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Sexual Health and Contraception

Update on Different ways of taking the combined contraceptive pill:

This is the most common type of pill. There are 21 pills in a pack and each pill has the same amount of hormone. Traditionally this was taken daily for 21 days before having 7 days break. However, more recently different ways of taking it have been introduced. You can take the monophasic pill in the following ways.

  • One pill a day for 21 days then no pills for the next 4 or 7 days (21/4 or 21/7). This has been the standard way to take the pill. You’ll usually have a withdrawal bleed during the pill-free break. Start taking the pill again on the fifth or eighth day even if you’re still bleeding.
  • One pill a day for nine weeks (three packs of pills) then no pills for the next 4 or 7 days (63/4 or 63/7). This is called extended use or tricycling. You’ll usually have a withdrawal bleed during the pill-free break. Start taking the pill again on the fifth or eighth day even if you’re still bleeding.
  • One pill a day every day with no break. This is called continuous pill-taking. You won’t have a withdrawal bleed but you may still get some bleeding, which may be occasional or more frequent. Any bleeding you get is likely to reduce over time if you keep taking the pill continuously.
  • One pill a day every day for at least 21 days. If you get bleeding that’s unacceptable to you for 3-4 days, then no pills for 4 days. This is called flexible extended use. Start taking the pill again on the fifth day, even if you’re still bleeding. This can help manage the bleeding. Restart with the pill marked with the correct day of the week and take at least 21 pills before taking your next break.

See https://www.sexwise.org.uk/contraception/combined-pill-coc for further information