Can my combined oral contraceptive pill withdrawal bleed be planned to avoid weekends?

If a pill packet is commenced on a Sunday, the withdrawal bleed should occur on weekdays. When starting the combined oral contraceptive pill for the first time, if you delay to the next Sunday rather than commence on the first day of the period, additional contraception is required for the first seven days. For those on monophasic pills (Table 16.1) who wish to convert to a Sunday start, it is probably best to take two packets back-to-back and then finish the second packet on the Saturday. The third packet is commenced on the following Sunday. The other option would be to continue taking the combined oral contraceptive pill from a spare pack until the next Sunday. This spare packet can be kept in reserve for similar cycle adjustments when required. 

Table 16. 1 Monophasic combined oral contraceptive pills:

Preparation	Ethinyl Oestradiol (mg)	mg / Progestogen	Manufacturer
Loestrin 20	20	1 norethisterone acetate	Parke Davis
Loestrin 30	30	1.5 norethisterone acetate	Parke Davis
Brevinor? Ovysmen	35 35	0.5 norethisterone 0.5 norethisterone	Searle Jannsen-Cilag
Norimin	35	1 norethisterone	Searle
Norinyl  -1 Ortho-Novin 1/50	50 (mestranol)	1 norethisterone	Searle Janssen-Cilag
Microgynon  30 Ovranette?	30 30	levonorgestrel 0.15 levonorgestrel	Schering Wyeth
Eugynon ? 30 Ovran 30	30 30	levonorgestrel 0.25 levonorgestrel	Schering Wyeth
Ovran	50	0.25 levonorgestrel	Wyeth
Cilest	35	0.25 norgestimate	Janssen-Cilag
		3rd GENERATION:
Mercilon	20	0.15 desogestrel	Organon
Marvelon	30	0.15 desogestrel	Organon
Femodene Minulet	30 30	0.075 gestodene 0.075	Schering Wyeth
Femodette	20	0.075	Schering
Yasmin? Evra Patch	30 (see 16-01a-)	3 drospirenone	Schering Janssen-Cilag

Table 16. 2 Phasic combined oral contraceptive pills:

Preparation	Ethinyl Oestradiol (mg)	mg / Progestogen	Manufacturer
Binovum	35	0.5/1  norethisterone	Janssen-Cilag
Trinovum	35	0.5/0.75/1  norethisterone	Janssen-Cilag
Synphase	35	0.5/1/0.5 norethisterone	Searle
Logynon Trinordiol	30/40/30 30/40/30	0.05/0.075/0.125 levonorgestrel 0.05/0.075/0.125 levonorgestrel	Schering Wyeth
		3rd GENERATION
Triadene	30/40/30	0.05/0.07/0.1 gestodene	Schering
Tri-Minulet	30/40/30	0.05/0.07/0.1 gestodene	Wyeth

Please click on the required question.

Q16. 1 What are the different types of combined oral contraceptive pills?

Q16. 1a What is the new Evra Patch?

Q16. 2 What are the benefits and problems of the phasic pills?

Q16. 3 How will my doctor help me to decide which is likely to be the best pill for me?

Q16. 4 Whilst I am taking the combined oral contraceptive pill, what monitoring should I receive?

Q16. 5 A member of my family has a history of a deep venous thrombosis (DVT) or pulmonary embolism (thromboembolism). Should I have a screening blood test?

Q16. 6 Does an aeroplane journey increase the risks of taking the combined oral contraceptive pill?

Q16. 7 Are there times when the combined oral contraceptive pill should be prescribed only with special caution?

Q16. 8 Are there any contraindications to taking the combined oral contraceptive pill?

Q16. 9 On which day of my menstrual cycle should I start my first course of the combined oral contraceptive pill?

Q16. 10 Can I start the combined oral contraceptive pill whilst I am breast-feeding?

Q16. 11 Can I take the combined oral contraceptive pill if I have had episodes when I did not see my periods (amenorrhoea)

Q16. 12 Can I start the combined oral contraceptive pill if I am not currently seeing my periods?

Q16. 13 Does it matter if I do not see a period whilst taking the combined oral contraceptive pill?

Q16. 14 What is the advice when my changing pill preparation?

Q16. 15 What should be done if breakthrough bleeding occurs whilst I am taking the combined oral contraceptive pill?

Q16. 16 Can my pill withdrawal bleed be planned to avoid weekends?

Q16. 17 Can I take the combined oral contraceptive pill without a seven-day pill-free gap?

Q16. 18 What should be done if a pill is missed?

Q16. 19 Could I conceive whilst I am taking the combined oral contraceptive pill?

Q16. 20 Can combined oral contraceptive pills interact with other medication?

Q16. 21 I am taking the combined oral contraceptive pill. Will this reduce my future fertility?

Q16. 22 I have been on the combined oral contraceptive pill for sometime. Is there any need to take a break from it?

Q16. 23 I am due to have an operation. Should I stop taking my pill?

Q16. 24 What is the advice with regard to third generation combined oral contraceptive pills?

Q16. 25 Until what age can I take the combined oral contraceptive pill?

Q16. 26 I have taken the combined oral contraceptive pill. Will this change the time when I will go through the menopause?

Q16. 27 I am taking the combined oral contraceptive pill. How will I know if I have reached my menopause?

Q16. 28 In what circumstances should the combined oral contraceptive pill be stopped immediately?

Q16. 29 What symptoms are commonly associated with taking the oral contraceptive pill?

Q16. 30 Should the combined oral contraceptive pill be discontinued if I develop headaches?

Q16. 31 If I have varicose veins can I take the combined oral contraceptive pill?

Q16. 32 I have developed vomiting and diarrhoea. How does this affect my pill taking?

Q16. 33 How long before starting a pregnancy should I stop taking the combined oral contraceptive pill?

Q16. 34 Family Planning Support Groups.

Q16. 35 Support Groups.




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