Pills Related To Getting Pregnant

The two main types of regular contraceptive pills are:

• Combined contraceptive pill (COC) – contains synthetic versions of the two main female sex hormones, oestrogen and progesterone
• Mini-pill or progesterone only pill – contains only progesterone

About taking either pill:

• Each pill is available as a tablet
• The pill can be up to 99% effective if taken daily as prescribed by your doctor
• Taking your pill at the same time each day is very important, as this will ensure that your hormone levels remain constant and you are protected effectively against pregnancy

About the mini-pill:

• When taking the mini-pill, you should not be late by more than 3 hours (12 hours for desogestrel)
• They are only available as 28-day packs and you would need to take one pill each day in the pack to fully protect yourself against pregnancy

About the combined pill:

• Most COC’s are available in 21-day packs, where you take it daily for 21 days (3 weeks) followed by a 7 day break
• The 7 day break of taking tablets allows you to have a ‘withdrawal bleed’, which is similar to your period
• They are also available in packs of 28 where 7 tablets are placebo tablets. This helps you remember to take your tablets daily

The COC’s available from ZAVA are:

• Brevinor®
• Cilest®
• Femodene®
• Femodette®
• Gedarel®
• Katya 30/75®
• Levest 150/30®
• Loestrin 20®
• Lucette®
• Logynon®
• Logynon ED®
• Marvelon®
• Mercilon®
• Microgynon 30®
• Millinette 20/75®
• Norinyl-1®
• Norimin®
• Ovranette®
• Qlaira®
• Rigevidon®
• Sunya®
• Synphase®
• Triadene®
• Triregol®
• Yasmin®
• Zoely®

The mini-pills available from ZAVA are:

• Cerelle®
• Cerazette®
• Norgeston®
• Noriday®

You can consider taking an emergency contraceptive pill after unprotected sex to avoid pregnancy – emergency contraception is not recommended for daily use. It is used for one-off occasions after unprotected sex. It is also helpful if the condom splits during sex or if you miss taking your contraceptive pill.

The emergency contraceptive pills available from ZAVA are:

• EllaOne®
• Levonelle®
• Generic Levonelle (contains the same active ingredient as Levonelle®)

EllaOne® – this is a newer brand of emergency contraception. The active ingredient is ulipristal acetate. It modifies the activity of progesterone, which delays ovulation. It can be taken up to 120 hours (5 days) after unprotected sex. It is just as effective throughout this 5 day period and it's slightly more effective than Levonelle.

The most common brand is Levonelle® – the active ingredient is levonorgestrel, which is a synthetic version of progesterone. You should ideally take it within 24 hours after unprotected sex as it is most effective within this timeframe (this offers 95% protection). You have to take it within 72 hours (3 days) of unprotected sex but the longer you leave it, the less effective it will be. It is not suitable for you if you have had unprotected sex more than 3 days ago.

When will they not work? – no emergency contraceptive pill is effective once you have already ovulated. The copper coil is the only emergency contraception, which would be helpful in this instance. If you vomit within three hours of taking the pill, then you must take another one.

Yes, it is easy and simple to order different types of contraceptive pill online – ZAVA can provide you with a prescription and send your medication to an address of your choice in three simple steps:

1. You need to complete an online consultation, which is a few simple questions about your health
2. Our doctors will review your order to confirm your suitability and issue your prescription
3. Our pharmacy dispatches your medication. We offer a fast and discreet delivery service, which sends your medication to an address of your choice

The advantages of using the online service are:

• Simple and easy to use
• Discreet
• Quicker as you avoid face-face consultations and don’t have to visit a pharmacy with your prescription
• Fast delivery options which is particularly important for emergency contraception
• Some contraceptives are cheaper online
• 3 month and 6 month courses are available for COC’s

You can get also get contraceptives from either:

• Your GP
• Any GUM (Genito-urinary medicine) clinic or sexual health clinic
• Any family planning clinic
• Any young person’s clinic or Brook Advisory Centre

Emergency contraceptives are available from:

• Some NHS walk-in centres
• Your GP
• GUM/sexual health clinics
• Some pharmacies
• Some A&E departments (used as an absolute last resort)

Specific details for some providers – some pharmacies also participate in an NHS scheme that allows emergency contraception to be made freely available to all under 25’s. Check with your local clinics or centres for further advice about their services and opening times.

Most COCs work by:

• Preventing ovulation – a process where your eggs ripen and are released from your ovaries each month
• Thinning your womb lining, making it less likely for the fertilized egg to attach to your uterus lining
• Increasing the thickness of your natural mucus at the neck of the womb, making it more difficult for sperm to reach your egg

Emergency contraceptives – these also work by either preventing ovulation or fertilisation by increasing the thickness of your natural mucus after unprotected sex. Emergency contraceptives are not recommended for long term use, it is not as reliable as regular contraception and can disrupt your periods. You can consider COC if you want a long term contraceptive.

How do I get the most out of pregnancy pills? – contraceptive pills are highly effective if they are taken correctly. Tips to get the most out of them are:

• Contraceptive pills do not protect against sexually transmitted infections (STI’s), making it important to also consider using a condom
• Take them correctly as prescribed by your doctor. COC are available on prescription only, but emergency contraceptives can be purchased without a prescription
• Take them at the same time each day. This is very important as a delay in taking them by a few hours can count as a missed pill and won’t protect you from an unwanted pregnancy
• You can download free apps on your mobile to help remind you about when to take your contraceptive e.g. myPill®
• Common side effects usually settle within the first few months, especially during the first 3 months while your body adjusts to your contraceptive
• Adjust your lifestyle to improve your overall health such as weight loss or stopping smoking. This will reduce your chances of experiencing serious side effects from contraceptives
• Speak to your doctor about managing other risk factors such as blood pressure or diabetes, as this will also reduce your chances of experiencing serious side effects
• You can exercise and wear graduated compression hosiery during long periods of travel to reduce the risk of blood clots if you are taking long term contraceptives
• Seek advice from your doctor if you have severe diarrhoea or persistent vomiting whilst on the COC, as you may need additional precautions to protect you
• Always tell your doctor if you are taking other medicines including any herbal remedies. Some medicines interact with contraceptives making them less effective. Contraceptives can still be less effective even after you stop taking the interacting medicine

Fertility medication – many medical fertility treatments have been used successfully for years and are usually prescribed by a specialist doctor. The most common treatments available on prescription are:

• Clomiphene also known as the branded version Clomid®
• Metformin
• Gonadotrophins e.g. Menopur®, Puregon® or Ovitrelle®
• Dopamine agonists e.g. Cabergoline or Bromocriptine
• For men – gonadotrophins are also used to treat infertility in men, which is caused by a low sperm count or reduced sperm motility

They all help to stimulate ovulation. Deciding on which treatment is right for you depends on your reason for not ovulating, conceiving or if the treatment is used alongside another assisted treatment such as in-vitro fertilisation (IVF).

Are there any natural fertility treatments? – there is unfortunately no good clear evidence that any herbal remedy will help with fertility. There have been some studies but they are small and currently inconclusive. Some examples of natural fertility treatments are:

• Agnes cactus (chasteberry)
• Black Cohosh – considered unsafe in pregnancy
• Saw palmetto – it’s suggested to improve sperm count, but there is some evidence that it may harm sperm count.
• She oak – some women take it to help with emotions and anxiety about infertility

Speak to your doctor before deciding to try an herbal remedy because they may have side effects and can cause harmful interactions.

Choosing to buy herbal treatment – if you are considering buying an herbal remedy over the counter, then ensure it has a Traditional Herbal Registration (THR) logo on its packaging. This ensures that the medicine meets government standards for safety and includes clear instructions on how to take it. If you are considering consulting an herbalist, then ensure you choose someone who is qualified and registered with the National Institute of Medical Herbalists.

Which supplements exist for women who are already pregnant? – eating a healthy, varied and balanced diet during your pregnancy will help you get most of the vitamins and minerals. When you are pregnant, you need to take a folic acid supplement. It is recommended you:

• Take 400 mcg (micrograms) of folic acid each day (this may need to be higher for some women) – you should take this before you conceive and for 12 weeks after you become pregnant
• Take vitamin D supplements – you can consider taking a supplement with 10 mcg of vitamin D each day to help keep the bones, teeth and muscles healthy
• Do not take vitamin A supplements – or supplements containing vitamin A (or retinol), as too much can cause harm to your baby.

Guidance for these supplements – it is important to take a folic acid supplement, as its difficult to obtain the required amount from food alone. Folic acid can help prevent neural tube defects such as spina bifida. You may need a higher dose, which is available on prescription if you are at a greater risk. Speak to your doctor for further advice. Current guidance recommends only folic acid and vitamin D supplements.

Getting supplements or advice on supplements:

• You can purchase supplements from pharmacies or supermarkets. Your GP can also prescribe them for you
• You may be eligible for the Healthy Start scheme that provide vouchers for healthy eating during pregnancy. More information is available on the website https://www.healthystart.nhs.uk
• Some popular pregnancy supplements are also available to purchase from pharmacies. They have limited evidence and results on whether they are beneficial are inconclusive. Speak to your doctor or pharmacist for further advice

Some common examples of branded combined supplements include:

• Pregnacare®
• Seven Seas Pregnancy®