The combined pill (oestrogen and progestogen) with a break

This pill contains synthetic hormones (oestrogen and progestogen) similar to the hormones produced by the female body. In certain cases, these hormones may affect your health. It is best to talk to a doctor about your personal situation.

The following information only relates to combined pills (oestrogen and progestogen) in packets of 21 active pills.

How it works

The combined pill (oestrogen and progestogen) with a break...

• prevents ovulation (release of an egg) as the ovaries become inactive.
• alters the lining of the uterus (endometrium) so that implantation of a fertilised egg is not possible.
• makes the cervical mucus thicker, thus preventing sperm from entering the uterus.

If used correctly, the method of contraception prevents pregnancy.

How to use it

• When you take the pill for the first time: Begin the packet on the first day of your period = instant protection. If you start using the method after the second day of your menstrual cycle (period), use a condom for seven days.
• Take the pill at the same time each day (a maximum of 12 hours delay is possible without risk of pregnancy).
• Stop taking pills for seven days after taking the last of the 21 pills in the packet,
• Start the new packet on the same day of the week as with the first pack, then take another one-week break after finishing this packet. Continue this 21/7-day rhythm.

If used correctly, the method also guarantees protection during the pill free week.

Bleeding starts during this pill free week. It is normally lighter and less painful than a  normal period (menstruation).

If you …

• …experience breakthrough bleeding while using the contraceptive, this is nothing to worry about. Keep taking the pill as usual. If the irregular bleeding continues  in the months following, consult a doctor.
• …have vomiting or diarrhoea, it is possible that the pill has not been absorbed well and therefore its efficiency is lessened. Continue to take the pill and use a condom during 7 days. IIf you vomit within 3 hours of taking a pill or have severe diarrhoea for more than 24 hours: take another pill (use the last pill in the packet so that the day noted on the packaging still corresponds with the day of the week the pill is taken).
• ...are taking any medicine, ask a doctor or a chemist whether you are still protected. Preparations containing St. John’s wort, some antibiotics, certain antiepileptic drugs and HIV medication can reduce the contraceptive effect. Keep taking or using the contraceptive and use a condom during sex.
• ...stop using this method of contraception, the contraceptive effect ceases immediately. We recommend that you finish taking the pack of pills.
• …do not have any bleeding during the break, start the new pack on the planned date and consult a sexual health centre or a doctor.

If you a miss a pill by LESS than 12 hours

• Take the missed pill as soon as possible.
• If you are less than 12 hours late taking the pill (meaning you take it less than 36 hours after you took the previous one), the contraceptive effect of the pill will not be reduced.

If you miss a pill by MORE than 12 hours

Effective contraception may no longer be guaranteed. Check your pill packet to see which pill you have forgotten to take.

If you forget the pill during the first week (on days 1 to 7)
… and you have not had sexual intercourse in the previous 5 days

• take the forgotten pill as soon as possible even if it means taking 2 at the same time.
• Take the next pill at the usual time.
• use a condom for the next 7 days.

… and you have had sexual intercourse within the last 5 days

• Request emergency contraception as soon as possible and follow the instructions given by a qualified professional.
• Use condoms until the contraceptive pill is effective again. How long you need to do this for will depend on the type of emergency pill that you use.

If you forget the pill during the second week (on days 8 to 14):

• If you have taken the pill correctly during the previous 7 days, and whether or not you have had sexual intercourse:
• take the missed pill as soon as possible, even if this means taking 2 pills on the same day or at the same time
• keep taking the remaining pills at the usual time

If you forget the pill during the third week (on days 15 to 21):
If you have taken the pill correctly during the previous 7 days, and whether or not you have had sexual intercourse:

• take the forgotten pill as soon as possible even if that means taking 2 at the same time
• keep taking the remaining pills at the usual time until the packet is finished
• start a new packet of pills straightaway, with no pill-free days

If you have missed 2 (or more) pills in a row or if you have missed 1 pill and not taken a pill everyday for the previous seven days

Effective contraception is no longer guaranteed and there is a risk of a pregnancy .

Contact a sexual health centre or a doctor.

Good to know

• The best way to protect yourself against HIV or other sexually transmitted infections is to practice safer sex. This means:
  1. Use a condom during sexual intercourse with vaginal or anal penetration.
  2. Further information can be found at www.lovelife.ch

2023, SANTÉ SEXUELLE SUISSE, Fondation suisse pour la santé sexuelle et reproductive;ALECSS Association suisse latine des spécialistes en santé sexuelle, Éducation – Formation – Conseil; faseg, Fachverband sexuelle Gesundheit in Beratung und Bildung