On which day of my menstrual cycle should I start my first course of the combined oral contraceptive pill?
Nowadays, we recommend that it should be started on the first day of a period as this provides immediate contraceptive cover. The next period will occur after 23 days but subsequent periods will be at 28 day intervals.
Following childbirth, the combined pill can be taken if the baby is not being breast-fed; breast feeding combined with progestogen-only pills provides excellent contraception. During pregnancy and for the first two weeks after childbirth there is an increased risk of thromboembolism (blood clot problems -surgery risks) and this may be further increased by the combined oral contraceptive pill (Q15.14). The pill should be commenced no earlier than 21 days after childbirth. If there has been a high blood pressure problem associated with pregnancy or there is a tendency to obesity, the combined oral contraceptive pill should be further delayed. If the combined oral contraceptive pill is commenced more than 21 days after childbirth, additional contraceptive precautions are required for the first seven days. The combined oral contraceptive pill can be commenced immediately after early miscarriage or pregnancy termination.
If periods are absent or infrequent, and this problem has been appropriately investigated (Q6.6), a course of progestogen tablets will usually provide a withdrawal bleed and the combined oral contraceptive pill can be commenced on the first day of bleeding.
Please click on the required question.
- 1 What are the different types of combined oral contraceptive pills?
- 1a What is the new Evra Patch?
- 2 What are the benefits and problems of the phasic pills?
- 3 How will my doctor help me to decide which is likely to be the best pill for me?
- 4 Whilst I am taking the combined oral contraceptive pill, what monitoring should I receive?
- 5 A member of my family has a history of a deep venous thrombosis (DVT) or pulmonary embolism (thromboembolism). Should I have a screening blood test?
- 6 Does an aeroplane journey increase the risks of taking the combined oral contraceptive pill?
- 7 Are there times when the combined oral contraceptive pill should be prescribed only with special caution?
- 8 Are there any contraindications to taking the combined oral contraceptive pill?
- 9 On which day of my menstrual cycle should I start my first course of the combined oral contraceptive pill?
- 10 Can I start the combined oral contraceptive pill whilst I am breast-feeding?
- 11 Can I take the combined oral contraceptive pill if I have had episodes when I did not see my periods (amenorrhoea)
- 12 Can I start the combined oral contraceptive pill if I am not currently seeing my periods?
- 13 Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?
- 14 What is the advice when my changing pill preparation?
- 15 What should be done if breakthrough bleeding occurs whilst I am taking the combined oral contraceptive pill?
- 16 Can my pill withdrawal bleed be planned to avoid weekends?
- 17 Can I take the combined oral contraceptive pill without a seven-day pill-free gap?
- 18 What should be done if a pill is missed?
- 19 Could I conceive whilst I am taking the combined oral contraceptive pill?
- 20 Can combined oral contraceptive pills interact with other medication?
- 21 I am taking the combined oral contraceptive pill. Will this reduce my future fertility?
- 22 I have been on the combined oral contraceptive pill for sometime. Is there any need to take a break from it?
- 23 I am due to have an operation. Should I stop taking my pill?
- 24 What is the advice with regard to third generation combined oral contraceptive pills?
- 25 Until what age can I take the combined oral contraceptive pill?
- 26 I have taken the combined oral contraceptive pill. Will this change the time when I will go through the menopause?
- 27 I am taking the combined oral contraceptive pill. How will I know if I have reached my menopause?
- 28 In what circumstances should the combined oral contraceptive pill be stopped immediately?
- 29 What symptoms are commonly associated with taking the oral contraceptive pill?
- 30 Should the combined oral contraceptive pill be discontinued if I develop headaches?
- 31 If I have varicose veins can I take the combined oral contraceptive pill?
- 32 I have developed vomiting and diarrhoea. How does this affect my pill taking?
- 33 How long before starting a pregnancy should I stop taking the combined oral contraceptive pill?
- 34 Family Planning Support Groups.
- 35 Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
