Contraceptive Pill, Patch or Ring

This service is suitable for you if you:

• Are a female (birth sex)
• Are aged 17–50 years for combined contraceptive pills, or up to 55 years for progesterone-only pills
• Can provide: 
  • Up-to-date height and weight measurements
  • A blood pressure reading from the last 12 months

This service is not suitable for you if:

• You are experiencing significant side effects with your current contraception
  • In this case, please book a video consultation to discuss alternatives with a doctor
• You require contraceptive injections, implants, or coils (we cannot prescribe these via this service)
• You have any of the following:
  • Malabsorption problems from any cause, including after weight loss surgery (e.g. gastric band or sleeve)
  • A history of breast cancer
  • You are less than 12 weeks post-partum

If this service is not suitable for you, please contact your local GP or family planning clinic for contraceptive advice.

There are two types of oral contraceptive pills: combined pills and progestogen-only pills (often called “mini pills”). Both contain synthetic versions of hormones that naturally occur in the body, but they differ in which hormones they contain and how they work to prevent pregnancy.

When taken correctly, both types are more than 99% effective. For the pill to work best, it’s important to take it at the same time every day.

The Combined Contraceptive Pill

This pill contains two hormones, oestrogen and progesterone. There are many different brands of the combined pill. Although they all work in the same way, they contain different types and amounts of these hormones.

Because everyone’s body is different, side effects can vary from person to person, and some people may find one type of pill suits them better than another.

In the past, the pill was usually taken for 21 days followed by a 7-day break, and this pattern was repeated each month.

However, we now know that taking the pill in different ways can give more reliable protection against pregnancy. Below are the two most commonly recommended ways to take the pill today:

• 3 packets together with no break followed by a 4-day break

OR

• 21-day use with a 4-day break (most pill-free intervals should now be a maximum of 4 days).

We can offer you advice on this, just send us a message when you have completed the medical questionnaire.

You can find important information about the combined pill on the IFPA website here.

The Progesterone Only Pill

This pill only contains progesterone and is sometimes referred to as the “mini-pill”. It is an excellent pill when taken correctly, with less risk factors than the combined pill. However, it does not have the same menstrual cycle control.

This pill is taken every day without any break. Sometimes irregular bleeding/ spotting can occur for the first 2-3 cycles. After this, most women settle into a bleeding pattern, which can mean no periods for months on end.

You can find important information about the progesterone only pill on the IFPA website here.

The contraceptive patch contains oestrogen and progesterone (like the combined contraceptive pill) and these hormones are absorbed through the skin. You apply a new patch once a week for 3 weeks, then have a 4 day patch-free break. After this, you start the cycle again with a new patch. 

One of the benefits of the patch is that it is not affected by vomiting or diarrhoea, and you don’t need to remember to take a pill every day.

When used correctly, the patch is up to 99% effective at preventing pregnancy.

You can find important information about the contraceptive patch on the IFPA website here.

The contraceptive ring is a small, soft silicone ring that contains oestrogen and progesterone. You insert a new ring into the vagina every 21 days. During this time, the hormones are slowly released into your bloodstream through the vaginal wall.

After 21 days, you remove the ring and have a 4-day break, then insert a new ring and repeat the cycle.

The ring is very small and usually cannot be felt, so it does not interfere with sex.

You can find important information about the contraceptive patch on the IFPA website here.

Each of these hormones can cause different side effects. If these occur, they vary depending on the dose and type of hormone, and the delivery mechanism eg tablet, patch or ring.

Below are some of the common side effects of combined hormonal contraceptives and progesterone only contraceptives that might occur.

Oestrogen:

• Vaginal bleeding/ spotting in the early months.
• Transient Breast tenderness is very common early on but usually settles after the first 2-4 cycles.
• Bloating.
• Headaches & migraine: This would need to be reviewed if NEW migraine starts on this pill.
• Nausea, in the early stages of pill taking.
• Increased blood pressure: This is why a reading is essential every 6 months.
• Blood clots (very rare but potentially fatal).

Progesterone:

• Irregular vaginal bleeding/ spotting (very common).
• Transient Breast tenderness.
• Headaches.
• Nausea.
• Low mood & low libido: Progesterone only pills are not thought to be causative of this though.
• Acne: This can improve, stay neutral or disimprove.

For full details of the potential side effects of these medications, please ensure that you read the patient information leaflet that comes with your medication before you start to use it.

No, they do not protect against STIs. The best way to reduce your risk of catching an STI when having sex (vaginal, anal or oral) is to use a condom.

Yes, some medications can make these methods of contraception less effective and increase the risk of pregnancy so it is important that you tell us about all the medications & treatments you are taking, including any use of the morning after pill/emergency contraception so we can advise you safely and appropriately.

Some over the counter medications and herbal therapies can also affect how well the pill works. 

It is also essential that you tell any other doctor treating you that you are using a contraceptive pill, patch or ring.

All combined hormonal contraceptives (those containing both oestrogen and progesterone) can increase the risk of potentially serious blood clots. Some types have a slightly higher risk than others, but for most people the chance of developing a blood clot is very small.

It’s important that you are aware of:

• What can increase your risk
• The warning signs to look out for
• What to do if you are concerned

Blood clots can form in different parts of the body and can sometimes move to other areas:

• A clot in the leg is called a deep vein thrombosis (DVT)
• A clot that travels to the lungs can cause a pulmonary embolism (PE)
• A clot in the heart can cause a heart attack
• A clot in the brain can cause a stroke

These conditions are serious, so it’s important to get medical help quickly if you develop any of the following symptoms while taking combined hormonal contraception:

• Pain or swelling in one leg
• Severe chest pain
• Sudden shortness of breath or coughing up blood
• Collapse or fainting
• Severe or unusual headaches
• Problems with speech or vision
• Sudden numbness or weakness in your face, arm, or leg

Your risk of developing a serious blood clot is usually very low, but it can be higher if any of the following apply:

• You are in your first year of using a combined contraceptive
• You are very overweight
• You smoke
• You are over 35 years old
• A close family member had a blood clot before the age of 45
• You gave birth in the past 6–12 weeks
• You have reduced mobility, even for a short time
• You are having certain types of surgery
• You are restarting the pill after a break of 4 weeks or more

Knowing these factors can help you and your healthcare provider choose the safest option for you.