Starting a new form of birth control can be daunting, especially when it’s one that works internally. Unlike natural contraceptive barriers such as condoms, it can be difficult to know whether or not you are protected. There are many questions that come from this uncertainty, and the answers to those questions depend on the type of pill, where you are in your menstrual cycle, and other factors as well. Here, the HANX team (led by our co-founder and gynecologist doctor, Dr. Sarah Welsh) we give you the lowdown on everything you need to know to feel comfortable moving fully into hormonal contraception.
How does the pill work?
To understand when you are and are not protected by the pill, you need to understand how the pill works to prevent pregnancy.
Pregnancy results when an egg, released from an ovary, is fertilized by sperm. This then develops inside the uterus, forming an embryo. There are several ways to prevent pregnancy – some methods, such as condoms, prevent sperm from entering the vagina, and others, such as the pill, use hormones.
Birth control pills prevent pregnancy by:
- Cessation of ovulation so that the egg cannot be released to be fertilized.
- Thickening cervical mucusmaking it harder for the sperm to swim to the egg if it is released.
- Thinning of the uterine liningtherefore the eggs that may come are much more difficult to implant in the uterus and develop.
There are two types of birth control pills – the Combination pilland Progesterone only pill (commonly called the mini-pill). Both types birth control pills work by releasing additional hormones in your body. For the combined pill, this is estrogen and progesterone, while the mini-pill contains only progesterone. These hormones are naturally present in the menstrual cycle, but the additional hormones found in the birth control pill adjust the cycle and bodily functions to prevent pregnancy.
How long does the combined birth control pill take to work?
The combined contraceptive pill can be started at any time during the menstrual cycle, but the point at which it becomes effective can vary. Although it’s tempting to go off other forms of birth control right away, depending on when you start the pill, you may need to use other forms of birth control.
- If you start the pill on the first day of your periodor on or before day 5 of your cycle, you will be protected immediately.
- If you start after day 5 of your cycle (5 days after your period starts)you will not be protected immediately and it will be necessary Take the pill for 7 days before you are protected.
- However, as cycles can change and fluctuate due to external factors such as stress, if you are not sure where you are in your cycle, it is best to use additional contraception for 7 days to be sure you are protected.
If you have just given birth or had an abortion or miscarriage, the instructions may be different. We always recommend checking with your doctor if you are in this situation or if you have other medical concerns that may affect your contraception.
How long does the mini pill take to work?
As with the combined pill, you can start taking the mini-pill at any point in your cycle.
- If you are up days 1-5 of your menstrual cycleyou will be are directly protected.
- However, if you take it after those 5 days, you will need it use additional contraception for 2 days before relying on the pill alone.
- If you have a short menstrual cycle or are not sure where you are in your cycle, it is recommended that you use additional contraception, such as condoms, for the first few days on the pill.
What to do if you miss a pill:
We are all human and sometimes after a long day you may find you missed your pill. It does happen, but it can be hard to know if you’re still protected.
If you miss a combined pill:
- If you have only lost a pillyou are still protected against pregnancy.
- Just take the missed pill as soon as you remember, even if that means taking two in one day, and continue with your regular pill routine.
- If you have missed two or more pills, you will need to use additional contraception for the next 7 days.
- Take the most recent missed pill, but don’t take multiple pills if you’ve missed several days.
- For example, if you go on holiday and forget your pack and miss 3 pills, take the last one on your return and then continue your pill routine.
- If you missed two or more pills in the first week of a pack after a pill break, you may need emergency contraception if you had sex in the previous 7 days.
Note When we say pill break, we mean the 7 inactive pills that contain the most combination pills and cause bleeding.
As the combined pill often includes a 7-day break, this may affect your level of protection against pregnancy when you miss a pill.
- If you have at least 7 pills left in the pack after the missed pill, just refill the pack with the pill break as usual.
- If there are less than 7 pills, finish the pack and start the new pack the next day to ensure you stay protected, without taking the pill break.
If you missed a progesterone-only pill:
- If it was 3 hours or lesstake your pill as soon as you remember and carry on as usual.
- For some types of minipills that use desogestrel (you can see examples in our pill guide here), this window expands for 12 HOURS.
- If more than this time has passed, take a pill as soon as you remember.
- Continue to take the pills as usual, even if this means that there is a shorter gap than usual between the first and second pills.
- For example, if you usually take your pill at 9pm and you missed it the day before, you can take a pill in the morning when you remember and then take your usual pill as usual that evening.
- Use additional contraception for the next 48 hours after taking the missed pill.
- If you had unprotected sex before you realized you missed a pill, you may need to emergency contraception.
What happens if I am sick or have diarrhea after taking my pill?
While the pill tends to be absorbed relatively quickly, if you are sick or have diarrhea 2 hours after taking the mini-pill or 3 hours after taking the combined pill, then it is it is unlikely to have been absorbed by your body. In this scenario, it is recommended that you take the next pill immediately and continue as normal.
If you continue to have sickness or diarrhoea, count each day you are sick as a day you missed your pill and follow the instructions above.
Final words
While the pill is a very effective method of contraception, it must be taken at the same time each day for maximum effectiveness. If you miss a pill (or more), it is highly recommended that you use additional methods of contraception, such as condoms, to avoid pregnancy.
If you’re struggling to make an appointment with your doctor, we also sell a variety of birth control pills here at HANX – avoid the frantic 8am call. just to stand by and make sure you buy your preferred brand. Simply fill out a form for review by our pharmacy and pick up the pill easily and discreetly.
