* Please ensure that you have a joint doubt appointment with the doctor and nurse.
* If you are having a first coil fitting, please ensure that you are using a regular form of contraception carefully in the few weeks prior to the appointment. Please bring an early morning urine sample with you on the day in case we need to do a pregnancy check (bottle and form available from reception. Please do not re-use containers from home).
* If you are having a coil RE-fit, please abstain from intercourse completely for 7 days prior to your appointment.
* It is a good idea to take a simple pain killer an hour or so before your coil fit in case you experience some mild cramps (e.g.: Paracetamol/Ibuprofen)
* Please bring a sanitary pad with you on the day.
Continuous Pill Taking
Your GP may send you a weblink to this information via text message. If you have any questions about the information below, please speak to your GP.
This information should be read together with the latest FPA Leaflet Your guide to the Combined pill available at www.fpa.org.uk/contraception-help/combined-pill
What is continuous pill taking?
➢ This is a way of taking the pill leaving out the regular pill free break – i.e. not in the usual way, 21 tablets then stopping for 7 days (21/7 for short).
➢ This is an “off licence” prescription, meaning that the instructions are different from those recommended by the manufacturer (see box). However, there is evidence that continuous pill taking is safe and the practice is supported by medical authorities in the UK and by WHO.
➢ A non-phasic 20 mcg oestrogen pill is usually used - your healthcare provider will be able to tell you about this.
What are the benefits for me?
➢ It makes the pill more effective as a contraceptive. There’s lots of evidence for it making your pill much safer, contraceptively. We have known for some time that the routine of not taking tablets for 7 days weakens the pill’s main effect of stopping your ovaries from releasing an egg: so it makes egg-release more likely when pills are missed.
➢ It also means you don’t have to have regular monthly bleeds, which have no known benefits.
➢ It reduces problems such as period pain, PMT, migraine and other headaches, and more.
➢ It’s convenient for when you want to avoid bleeding 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 long can I take the pill continuously?
Indefinitely – until either you choose another method or your surgery/clinic advises this.
Isn’t it better for me to have “periods” every month?
➢ Continuous pill taking is very safe and women do not need to bleed every month to know that they are not pregnant.
➢ The “period” on the pill is completely artificial and is just your womb’s response to stopping the pill (and therefore the hormones) for a few days. It is called a “hormone withdrawal bleed”.
➢ Continuous pill-taking just stops you having that completely unnecessary regular bleed.
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 the bleeding is troublesome to you, e.g. by continuing for more than a few days, and has not settled after at least a month since you first started the pill: stop taking tablets for just 4 days. No need to contact the surgery or clinic first. Also:
o Unless you also missed other tablets for any reason in the previous week, no need to take extra precautions when you take a break like that.
o Then restart your pill taking the correct pill for that day, leaving out the 4 unused pills.
Continue as before. If you find this 4-day break does not stop or improve the bleeding, seek advice from your surgery/clinic in case you need a check-up to exclude other causes of bleeding e.g. Chlamydia.
What is an “off licence” prescription?
➢ All medicines have a product licence. The licence tells us under which conditions the medicine can be prescribed for patients.
➢ If expert medical opinion is that a medicines can be used also in different ways or under different conditions, this is called prescribing “off-licence”.
➢ Prescribing off-licence is as safe as taking the pill in the standard way because we still follow medical guidelines.
How do I start this pill?
➢ You should start the pill up to, and including, the fifth day of your period and you will be protected from pregnancy immediately.
➢ 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.
Managing missed or late pills during continuous use
➢ You can miss up to seven pills and still be protected against pregnancy, even if you had sex in that week.
o Restart your strip of pills straight away.
o Extra precautions for 7 days? Not required – except, unusually, if you had NOT taken at least 7 pills in a row ahead of the first missed one.
o No need for emergency contraception.
o Continue with the next strip without any more breaks in pill taking.
➢ If you miss seven or more pills you might need to discuss emergency contraception.
o Please contact or attend the surgery/clinic.
o You should then restart the pill and use condoms or abstain from sex for seven days.
o You should do a pregnancy test after 3 weeks.
What if I have vomiting and/or severe diarrhoea?
These might affect your absorbing pills properly but if you have been taking the pill continuously:
o No extra precautions unless either or both last for 7 days.
o If they do (or earlier), contact or attend your surgery/clinic.
o Mean time continue pill-taking.
If I take other medicines will it affect my pill?
➢ If you are prescribed any medication always inform the prescriber that you are taking the combined pill as some drugs may make it less effective. St John’s Wort, which you can buy from the chemist, may also reduce the effectiveness of the pill.
➢ If you take these medicines, talk to your doctor or nurse about how to take the pill - you may need to use a different method of 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 also have your blood pressure and may also have your weight and height checked.
➢ If at any other time you have any questions, have a problem or want to switch methods, make an appointment with your surgery/clinic for review.