What happens if I miss a pill?

For patients taking oral contraceptives, it is important to be aware of what you should do if you miss a pill. The NHS website has a useful page explaining these rules in a simple way. If you have any questions or concerns, please contact our Nurse Practitioner, Lyndsay, who can talk you through.

Are there any health conditions or risk factors that my GP should be aware of before I start the combined pill?

Before starting the combined pill, it is important that we check your blood pressure and BMI. You must also let us know if there is a history of blood clots (deep vein thrombosis or pulmonary embolism) in you or your family, whether you have had migraines with aura (vision changes) or if you smoke. Depending on your history, it may be the case that another type of contraceptive is more suitable. Please let us know if anything changes after you start the combined pill, as we may need to change your contraception. 

Does being ill effect how effective my contraception is?

It depends on whether you have been sick (vomited) or had diarrhoea. If you vomit within 3 hours of taking a combined pill, or within 2 hours of taking a progestogen-only pill, it probably will not have been absorbed by your body. You should take another pill straight away.

As long as you're not sick again, you're still protected against pregnancy. Take your next pill at the usual time. If you continue to be sick or have diarrhoea for more than 24 hours, this can mean your protection against pregnancy is affected. More information on this is found on the NHS website. 

The previous traditional way of taking combined pills, (21 days followed by a 7 day break) was to allow a withdrawal bleed once a month. A withdrawal bleed is not the same as your period. It is caused by you not taking hormones during the pill-free break.

If you forget to restart your pill on day 8 after a seven day break you could become pregnant.

New guidance is to shorten this pill free break to four days or to omit the break altogether and not have a withdrawal bleed. Missing or shortening the break could help you if you get heavy or painful bleeding, headaches or mood swings on pill-free days.

There are alternative ways to take COCP which include:

• Taking the pill every day without a break
• Taking the pill every day for three weeks, then have a four-day break- this may reduce the risk of pregnancy if you miss a pill
• Taking three 21-day packs of pills in succession, followed by a break of four to seven days
• Taking pills continuously without a break until you have a 'breakthrough bleed' for three to four days, then taking a break of four or seven days before starting the next pack.
• If you take packets of pills without a break, you are more likely to get irregular bleeding now and again, known as breakthrough bleeding. However, if you keep going, this usually settles down.

I am post-partum and want to start contraception. What options do I have?

There are a few methods that can be used or started any time after birth, including condoms, the implant, the progesterone-only pill, and fertility awareness methods. You can start the combined pill, the contraceptive patch or vaginal ring three weeks after birth if you're not breastfeeding, or from six weeks if you are breastfeeding. Another option is the coil (hormonal or copper), which can be fitted within 48 hours after giving birth or from four weeks after birth. Sexwise has a very useful webpage about the different contraceptive choices after childbirth. If you have any questions, speak to your midwife or health visitor who can walk you through the different options. 

Do I still need to take contraception if I am peri-menopause or have went through the menopause?

Although there is reduced fertility during the perimenopausal period, it is still possible to get pregnant. If you are in your 40s, all contraceptive methods we have listed above are safe and effective. If you are 50 or above, you should avoid the combined pill (COCP), due to the increased risks of oestrogen with age, such as blood clots.

If you are over 50, menopause is diagnosed if you have had no periods for a year. If you are between 40 and 50, menopause is diagnosed if you have had no periods for two years. You can stop contraception when menopause is diagnosed. Additionally, all women can stop using contraception at the age of 55, as even if you are still experiencing periods, as pregnancy is exceptionally rate after this age. 

Our nurse practitioner Lyndsay runs a weekly menopause clinic, where you can discuss your contraception options further. The NHS website also has a useful pageabout menopause and contraception.

Is sterilisation an option for me?

The different methods of female sterilisation are explained on the NHS inform website. Almost any woman can be sterilised, but it should only be considered by women who do not want any more children or do not want children at all. Once you're sterilised it's very difficult to reverse it, so consider all options before making your decision. For example, consider long-acting reversible contraceptives such as the coil, implant or injection. If you are considering long-acting contraception or sterilisation, speak to your GP, who will be able to talk you through different options and refer to gynaecology. You may be more likely to be accepted for the operation if you're over 30 and have had children.

I'm worried that I have a sexually transmitted infection (STI). What do I do?

If you are concerned you may have been exposed to a Sexually Transmitted Infection, then you can recieve a Home Sampling Kit, by calling Chalmers Sexual Health Centre on 0131 536 1070; you can also view symptoms and advice on their website here.

Alternatively, you can also call us on 0131 552 7676 to see if our practice nurse can leave out a swab kit for you collect.

Do you provide condoms?

If you are looking for Condoms we are a c:card distribution site. That means we can provide free condoms to you if you have a C:card, and can issue you one if you need. C:card is a confidential service, so they don't collect any information on their users, I fyou would like further information- you can visit their site here