Contraception

UPDATED MARCH 2021

For Patients:

Advice on Contraception – including Covid information

Your Choice:

If you would like to know more about all methods of contraception, there is clear and helpful information available here: https://www.sexwise.org.uk/contraception/which-method-contraception-right-me.

Some of the choices are less readily available during Tier 5 restrictions, and we may suggest an interim solution to reduce footfall in the practice to keep our patients and staff safe. We will not be offering routine coils/implants during the severest restrictions.

During the Pandemic:

Emergency Contraception is important and available. https://www.nhs.uk/conditions/contraception/emergency-contraception/

The Combined Oral contraceptive pill

If you are taking the combined oral contraceptive pill, information on how to take the pill is available here: It is safe to take until you are 50, unless you have other risk factors for heart disease or stroke, such as obesity, you are a smoker, or have migraines with aura.

https://www.fpa.org.uk/sites/default/files/the-combined-pill-your-guide.pdf

There are new rules for taking your pill which may not be explained in the literature in your pack.

The main changes which help to reduce the chance of you getting pregnant while taking your pill are:

  • Never have a break of more than 4 days between pill packs
  • There is no need to have breaks at all, with no adverse health consequences.

You now have 3 choices about how to take your pill:

  1. The safest option is to run your packs together, without a break. This way you may not have a period at all. Some people may naturally start to bleed after a few months -if so, stop your pill for 4 days, ( no matter where you are in the pack), then restart.
  2. Have a scheduled break after running 2 or 3 packs together. Again, only have a break of 4 days before starting your next pack.
  3. The least safe option ( in terms of an unplanned pregnancy ) is to have a 4 day break at the end of each pack.  

Emergency contraception:

If you are worried that you have forgotten or missed pills, you may need emergency contraception:

https://www.nhs.uk/conditions/contraception/emergency-contraception/ If in doubt, please contact the surgery for advice as soon as possible.

Your annual pill check is important to ensure you are still on the best contraception for you. To arrange this efficiently and remotely, please fill in the linked questionnaire and email it to the team, who will either update your medication for a further 12 months, or contact you to discuss your options further.

Progesterone Only Pill (Cerelle, Cerazette, Desogestrel, Micronor) These pills are always taken continuously without a break, and ideally at the same time each day.

https://www.fpa.org.uk/sites/default/files/progestogen-only-pill-your-guide.pdf. Your annual review will be undertaken remotely, and can be helped by filling in the following questionnaire:

Contraceptive-Pill-Checklist-for-patient

  

Long Acting Reversible Contraception – Extended use in LockDown:

There are injections, coils and implants used as long acting, reversible contraception. The recommendations for extended use of these during the pandemic have been based on evidence collated and reviewed by the Faculty for Sexual and reproductive health. If you have a coil or implant, in discussion with your GP we may recommend delaying the change by up to a year for certain types of contraception. https://www.fsrh.org/fsrh-and-covid-19-resources-and-information-for-srh/.

Injectable contraception: Sayana Press – This is the same hormone as in the depo provera injection, but the injection goes under the skin rather than into a muscle. This means that, like diabetes injections, this can be taught to be done easily at home by yourself or a partner. There is a clear video demonstration of the process of self administration here: https://www.youtube.com/watch?v=PYRQiDX_kBA

We are encouraging all patients currently using Depo Provera to consider switching to Sayana Press and we are happy to teach you how to use these at home via video link to reduce your risk during this pandemic time.

Coming for a coil fit:

Once the pandemic eases, we will be offering a full family planning service again with coil and implant fits.

Prior to booking a coil fit, you will need a conversation to ensure this is the most suitable contraception for you. We would recommend you watch this short video which describes the procedure https://www.youtube.com/watch?v=XHRYE2FsXmc.

FAQs:

I’m having problems with my current Contraceptive method, what should I do?

If you are having problems with your current method, or you have any questions, please book a routine telephone appointment.

I can’t remember what to do if I miss a Pill?

Please remember to take your Pill at the same time each day, but if you miss one:

 If you are on a Combined Oral Contraceptive Pill ( Rigevidon, Millinette, Levest, Gedarel,Yasmin) and you are more than 24 hours late ( so 48 hours since your last pill), take it as soon as you remember, then continue to take your Pill at your usual time, but you will need to use another form of contraception-like condoms-for the next 7 days

If you are on a Progesterone-only Contraceptive Pill ( Desogestrel- Cerazette, Cerelle, Zelleta, Norgestron ) and you are more than 12 hours late ( so 36 hours since your last pill) then you will need to use another form of contraception-like condoms-for the next 3 days.

I’m confused about the rules for taking my Combined Contraceptive Pill?

There are new rules for taking your pill which may not be explained in the literature in your pack.

The main changes which help to reduce the chance of you getting pregnant while taking your pill are:

  • Never have a break of more than 4 days between pill packs
  • There is no need to have breaks at all, with no adverse health consequences.

You now have 3 choices about how to take your pill:

  1. The safest option is to run your packs together, without a break. This way you may not have a period at all. Some people may naturally start to bleed after a few months -if so, stop your pill for 4 days, ( no matter where you are in the pack), then restart.
  2. Have a scheduled break after running 2 or 3 packs together. Again, only have a break of 4 days before starting your next pack.
  3. The least safe option ( in terms of an unplanned pregnancy ) is to have a 4 day break at the end of each pack.

I think I need Emergency Contraception-how do I get it?

Remember you can take a pill-form of Emergency Contraception for up to 5 days after unprotected intercourse, but it’s effectiveness is decreased the longer it is since the time of intercourse

If you need to access a pill form of Emergency Contraception, you can do so by:

  1. Arranging a telephone or Face to Face consultation with one of the clinicians at Bourn Surgery
  2. Going to a Pharmacist-You do not need a prescription
  3. Contact iCASH- the local Sexual Health Clinic by phoning 0300-300-30-30

If it has been 5-7 days since an episode of unprotected intercourse, you can have a copper coil fitted, either at Bourn Surgery or at ICASH.     

I have a Nexplanon implant, but I can’t remember when it needs replacing?

 Nexplanon is licenced for 3 years, but it’s use can be extended in certain circumstances.

At the time of its insertion, you would have been given a card with the replacement date on it, but don’t worry if you have lost it; we run a monthly audit to check who is due for a replacement, and we will send you a text message to make an appointment to discuss its replacement or removal.

I have a Copper or Mirena coil, but I can’t remember when it needs replacing?

 – Copper coils inserted before you are aged 40 need replacing every 10 years. Copper coils inserted after the age of 40 can be left in place until aged 55.

– Mirena coils need replacing every 5 years whether for contraception or for HRT, however, if a Mirena is inserted after aged 45 and is used for contraception alone, it can now be left in place until aged 55.

– Kyleena coils need replacing every 5 years.