregnant while taking Combined Hormonal Contraceptive Pill you should speak to a doctor for guidance.

Taking Combined Hormonal Contraceptive Pill while breastfeeding is also not recommended, you should speak to a doctor or nurse for advice about your contraceptive options.