COMBINED PILLS

It depends on whether you’re taking the pill for the first time, coming back after a break, or switching from a different type of birth control. If you’re taking the pill for the first time, you can start on any day.

When you start using the pill on the first day of your period, you’re protected from becoming pregnant immediately — so you don’t need to worry about using a condom. You’ll also be protected immediately if you start taking the pill before the fifth day of your period.

If you start using the pill after the fifth day of your cycle, you won’t be protected right away. Use a back-up birth control method (like condoms) for seven days while the pill starts to work.

Another option is the Sunday start approach. If you start taking the pill on the first Sunday after your period begins, you avoid withdrawal bleeding on a weekend (if you want to skip having your period on a weekend, this is the way to go).

You shouldn’t leave a gap when you’re switching from one birth control method to the combined pill.

If you’re already taking a hormonal birth control pill, start your new prescription the day after you finish your last pill.

If you’re using a transdermal patch like Evra, start the pill a day before you’re due to take off the patch.

If you’re using the vaginal ring, start the pill a day before you’re set to take out the ring.

If you normally have the Depo-Provera injection, you can start taking your pill up to 15 weeks after your last shot.

If you have an IUD (copper or hormonal), you should begin your combined birth control pill pack a week before having your IUD removed.

Any that contain two active ingredients, a progestin and an oestrogen. To find out if your pill is a combined pill, just check the active ingredients.

In the patient information leaflet, the ingredients should be clearly listed at the top underneath the name of the drug. For combined pills you should see two ingredients, front and center, that are progestin and oestrogen.

With Loestrin, for example, the active ingredients are norethindrone acetate and ethinyl estradiol. This pill is clearly stated as a progestin-oestrogen combination.

At EveAdam, we offer a range of combined birth control pills so there’s plenty of choice for you. But if you can’t take combined pills, for any reason, it’s important to share this with the prescriber for your safety.

There are two ways of measuring how effective pills are at preventing pregnancy. One way is according to perfect use. This involves someone taking the pill exactly right, every day, without making a mistake. The level of effectiveness of the combined oral contraceptive pill when taken like this is over 99%.^[1] This means that in a whole year, fewer than 1 in 100 women taking the combined birth control in that time will become pregnant.

The other way is typical use. This is when someone takes the pill but makes realistic errors, such as forgetting the occasional pill or taking it late. It’s 91% effective when taken like this, which means about 9 in 100 women taking it over a year will become pregnant.

So the best way to make sure the pill is effective is to follow the instructions as closely as you can when you take it.

When you use any kind of medication, there is a chance you’ll experience some kind of side effect. It’s quite common to notice some side effects when you start a new pill. A lot of the time, these side effects are pretty mild and will normally go away as you continue using the pill, usually after the first two to three months.

But if you get any side effects that concern you, or don’t go away after a couple of months of use, speak to your doctor or prescriber. They may suggest moving you on to a different pill.

Some of the most common side effects when you start using the pill include nausea, headaches, tender breasts, changes to your mood, bloating and breakthrough bleeding.

Serious side effects like allergic reactions or blood clots are rare, but you should go to your nearest hospital right away if you get any signs of these.

Sometimes, yes (provided you’re a woman who also needs birth control). There are some pills that are useful for acne.^[2]

The combined pill acne treatment is usually reserved for those with moderate to severe symptoms. It is most likely that topical treatments alongside antibiotics will be prescribed first, with hormonal medications like the combined pill used if this has proven ineffective. It may take some months to take full effect but its benefits will be felt by most in time. It is important to note that the mini pill (progesterone only pill) may make acne worse.

A lot of the birth control pills you know will probably be branded versions. You’ll know them by name, they’re popular choices and you know what’s in them and what to expect.

But there are also “generic” versions of those pills.

Generic versions have the same ingredients and are tested in the same way as their branded counterparts. So while their name may be different, these options are completely safe for you to use.

The main difference is the company that makes them. So for example, there may be several names for a specific formulation of a pill, in a specific dose, because multiple companies make that pill.

For example, Levest contains 0.15mg levonorgestrel and 0.03mg ethinyl estradiol. Rigevidon, Maexeni and a number of other pills contain exactly the same hormones in the same amounts, but may look slightly different and come in different packaging. But there shouldn’t be any real difference in how they work. In some cases one version of a pill may be cheaper than the other, because different companies make and market them.

There can be interactions between combined pills and other medications, which is why it’s important for you to let us know if you’re currently taking medication for any health issues.

For the most part, antibiotics are safe to take when you’re on the pill — except for rifampin that is used to treat tuberculosis. These antibiotics can affect your periods, making them irregular so your chances of becoming pregnant increase.

Let the prescriber know if you’re currently taking medication to treat HIV, as some of these treatments can impact your pill. Medications like Darunavir, Efavirenz and Nevirapine all interfere with the combined birth control pill so another birth control option may be better for you.

Anti-fungal medications used to treat skin conditions like jock itch may interfere with your pill, as can anti-seizure drugs. Drugs like carbamazepine, phenobarbital and primidone can impact how the hormones in birth control are broken down. Another birth control option should be used instead of the combined birth control pill.

Modafinil (you may know this under the name Provigil) is used to treat sleep issues like narcolepsy and shift work sleep disorder. It can reduce the effectiveness of your pill so you shouldn’t use a combined birth control method if you’re taking this medication.

Be mindful of herbal remedies too, because they can have an impact on your pill. St John’s Wort (used to treat mild depression or sleep disorders) can affect how oestrogen is broken down so the pill may not work as well and the chances of breakthrough bleeding increase.

Saw palmetto (used for hair loss), alfalfa (for kidney or bladder problems), garlic pills (taken for heart and blood diseases) and flaxseed (for digestion problems) can all impact the effectiveness of your pill. Combined birth control pills will probably not be a good fit for you if you’re using any of these treatments.

There isn’t a single price for combined birth control pills. Because they’re made by different pharma companies, the price of the pill can vary. But at EveAdam, we have a number of options with different prices so you can find a pill that suits you and fits within your budget.

As we’ve mentioned, combined birth control pills aren’t suitable for all women to use. That’s why it’s important to share any health problems with the licenced doctor to ensure your safety. You should not use combined birth control pills if you:

• Have uncontrolled high blood pressure
• Are in the first month of breastfeeding your baby
• Currently have, or have a history of deep vein thrombosis or pulmonary embolism
• Have a history of stroke or heart disease
• Older than 35 years of age
• Smoke
• Migraines with aura (you might see flashing lights just before the migraine begins)
• Have liver complications
• Have unexplained vaginal bleedingHave diabetes-related complications
• Have a history of breast cancer
• Will be off your feet for an extended period after having surgery 

Setting up a regular subscription plan to get the pill online is simple with EveAdam. Take an online consultation to get treatment recommendations from a UK prescriber, and once you have made your choice, a prescription will be created for you. This is sent electronically to our UK pharmacy, where your contraception is dispensed and shipped to you in discreet packaging. Your first package should arrive in one working day, and you can choose how often you receive your packages after that.