Why use the new regime?
- Continuous use is as effective as standard regime
- Women on CHC do not need to have a withdrawal bleed
- There will be no build-up of menstrual blood
- Frequency of withdrawal bleeds and associated symptoms are reduced
- Withdrawal bleeds have been documented in pregnant women, so should not be used as reassurance against pregnancy
- Incorrect use is highest during the drug free interval by reducing number of these intervals and reducing to 4 days will reduce incorrect use
- Although this is off license it is recommended by medical authorities in the UK (Faculty of Sexual and Reproductive Health) and WHO (World Health organisation)
Options
- Standard use – Take one pack of pills have 7 day break restart and repeat
- Shorter pill free break – Take one pack of pills have 4 day break and restart and repeat
- Tricycling – Take three packs of pills back to back without a break until the end of the third pack then stop for 4 days, restart and rpt cycle
- Continuous – You can take packs continuously back to back without a break week, if you start to have a vaginal bleed for four or more days, have a four day break from the medication then restart. You can only stop taking the pills if you have taken at least one complete pack, if you stop and you have not taken a complete pack (21 pills) you could be at risk of pregnancy.
What to do if I miss a pill?
If you have taken 21 tablets prior to the missed pills, you can miss up to seven pills and still be protected against pregnancy. If this happens restart the pills within seven days and no extra precautions are required.
If you have not taken 21 tablets continuously (one day after another) prior to the missed pills or if you have missed more than 7 pills please contact the surgery for advice and guidance.
When to seek medical review
Urgent review
- Calf pain, swelling and/or redness
- Chest pain and/or breathlessness and/or coughing up blood
- Loss of motor or sensory function
Prompt review
- Breast lump, unilateral nipple discharge, new nipple inversion, change in breast skin
- New onset migraine
- New onset sensory or motor symptoms in the hour preceding onset of migraine
- Persistent unscheduled vaginal bleeding
Inform you contraceptive provider
- High blood pressure
- High body mass index (>35 kg/m2)
- Migraine or migraine with aura
- Deep vein thrombosis or pulmonary embolism
- Blood clotting abnormality
- Antiphospholipid antibodies
- Angina, heart attack, stroke or peripheral vascular disease
- Atrial fibrillation
- Cardiomyopathy
- Breast cancer or breast cancer gene mutation
- Liver tumour
- Symptomatic gallstones