'The Pill' or combined-pill is a tablet containing two female hormones – an oestrogen and a progestogen. These two hormones stop you from ovulating (producing an egg) each month. If you don’t ovulate, you can’t become pregnant. In addition, the hormones thicken the secretions round your cervix, making it more difficult for sperm to get through. Hormones also make the lining of your womb thinner, so that it’s less receptive to an egg.

The two are not the same. ‘The Pill’ or combined pill contains two hormones; the mini-Pill only one, progestogen. The mini-Pill is taken continuously, on a daily basis, 365 days a year.

The mini-Pill is not a low-strength version of the ordinary Pill. It’s a completely different product, because it contains only one hormone instead of two. This may mean less side-effects, but needs to be taken more carefully to be effective.

Take one tablet daily at the same time every day. You must take your oral contraception every day even if you do not have sex very often.

It does not matter if you take your pill before or after food but be sure to swallow the tablets whole with some water.

Always start your pill packet on the day of the week that corresponds with the first day of your bleed.

If you are starting your oral contraception after a natural period cycle, and you have not used a hormonal contraceptive in the past month, start on the first day of your period, i.e. on the first day of your menstrual bleeding. Additional barrier contraceptive precautions (e.g. condom) must be used for the next 7 days.

Remember, always start a new blister pack on the same day of the week as you started your previous pack, regardless of whether you are still bleeding or not.

For your contraception to be effective, tablets need to be taken uninterrupted for at least 7 days.

If you miss a pill and you are less than 12 hours late in taking any tablet, contraceptive protection is not reduced. You should take the tablet as soon as you remember it and take your next tablet at your usual time.

If you miss a pill and you are more than 12 hours late in taking any tablet, contraceptive protection may be reduced. The more consecutive tablets you have missed the higher the risk that the contraceptive effect is decreased. You should take the missed tablet as soon as you remember it (even if it means taking two tablets at the same time) and take the next tablet at your usual time. Use extra contraceptive precautions (barrier method or abstinence) for the next 7 days.

If you miss a pill and have had sexual intercourse during the missed pill interval, or during the 7 days following the missed pill, you may need Emergency Contraception. Please consult your doctor.

It takes some time for the pill to be fully absorbed in your system. It is the 12 hours immediately after you take the pill that is dangerous, not 12-24hours. The pill is usually absorbed within 3 hours. So you must treat a vomit that happens in less than 12 hours as if you have missed a pill. That is, you are not safe for 7 days. If your tummy upset lasts for more than 1 day, you are not safe for the days you are unwell and for 7 days after. 'Tummy upset' includes diarrhea (just in case you don't absorb the pill properly).

Always remember:

• If the 'unsafe' days run to the end of the packet, do not take a break and go straight on to the next packet.
• 'Unsafe' means you should either abstain from sex or use alternative barrier contraception such as a condom.
• If you have unprotected sex, then you should seek advice as you may need emergency contraception.

The Pill is a highly reliable and effective method of contraception when taken exactly as prescribed.

You should return to the surgery or clinic for ‘Pill checks’, at least every 6 months.

These visits are very brief, and the areas covered during your consultation are:

• whether you’re having any problems with the Pill, ie any side effects
• ensure that you haven’t developed any new 'risk factors'
• check your blood pressure (and possibly weigh you)
• discuss any concerns re sexually transmitted disease

You do not have to have a smear test before going on the Pill.

During the first few packs of the Pill, many women get minor, passing side-effects, such as: headaches, nausea, breast tenderness, slight weight gain, slight ‘spotting’ of blood between the periods.

These side-effects usually go away after the first few packs. If they don’t, don’t worry, you may need a slightly different type of hormone to suit you better. Changing to a pill that suits you is very straight –forward. Just consult with your doctor.

The Pill can occasionally cause serious problems like: deep vein thrombosis (DVT) or clotting (this is now thought to be slightly more common in women who are taking Pills containing the progestogens desogestrel and gestodene), heart attacks and possibly strokes.

These events are very rare but they are much more likely to happen if you have certain ‘risk factors,’ which include: being a smoker, having a family history of thrombosis or some similar illness, being severely overweight, being diabetic, having high blood pressure, having a high cholesterol level (hypercholesterolaemia), a past history of phlebitis (vein inflammation) or thrombophlebitis, being immobile for a while (especially when having a surgical operation).

There are other risk factors, for instance making a very long journey in a plane or a cramped car seat. Your doctor or family planning nurse can give you more details.

Check your breasts regularly for lumps or for any changes that are new. If you are aware of your breasts and their shape/texture, you will more readily identify any changes. IF you notice any changes in your breasts, please consult your doctor.

Yes. The following things make it less effective:

• forgetting Pills – especially at the beginning or end of a pack
• diarrhoea and/or vomiting (a common holiday risk),
• taking certain antiepilepsy drugs including Epanutin (phenytoin) and Tegretol (carbamazepine),
• taking antibiotics – notably those used for fungus infections and tuberculosis (TB), but also commonly prescribed antibiotics like tetracyclines and Amoxil (amoxicillin).

In general, take extra contraceptive precautions (barrier method or abstinence) for two weeks if you’re put on an antibiotic. If a doctor needs to prescribe something for you, always tell them you’re on the Pill.

Emergency contraception is a secondary method of contraception. It can be used up to 72 hours after unprotected sex. It is more effective if it is taken after sex or as soon as possible. It does not protect against sexually transmitted infections.

If you have had sex without using contraception or if you think your method might have failed (e.g. burst condom or forgotten pill) you can use emergency contraception. This will usually stop you becoming pregnant.

Emergency contraception can be obtained through your GP, local doctor or a sexual health (family-planning) clinic.

The pill will only protect you from pregnancy, not STIs. Only a barrier method like the condom protects against STI's.