The Contraceptive Thread - information and questions Watch

Helenia
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The contraceptive pill


Where can I get the pill?

The contraceptive pill has to given on prescription in the UK. There are two main places that you can go and get the contraceptive pill your GP or a family planning clinic. You can find a family planning clinic near you here.

What will happen when I see a doctor about going on the pill?

When you go to your GP/a clinic about going on the pill there are a number of things that you can expect to happen. The doctor will probably have a talk to you about your past sexual experiences and any health problems that you might have, this is so that they can determine whether or not you might be at risk of a sexually transmitted infection and to determine if it is safe for you to go on the pill. Before you get your pill the doctor/clinic nurse will also take your blood pressure and weigh you, this is again just to make sure that it is safe for you to go on the pill.

How many types of pill are there?


While there are many brands of the oral contraceptive pill there are two main types. The most important thing when it comes to the pill is making sure that you are on the one that is best suited to you. It can take a few tries before you find the right one, so if after a month or so of taking it you are still experiencing uncomfortable side effects don’t be scared to go back to your doctor and talk to them about changing. The two main types of pill are the combined oral contraceptive pill and the progesterone only pill.

Combined oral contraceptive pill: Fact File


How does it work?

The combined pill contains two hormones oestrogen and progesterone. These hormones work to stop you ovulating (releasing an egg), making the lining of the womb thinner to prevent a fertilised egg from implanting and thickening the mucus at your cervix to stop sperm getting into your womb.

How effective is the combined pill?

The combined pill is 99% effective if taken perfectly. This means that if 100 women are using the pill perfectly for a year then one of them will become pregnant.

How do I take the combined pill?

There three main types of combined pill that you could be prescribed.
Monophasic 21 day pills: With this pill you will get 21 pills to take. Each of them will contain the same amount of hormone and it doesn’t matter which order you take the pack in. You take the pill for 21 days and then take no pills for the next seven days.
Phasic 21 day pills: This type of pill will again come in packs of 21, however the different pills will contain different amounts of hormones. It is important that you take these pills in order, they will be in two or three different coloured sections. You again take these pills for 21 days and then take a seven day break.
ED (everyday pills): ED pills come in packs of 28. In each pack 21 pills will contain hormones and seven will be inactive (contain no hormones). With the ED pill you don’t take a break between packets but it is important that you take the pills in order.

When you go and talk to your doctor about taking the contraceptive pill you can ask them about which pill they think would work for you.

Progesterone only pill: Fact File

How does it work?
The progesterone only pill works in a similar way to the combined pill however it only contains the hormone progesterone. The main ways that the progesterone only pill prevents pregnancy is to thinken the mucus at your cervix to prevent sperm entry and prevent the lining of the womb from becoming thick which reduces the chances of implantation however it is not uncommon for the minipill to also prevent ovulation.

How effective is the progesterone only pill?
Generally the minipill is considered slightly less reliable than the combined pill. However it is still said to have a reliability of about 99%. This means that if 100 women and taking the minipill for a year one of them will become pregnant.

How do I take the progesterone only pill?
Each pill in the pack will contain the same amount of progesterone so you just need to take the pack. You can then start a new pack straight away without taking a break.

How do I start my pack of pills?

You can start the pill at any time in your cycle as long as you are sure that you aren’t pregnant. However there are only certain times where you will get instant protection from pregnancy.
If you take your first pill up to and including the fifth day of your period then you will have immediate protection. If you start the pill at any point during your cycle then you have to use another from of contraception for the first seven days after starting the pill. It is important to not that if you have an unusual or irregular menstrual cycle then you should discuss this with the doctor or nurse before stating the pill.

Is it important that I take my pill at the same time every day?


This depends on the type of pill that you are taking, however it can be useful to take your pill at the same time each day (e.g. as you brush your teeth) because it can help you to remember to take it.
The combined pill: With the combined pill it is important that you take the pill within in the same twelve hour window each day. However it is recommended that you don’t take the pill this irregularly and that you have a three to four hour window each day in which you take the pill.
The progesterone only pill: With the progesterone only pill it is more important that you take your pill at the same time each day. There is a three hour window in which you should take your pill. The exception to this is Cerazette which is a progesterone only pill but has a twelve hour window in which to take it like the combined pill.

What do I do if I miss my pill?

If you are on the combined pill
:
This depends how many pills you have missed. If you have only missed one or two pills then you need to take the last pill that you missed as soon as you remember and then finish the pack as normal. You shouldn’t need to use any additional contraception. If you have missed more than two pills then you need to finish the pack as normal but use additional contraception for the next seven days. If when you miss the pill less than seven pills are left in your pack it is advisable that you do not take the usual seven day break and start the next pack when the current one finishes.

If you are on the progesterone only pill:
Your pill is consider late if you take more than three hours late unless you are taking Cerazette in which case if it is more than twelve hours late. If this happens you will not be protected against pregnancy. Take the next pill in your pack as soon as your remember (even if this means taking two pills in one day). Use and additional method of contraception for the next two days.

Is it safe to run two pill packs together (take them without a break)?

It is not harmful to run two or potentially three pill packets together. To do this just start a second pill packet the day after your pill pack finishes and you will be protected against pregnancy. You may experience some spotting (light bleeding) but this isn’t something that you should be concerned about in this situation.

I didn’t bleed during my break week, am I pregnant?


If you have taken your pill correctly then you are unlikely to be pregnant. However if you have any reason to suspect that you might be pregnant it is important that you take a pregnancy test of consult your doctor. If you have two breaks where you do not have a bleed then take a pregnancy test just to be sure.

I am bleeding when I am not meant to be, is something wrong?

When you first start taking the pill it is not uncommon for you to have some bleeding. So if this bleeding is happening in the first three months of taking a new pill there is unlikely to be any cause for concern. Bleeding can be caused by missed pills as well as sexually transmitted infections (STI) so if you think you may have been at risk of contracting an STI contact your GP or local GUM clinic.

I am unwell, am I still protected against pregnancy?


Being unwell will only effect your protection if you have diarrhoea or if you have vomited. If you vomit within two hours of taking your pill then it is important that you take a second pill as soon as you feel able to. As long as you do this you should be protected.
If you have diarrhoea for more than 24 hours then you pill may be less effective so continue taking your pill and behave in the same way you would if you had missed a pill using extra protection if necessary.

It is important that if you unwell for any prolonged period of time that you visit your GP.

I am on other medication, is this going to stop my pill being effective?

Most medication is perfectly safe to take with your pill. However certain types could make your pill less effective. Antibiotics can impact on your pills effectiveness, it is important that you use additional methods of contraception while you are taking your antibiotics and for seven days after you finish. If your pill packet ends during your course of antibiotics or will do in the seven days following continue straight on to your next packet without taking a break. Seek advice from a healthcare professional if you are in the first week of your pill packet and you have had sex recently as you may need emergency contraception or if you are on antibiotics fo more than two weeks. Other types of medication that can effect your pill are HIV,TB or epilepsy treatment or St Johns Wort (a herbal treatment for depression).

If is important that if you are prescribed any medication you inform the doctor of all the medication including the pill that you are on. If you have any concerns talk to the prescribing doctor or your pharmacist.

An important note:

It is important to note that the contraceptive pill does not protect you against sexually transmitted infections. If you have had unprotected sex with someone when you don’t know if they are clear from STIs the it is important that you contact your GP or local GUM clinic for an STI test.
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randdom
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Long-Acting Reversible Contraceptives (LARCs)
The Government and various health bods are very keen on promoting these to young people as they are more reliable than the Pill – there’s less opportunity for user error and they last a long time. There are three main types: Injections, Implants and IUD/IUS.

Before going any further, however, it is important to say that NONE of these protect you against STIs so you MUST use condoms every time or get yourself and your partner checked out before using any of these on their own, for the sake of your own fertility and mental and physical health.

The following are a number of resources on the LARCs (and other contraception). If you still have questions or want to find some more individuals’ experiences, please post here or in my big thread.
Firstly, the wiki has a great and very comprehensive article on all types of contraception, their advantages and disadvantages. Look here.
Other useful websites are the NHS Choices website where you can search for information on the different types of contraception and the FPA’s leaflet section which has info leaflets on everything under the sun. The FPA’s website also has a “find a clinic” function where you can search for your nearest clinic offering certain services from STI testing to contraceptives.

Now, some basic facts and useful links for all the options:

Injection
This is an injection of progesterone, usually given in the buttock, leg or arm. There are two main types – Noristerat and Depo Provera. They work by stopping ovulation, as well as making your cervical mucus thicker and the lining of your uterus less receptive to a fertilised egg.
Duration. 8 (Noristerat) or 12 (Depo Provera) weeks depending on type. It is extremely important not to be late for your next injection, as you may no longer be protected against pregnancy.
Efficacy. >99% - Depo Provera is slightly more effective than Noristerat.
Starting the injection. If you have your first injection within 5 days of the start of your period, you are immediately protected from pregnancy. At any other point in your cycle, you need to use a condom for the first 7 days after your first injection.
More information, including side-effects and contra-indications.
http://www.thestudentroom.co.uk/wiki...ive_Injections
http://www.fpa.org.uk/information/le...?contentid=135
Some practices may not offer the injection to under 18s as it affects bone growth and your skeleton may still be developing.

Implanon
This is a matchstick-sized piece of plastic which is fitted under the skin on the inner side of the upper arm. It releases progesterone at a steady rate, preventing pregnancy in the same way as the injection.
Duration. 3 years.
Efficacy. >99.9%. Fewer than 1/1000 women will get pregnant in the three years they have the implant.
Starting the implant. As with the injection, if inserted in the first 5 days of your cycle, you will be protected immediately, otherwise you must use condoms for 7 days. Some places like you to try Cerazette (a POP with a similar hormone to the implant) for a few months first to see if the hormones agree with you. If this is the case, you just need to carry on taking that for the first 7 days you have the implant in.
More information, including side-effects and contra-indications.
http://www.thestudentroom.co.uk/wiki...eptive_Implant
http://www.fpa.org.uk/information/le...?contentid=133

Mirena IUS
The Mirena IUS is a small T-shaped plastic device which sits inside your uterus. Like the implant, it releases progesterone at a constant rate. However, as it is within the uterus, the progesterone mainly acts locally rather than via the bloodstream so it is less likely that ovulation will be suppressed. It mainly prevents pregnancy by thinning the uterine lining (endometrium) and increasing the thickness of cervical mucus. Because of its effects on the endometrium, it tends to make periods much lighter and is often also used as a treatment for heavy periods.
Duration. 5 years.
Efficacy >99%. Fewer than 1/100 women will get pregnant in the 5 years they have the IUS.
Starting the IUS. The same rules apply for which point in the cycle to get it inserted (and use condoms for 7 days if needed). Having an IUS inserted increases the risk of infections, so it is a good idea to have an STI check before you get one inserted (some places may offer this as part of the service). It can be quite an uncomfortable procedure so taking a couple of painkillers beforehand might be a good idea.
More information, including side-effects and contra-indications.
http://www.thestudentroom.co.uk/wiki...stem_.5BIUS.5D
http://www.fpa.org.uk/information/le...?contentID=153

IUD
Formerly known as the copper coil, this is another T-shaped (usually) plastic device with copper wrapped around it, which sits inside your uterus. It does not contain any hormones, and is believed to work because the copper in it is toxic to sperm and prevents the implantation of a fertilised egg. For these reasons, the copper IUD can also be used as emergency contraception if inserted up to 5 days after unprotected sex. Unlike the Mirena, copper IUDs tend to make periods heavier after they are inserted, although this can improve with time.
Duration. 5-10 years, depending on type (make sure you check!)
Efficacy. Around 99% depending on type – newer designs are better than older ones.
Starting the IUD. I wasn’t able to find information about what stage of the cycle it needs to be inserted, though I believe it’s usually done mid-cycle as this reduces the risk of expulsion. As with the Mirena, it’s very important to be checked for STIs before getting an IUD as it increases the risk of getting pelvic inflammatory disease.
More information, including side-effects and contra-indications.
http://www.nhs.uk/conditions/intraut...hat-is-it.aspx
http://www.fpa.org.uk/information/le...?contentid=151

Sounds good - how do I get one?
Your first port of call should be your GP or local FPA clinic (use the link above to find yours), to discuss the risks and benefits of any of the above methods, and whether they'd be suitable for you. Certain medications and medical conditions can affect which ones are appropriate, as well as your personal preferences.

Once you've decided what you want, you may be able to get it at your GP if they have suitably trained staff, or they may have to refer you to the FPA or another clinic - this is particularly common for implants and IUS/IUDs as not all GPs are trained in inserting them. You may need to get a prescription for the device and pick it up from the pharmacist yourself, or they may have them ready for you at the clinic - check what the protocol is. If you are already on the pill or other contraception, you will need to discuss when to stop this - before or after the changeover.

All of these are usually inserted relatively quickly and you can then carry on with your normal life and enjoy the freedom of not having to think about contraception! (This does NOT mean you don't have to think about STIs though...)

I hope all this is helpful for you. If you still have questions or want to share any experiences of your own, please post here!
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randdom
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Emergency Contraception

You can find yourself in a situation where you need to use emergency contraception for any number of reasons. If you find yourself in a situation where you feel you may have put yourself at risk of pregnancy it is important that you act quickly. There are two forms of emergency contraception that you might want to consider.

You can also get the morning after pill at some pharmacies for free. This will depend upon whether the pharmacist working at the time is trained and signed up to something called a patient group direction (PGD) for supply of the morning after pill. Some pharmacies only supply it free to people within certain age ranges - this will depend on what is written in the PGD so will vary from pharmacy to pharmacy.

Also you can see a healthcare professional at your pharmacy - just ask to speak to the pharmacist! All pharmacies now should really have a private consultation room you can go into to talk into the pharmacy.

The morning after pill

Where can I get the morning after pill?

Due to recent changes in the law it is now possible for you to buy the morning after pill at most pharmacists or private clinics if you are over the age of 16 and it will cost you £26. If you want to get it free or you want to see a health care professional then you can get it free from your GP, any family planning or GUM clinic and some NHS walk in clinics.

How does the morning after pill work?

The morning after pill can work in three ways. It will either stop or delay ovulation (when your egg is released) or prevent a fertilised egg from implanting into the womb.

How effective is the morning after pill?

How effective the morning after pill has a lot to do with how soon after having unprotected sex you take it. It has to be taken within the first 72 hours after having sex.
If you take it:
  • within the first 24 hours then the pill then it is 95% effective
  • between 24 - 48 hours then the pill is 85% effective
  • between 48 - 72 hours then the pill is 58% effective


Are there any possible side effects of the morning after pill?

There are no serious long term or short tem complications of taking the morning after pill. You may experience some dizziness, headaches or abdominal pain. In extreme cases some women may vomit, if you vomit within 2 hours of taking the pill contact your doctor or pharmacist. . If any of this symptoms persist then contact your doctor . You may also find that your periods are disrupted for the next few months.

How can I be sure that the pill has worked?

If you have your period as normal it is very unlikely that you are pregnant. However it is recommended that you take a pregnancy test approximately two weeks after you have taken the morning after pill to be sure.

The IUD

What is an IUD and how does it work?

IUD stands for intrauterine device. It is a small device made out of copper and plastic. It is inserted into your womb by a trained nurse or a doctor. It can be fitted up to five days away after you have had unprotected sex. It works by preventing the egg from being fertilised or implanting in the womb.

Where can I get an IUD fitted?

An IUD is a more difficult method of emergency contraception to get hold of. The person who is fitting the IUD has to have been trained to do so and therefore your GP may not be able to. You should contact your local family planning clinic (find one here)

Is having an IUD fitted going to hurt?

It can sometimes be uncomfortable or painful to have the IUD fitted so it is advisable to take a painkiller such as paracetamol before you have it fitted. You also may experience some spotting or cramping in the days after you have had your coil fitted. For the first hand experience of someone who has had the coil fitted read this.

How long will this protect me from pregnancy?

Unlike the morning after pill and IUD can be used as a long term form of contraception. It is 99% effective and lasts for five years. It can also help with period problems. It is possible for you to have the IUD removed once the risk of pregnancy from your unprotected encounter has passed. Either way you should see a doctor or nurse six weeks after you have had your IUD fitted to have its positioning checked.

Is there anything else that I need to be thinking about?

Infection is one issue with an IUD. In the week after you have had it fitted you will be at increased risk of an infection so it is important that you user condoms during any sexual encounters htat you have in that time.

PLEASE NOTE

If you are in a situation where you are at risk from pregnancy there is also the possibility that you have contracted a sexually transmitted infection. If you think that there is any risk of this contact your doctor or local GUM clinic for a check up.
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Anonymous #1
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This is really useful, thanks - just a quick question, though. I went to the doctor to get the Pill and they gave me 3 months worth, when I go back to get some more will they give me another 3, or do they start to give you more because they know you're settled on it okay?

Do you need to go back to the clinic every 3 months, I mean? It's a pain to get to, that's all.
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randdom
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(Original post by Anonymous)
This is really useful, thanks - just a quick question, though. I went to the doctor to get the Pill and they gave me 3 months worth, when I go back to get some more will they give me another 3, or do they start to give you more because they know you're settled on it okay?

Do you need to go back to the clinic every 3 months, I mean? It's a pain to get to, that's all.
It depends on the doctor. I have come accross people who have been given anything from 6 months to a year on their second visit. But generally from my experiance they give you more than 3.
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Anonymous #1
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(Original post by randdom)
It depends on the doctor. I have come accross people who have been given anything from 6 months to a year on their second visit. But generally from my experiance they give you more than 3.
Thankyou
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YAP
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Good advice .

Just to add to that, go and find out now where you can get the morning-after pill - ideally, find somewhere you can go to 24-hours a day (typically a 24-hour pharmacist). It's a sensible precaution - it's far easier to find these details out now, with a clear head, than in the panic of if you find yourself needing it at 1am.

(This goes for men, too, of course - it's not just down to women to know where to get it from....)
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happy watermelon
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(Original post by Anonymous)
This is really useful, thanks - just a quick question, though. I went to the doctor to get the Pill and they gave me 3 months worth, when I go back to get some more will they give me another 3, or do they start to give you more because they know you're settled on it okay?

Do you need to go back to the clinic every 3 months, I mean? It's a pain to get to, that's all.
Mine gave me 3 months the first time, did a check up, and then gave me a year . Apparantly it was just so they could check that the pill they gave me was the right one for me.
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Anonymous #1
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Brill advice!! Can i ask a question though??

ive had too resort too this and am wanting too start the patch, i took it 2 weeks ago..no sign of a period yet, although i was at the beginning of my cycle when i took it..if i took a pregnancy test now, could i then start the patch without having too wait for my period??
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Caliowin
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ok, this may sound stupid but I'm going to cyprus in 2 weeks, and if I take my pill everyday at 8am in the UK, do i still take it at 8am in cyprus? or do i work out when it would be with the time difference? and then what happens when I get back to england...
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dani_88
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I'm on the implant. It was all dandy for 3 months.. then i started bleeding. Thankfully that's stopped now (and i'm hoping it wont come back for a while :p:). At the time the doctor said that if it didn't stop they could give me a pill (microgynon) to stop the bleeding. I was just wondering if it's possible, that if they can give you a pill to counteract this side effect, can they give you a pill to counteract other side effects - ie bad pms and spots? Or is this a bad idea? Because my mood swings are pretty horrific.. i've been feeling really down and she did say it could be my implant making me a bit depressed and what not.. and an option may be to have it removed (although i've only had it a few months so it was an extreme option), but if there's something i could take to counteract the side effects, i'd rather try that first..
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randdom
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(Original post by Caliowin)
ok, this may sound stupid but I'm going to cyprus in 2 weeks, and if I take my pill everyday at 8am in the UK, do i still take it at 8am in cyprus? or do i work out when it would be with the time difference? and then what happens when I get back to england...
This depends on what type of pill you are on really?
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randdom
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(Original post by Anonymous)
Brill advice!! Can i ask a question though??

ive had too resort too this and am wanting too start the patch, i took it 2 weeks ago..no sign of a period yet, although i was at the beginning of my cycle when i took it..if i took a pregnancy test now, could i then start the patch without having too wait for my period??
If your period isn't actually late yet I don't think you need to take a test. Your best bet is to go to the doctor who is going to be providing you with the patch and see what they say. I suspect that they will advice you to wait until your period and then start the patch but it is best to check.
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Helenia
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Microgynon is a contraceptive pill, which can work just on its own. In this case it's just used to regulate your bleeding by adding oestrogen to the mix (implanon is progesterone-only). Unfortunately, all the other side effects of the implant are down to the progesterone, and you need that to work in order for it to be an effective contraceptive - so blocking it is not an option! There are probably other things you can try in terms of behaviour change to improve your moods, but I wouldn't go for drugs straight away.
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Cj-Tj
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One more thing, the Morning After Pill can, and does, screw your cycle. Its normal to be up to a week either side of when you would be, but can be much longer.
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Anonymous #2
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Hey, I've been on Cerazette for about a month now, and my period came at expected time (though lasted longer than usual) and ended about a week ago. But I'm on again! I know irregularity is a side effect, but I'm slightly worried, I don't want weekly periods!

Does it settle down?
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saoirse
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I usually take it between midnight and 1am, went to take tonights and last nights is still there, had a very hectic night last night so must have forgot. Will I just take the other one now?!

I cant remember the correct thing to do. Its microlite if that makes any difference:rolleyes:
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emilina
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it should say on the leaflet you get with the pill if its ok or not. usually you just take it as soon as you remember, and use another form of protection for 7 days (as well as the pill obv)
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AmberB
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Don't worry, if it was over 12 hours late then just take the next one so you are up to date. And if you're having sex just remember to use extra protection for the next few days. You'll be fine, you're usually allowed a bit of a leeway when it comes to taking pills. You only need to start worrying if you've missed more than one
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screenager2004
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If there are more than seven days of pills left, you simply take the missing pill as soon as possible, and use protection for the next seven days.

If there are less than seven days of pills left (i.e. it's your last week of pills before the week off) then you take the missing pill ASAP and instead of having a week off you go straight into the next pack at the end of the current pack. Also use protection for the next seven days.
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