Apply for contraceptive pill and patch

Who is this service for?

We can provide contraceptive prescriptions for:

female (birth sex) patients
aged between 17 and 50 years for combined contraceptive medications
age up to 55 years for progesterone only pills
for the following indications, subject to suitability:

Prevent pregnancy
Regulate troublesome periods
Manage hormonal-related acne

To ensure safe use of this service, we require up to date height & weight information and a recent blood pressure reading (within the last 6-12 months). If you have had a blood pressure check by your GP/ nurse, you can use this. If not, a reading from your local gym, pharmacy or home monitor can be used.

It can sometimes take a little trial and error to find the most suitable pill for you. If you are experiencing significant side effects with your current pill, please let us know and we can advise on alternative options.

We are not able to provide prescriptions for depo-provera, contraceptive implants or coils.

Please be aware, this service is not suitable if you have malabsorption problems from any cause, including after weight loss surgery (e.g. gastric band or sleeve). You should speak with your local GP or family planning clinic for contraceptive advice.

What is the Contraceptive Pill?

There are two types of contraceptive pills;combined pills and progesterone only pills ("mini pills"). Both contain different types and amounts of synthetic natural female hormones.

If taken correctly, both types of pill are over 99% effective at preventing pregnancy. Ideally, you should take your pill at the same time every day.

The Combined Contraceptive Pill:

This pill contains two hormones; oestrogen and progesterone. There are many brands of combined pill – they all work in the same way but contain different amounts and types of oestrogen and progesterone. This can cause variations in side effects from person to person.

Traditionally, the combined pill was taken for 21 consecutive days with a 7 day break, and this cycle was then repeated. However, it is now recommended that these pills are taken one of the following ways to provide more reliable contraceptive cover:

21-day use with a 4-day break (most pill-free intervals should now be 4 days).
3 packets together with no break and then a 4-day break.
Continuous use of the pill until spotting for 2 days, then a 4-day break and then restart pill and continue until spotting occurs again.

If you need advice on this, just send us a message via your secure patient account when you have completed the questionnaire.

Here is some important information on the combined pill.

The Progesterone Only Pill:

This pill only contains progesterone and is sometimes referred to as the "mini-pill". It is an excellent pill and has less risk factors than the combined pill. However, it does NOT have the same cycle control.

It is taken every day without any break. Sometimes irregular bleeding/ spotting can occur for the first 2-3 cycles. After this most women settle into a bleeding pattern, which can be shorter, lighter bleeds or no periods for months on end.

Here is some important information on the progesterone-only pill.

What is the Contraceptive Patch?

The contraceptive patch contains oestrogen and progesterone (like the combined contraceptive pill) which are absorbed through the skin. You apply a new patch to your skin every week for 3 weeks, take a break (no patch) for 4 days and repeat the cycle.

This method is not affected by vomiting or diarrhoea and you do not have to remember daily pills.

If used correctly, the patch is up to 99% effective at preventing pregnancy.

Here is some important information on the contraceptive patch.

What is the Contraceptive Ring?

The contraceptive ring is a small, soft, silicone ring that contains both oestrogen and progesterone. Once a new ring is inserted into the vagina, it remains in place for 21 days. During this time the hormones are released slowly into your bloodstream through the vaginal wall. It is then removed for a 4 day break. This cycle is repeated.

As it is very small and usually not felt, it does not interfere with sexual activity.

Here is some important information on the vaginal ring.

What are the potential side effects of oestrogen and progesterone?

Oestrogen and progesterone have different side effect profiles. Side effects are not experienced by all patients, but if they do occur, they can be more or less pronounced depending on the dose and type of hormone, as well as the delivery mechanism e.g. tablet, patch or ring.

Below are examples of some of the common side effects of combined hormonal contraceptives and progesterone only contraceptives.

Combined (Oestrogen & Progesterone):

Vaginal bleeding/ spotting in the early months.
Transient Breast tenderness is very common early on but usually settles after the first 2-4 weeks.
Bloating.
Headaches & migraine: This would need to be reviewed if NEW migraine starts on this pill.
Nausea, in the early stages of pill taking.
Increased blood pressure: This is why a reading is essential every 6 months.
Blood clots (very rare but potentially fatal).

Progesterone:

Irregular vaginal bleeding/ spotting (very common).
Transient Breast tenderness.
Headaches.
Nausea.
Low mood & low libido: Progesterone only pills are not thought to be causative of this though.
Acne: This can improve, stay neutral or get worse.

For full details of the potential side effects of these medications, please ensure that you read the patient information leaflet that comes with your medication before you start to use it.

Do contraceptive pills/ rings/ patches provide protection against sexually transmitted infections (STIs)?

No, these types of contraception do not protect against STIs. The best way to reduce your risk of getting an STI when having sex (vaginal, anal or oral) is to use a condom (barrier protection).

Does the contraceptive pill/ patch/ ring interaction with other medications?

Yes, some medications reduce the effectiveness of these contraceptives and increase the risk of pregnancy. It is important that you tell us about all the medication/ treatments you are taking, including any use of the morning after pill /emergency contraception so we can advise you safely and appropriately.

It is also essential that you tell any other doctor treating you that you are using these medications.

Does the pill/ patch/ ring increase my risk of getting a blood clot?

Using a progesterone only pill may increase your risk of developing a blood clot, but the risk is significantly lower compared with using combined contraception (pill, patch or ring).

All combined contraceptives increase the risk of thromboembolism (potentially dangerous blood clots which can develop within blood vessels). Patches, vaginal rings and some combined contraceptive pills have a slightly higher associated risk than others. If you would like more specific information on your pill/ patch/ ring, please send us a message with your request.

The overall risk of a blood clot is very small.

It is very important that you recognize when you might be at greater risk of a blood clot, what signs and symptoms you need to look out for, and what action you need to take.

You should see a doctor immediately if you develop any of the following symptoms when taking the combined pill:

Pain or swelling in the legs.
Severe chest pain.
Breathlessness or coughing up blood.
Bad fainting attack or collapse.
Unusual headaches or difficulty with speech or sight.
Numbness or weakness of a limb.

If a blood clot:

Develops in the leg, it can cause a deep vein thrombosis (DVT).
If it travels to the lung, it can cause a pulmonary embolism (PE).
If it travels to the heart, it can cause a heart attack.
If it travels to the brain, it can cause a stroke.

Are there things that can increase my risk of developing a blood clot when using combined hormonal contraceptives?

The potential risk of a blood clot highest:

In the first year of using combined contraception; this is why it is not recommended that you have a ‘break’ from the pill unless there is a good reason. If you stop and restart, your risk goes back to that of someone who has never used it before i.e. increased for the first year of use.
If you are very overweight.
If you are a smoker.
If you are older than 35 years.
If you have a family member who has had a blood clot at a relatively young age (eg. below 45).
If you have given birth in the previous 6-12 weeks. There is also some evidence that the risk is higher if you are restarting use after a break of 4 weeks or more.

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