Starting the Oral Contraceptive Pill

hi there dr. Graham Blaschke from family

doctor expert today we're talking about

starting the oral contraception pill and

I have 10 questions for you to consider

if you're going to start a fill question

1 why you're starting it is it for

contraception is it because you're

getting painful bleeding or heavy

periods or is it to try and fix your

skin acne issues is it to help with new

premenstrual syndrome whatever your

reason you need to talk to this with

your doctor because it may affect which

pill they choose for you and always

remember that the oral contraceptive

pill doesn't provide you with protection

against sexually transmitted diseases

you need to use condoms to get that

protection question 2 is the appeal the

best contraception for you have a chat

with your doctor there's lots of

alternatives there's what we call the

Lark the long-acting reversible

contraception and there's things that

can be implanted and injected and I you

DS and lots of other possibilities such

chat with your doctor if the pill is the

best for you now if you do decide to go

on the pill there's a whole range of

different pills there's the mini pill

which we're not going to talk about much

today that's a subject of another family

doctor expert video but if as most girls

do you go on the combined pill there's

still quite a few questions to think

about are you going to go on we call the

mono dose pill where you get the same

strength of tablet every day you're

going to go on a phasic pill or a cyclic

or pick another question to discuss with

your doctor are you going on a week or a

strong dose and the other thing to think

about is which sort of hormone are you

going to go on the standard peel or

you're going to go on some of the new

synthetic pills which have a slightly

different risk profile seem to be quite

good at helping reduce acne and some

the mood problems but tend to cost more

so you have to chat with your doctor

about that the other thing to think

about is some of the pills come with the

little placebo tablets the sugar tablets

and do you want to have a packet of 21

which has no sugar tablets or a pack up

with 28 which includes the sugar tablets

so lots to think about now question 3

contraindications who shouldn't have the

pill or should at least think very

carefully before they take it people

with migraines especially visual

migraines visual auras anyone who's got

a history of clots in the legs what we

call deep venous thrombosis or any

propensity in your family or in your

history to have clots things like heart

attacks and strokes got to talk about

this with your doctor if you're over 35

in your smoke combined oral

contraceptive pill probably a bit risky

for you if you're overweight or you've

got type 2 diabetes gotta talk to your

doctor you're taking other medications

make sure you mention that to your

doctor they can interact so there's lots

of other contraindications which your

doctor will talk to you about question 5

what are the side effects common side

effects of the pill some women are lucky

you know how to get any effects but

common side effects are nausea vomiting

breast tenderness some women get

breakthrough bleeding especially the

first few months that means bleeding in

between your periods which is pretty

annoying some people get high blood

pressure your doctor will wanna check

that and there is some concern about

cancer risk these are all tiny changes

in the rates of cancer but there is some

debate as to whether the pill could

increase breast cancer and maybe

survival cancer very slightly but on the

other hand it seems to lower risk on

uterine and ovarian cancer and even

bowel cancer so your doctor will weigh

these up their tiny percentages but

they're worth considering and your

doctor will think about that and talk

about it with you next question sex

could you be pregnant don't really want

to start the pill if you're already

pregnant has potential problems so tell

your doctor when you had your last


think there's any risk that you actually

are pregnant that's worth checking for

before starting the pill how do you

start it as usual check the patient

information sheet look at the

instructions but the main principles are

to take it every day take it at the same

time every day considering getting a

mobile phone app which will remind you

to take it every day start on the first

day of your period and usually if you

have a look at the example packet here

if you get your period on sale Thursday

you start the pill in the colored

section on the Thursday similarly if

your period started on a Tuesday just

start in the colored section on the

Tuesday and take one every day so what

if you miss one easy to do first of all

if you take the pill within 24 hours of

realizing that you've missed your usual

pill then you're covered there's no

problem but a missed pill which we

define as more than 24 hours late so

that means 48 hours since you talked the

last pill this is a missed pill so what

do you do about that don't panic you

take the pill when you realize even if

that means taking two pills together the

next day that's okay and use alternative

contraception particularly for example

condoms for a week to make sure you

covered now the next thing you want to

do is you go I've missed a pill I'm

going to have a look at my packet was it

in the first week this is one of the

more risky times actually to a mr. pill

so the first week after the sugar

tablets is a time where you might be at

risk and you might talk to your doctor

about getting some emergency

contraception which is the subject of

another family doctor expert video but

it might be worth considering if it's in

the second week but you've missed the

pill you're probably fine if it's in the

third week when you've missed your pill

best thing to do would be to miss the

sugar tablets at the end of that cycle

to go straight on to the next round of

hormone pills so as usual check the

instructions but that's the general

approach to a mist fill how do I skip a

period this is what many women come a

nurse at the clinic so it's easier to do

if you're on a monophasic pill so

remember we talked about some of the

pills come with varying doses and some

of them are on one dose much easier if

you've got one dose the trick is not to

take the sugar pills so you take the

hormone pills and when you get to the

sugar ones just miss them and start the

hormone pills in the next packet so

final question question ten will taking

the long term oral contraceptive affect

your fertility the evidence suggests

know that appears to be no long-term

effects on pregnancy rates so you're

safe from that point of view so lots of

information and usual don't act just on

the information in this video check the

patient information talk with your

doctor and I wish you well from family

dr dot expert