In the SH:24 offices this week we have been discussing ‘new ways’ to take the combined pill - (the one with two hormones - oestrogen and progestagen).
The original way to take the combined pill is take 21 pills and have a 7 day break. Then start the next pack of 21 days and have a 7 day break.
There has been some discussion in medical literature on this with some health professionals saying that alternative ways to take the pill are just as safe and effective as the original way, and everyone starting the pill should be made aware of them.
This makes sense to me. The only thing to note is that this is an ‘unlicensed’ use.
This means that when the pill was originally given a licence to be used as a contraceptive that licence specified that it should be used for 21 days and stopped for 7. Despite new evidence that taking it in different ways is still safe and effective, the licence has not changed. So doctors who prescribe it in this way may well tell you that this is an ‘unlicensed use’ of the pill.
So, what are these alternative ways of taking the pill?
The first is 'tricycling’
This is when you take the pill every day for 3 packets in a row without a break and then stop for a 7 day break. This means that you will only have a bleed every 3 months.
The second is 'extended use’
This is when you take the pill every day for at least the first 21 days without any breaks. Then keep taking it every day without stopping - just keep taking one packet straight after the next, one pill every day, until bleeding occurs for 4 days in a row. Don’t worry if you don’t get bleeding - not everyone does. But if you do, then stop the pill for 4 days in a row (you will probably continue to bleed during these days) and then re-start and keep taking it every day until you get bleeding for 4 days in a row again - this may be many months later.
To be honest, I have found this a little difficult to explain clearly in this post - the instructions are a little complicated. It would be great to have feedback on whether this explanation makes sense to you - and of course to hear from people who have tried this and want to share their experiences.