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Frequently Asked Questions

How can I delay my period, which is due during my holiday?

If you are taking the combined contraceptive (monophasic) pill for 21 days in every 28 with a usual seven day break, you can take two packets of your pill without a break by starting the next packet immediately after the first. When you reach the end of the second packet, have a seven day break as usual and you will then have a period (also called a breakthrough or withdrawal bleed). Then start the next pack and continue to take it as normal.

If you are taking a phasic pill, you will have two or three sections of different coloured pills in the pack, again taking them for 21 days out of 28 with a seven day break. The pills contain different amounts of hormone and it is important to take them in the correct order. If you wish to postpone your period, you should start the final phase of a spare packet the day after finishing your current packet. This will give seven to ten days’ postponement before your period starts.

The advice for delaying your period using phasic pills also applies to the EveryDay (ED) pill. ED pills are usually taken without a break between packets, because each packet contains seven inactive tablets. Start the active phase of your next packet (usually the red part of the pack) instead of starting the seven days of inactive pills.

If you are not taking the contraceptive pill, there is medication that your doctor can prescribe you to delay your period. It is based on the group of female sex hormones called progestogens, which are produced naturally by the body. Providing that your medical history does not indicate any reasons why you should not take it, this medication can be taken for a limited time. Your doctor will advise you when to take it and for how long, based on the timing of your menstrual cycle. Your period should arrive a few days after stopping the medication.

Emergency contraception is used to prevent pregnancy occurring after unprotected sex has taken place, for example when usual contraception has failed or has not been used.

There are two methods of emergency contraception:

  • the emergency pill (also known as the morning after pill), and
  • the copper IUD (intrauterine device).

Emergency pills come in a packet of two. Both pills must be taken at the same time, as soon as possible after unprotected sex. The pills are available from doctors and Family Planning Clinics, and can be bought over the counter at pharmacies for around £25 if you are over 16.

The copper IUD is fitted in the womb by a doctor or nurse within five days of sex or the earliest time you could have released an egg (ovulation). The IUD has almost a 100% success rate. Make an urgent appointment with your doctor if you think an IUD is appropriate for your situation. You can also visit your local NHS Walk-In Centre.

Although most women can use emergency pills, women already taking other medications will need to consult a doctor first. Women considering using a copper IUD will need to have an examination to check that there is no existing infection. A doctor or pharmacist will be able to advise on the best method of emergency contraception.

I haven’t had a period for some time, and I know I’m not pregnant. What could be the cause?

It’s quite normal to have some delay before the return of your periods if you have recently stopped taking the contraceptive pill. However, if you have not been taking the contraceptive pill, usually have regular periods but have not had one for six consecutive months or more, several factors may be considered. Some of the more common reasons are:

  • polycystic ovarian syndrome (PCOS),
  • disorders such as hyperthyroidism,
  • disorders of the pituitary gland,
  • ovarian cysts or tumours,
  • stress,
  • being very underweight or very overweight,
  • sustained, strenuous exercise – particularly common in athletes,
  • breastfeeding, and
  • menopause, or premature ovarian failure (early menopause).

Further information:

Amenorrhea, absence of periods (Online Encyclopaedia)

Period pain (Self-help Guide)

Menorrhagia, heavy periods (Online Encyclopaedia)

Irregular periods (Sexual Health Advice Centre, Addenbrooke’s NHS Trust)

Painful periods (Embarassing problems)

Heavy periods (Embarassing problems)

It sometimes takes a few weeks for your hormone levels to return to normal after a miscarriage. If your period has not arrived within six weeks, consult your GP who should be able to reassure you and rule out any other cause of the delay.

There are several reasons for bleeding as a result of sexual intercourse (also called post-coital bleeding) in women. It is often caused by an inflamed area on the surface of the cervix (neck of the womb), and sex can cause it to bleed. This inflammation is called cervical erosion, and it is commonly found in young women, pregnant women and those on the contraceptive pill.

However, the bleeding may be caused by an infection (such as chlamydia or cystitis), or by changes to the cells of the cervix. It is important that this is checked by your doctor or family planning clinic.

Some women experience bleeding about 10-14 days after their period. Usually, this is caused by a temporary drop in levels of the hormone oestrogen at the time of ovulation (when an egg is released by an ovary). This is quite normal. However, if bleeding occurs at other points during the menstrual cycle, it is wise to consult your gynaecologist to rule out the possibility of other conditions.

Further information:

Endometriosis (Online Encyclopaedia)

Polycystic ovarian syndrome (Online Encyclopaedia)

Irregular periods (Sexual Health Advice Centre, Addenbrooke’s NHS Trust)

Menstrual cycle length varies tremendously among women, although most last between 24 and 36 days. The most fertile time is during ovulation, which normally occurs about 12 to 15 days before the beginning of the next menstrual period. At this time, levels of the hormone LH dramatically increase, and within 36 hours a follicle in the ovary ruptures and releases an egg ready to be fertilised by the man’s sperm.

Permanent (also called sterilisation):

  • Tubal ligation (female) - 99.9%
  • Vasectomy (male) - 99.9%

Available with a prescription:

  • Implant (over 5 years) - 98.0%
  • Injectable contraception - 99.0%
  • Combined Contraceptive Pill - 99.0%
  • Progestogen-Only Pill - 98.0%
  • Intra-Uterine Device (I.U.D.) - 98.0%
  • Intra-Uterine System (I.U.S.) - 99.0%

Available without a prescription:

  • Condom with spermicide - 95.0%
  • Condom only - 94.0% Success rate
  • Female condom - 95.0% Success rate
  • Diaphragm with spermicide (foam or jelly) - 92.0%

Natural Family Planning:

  • Withdrawal - 77.0%
  • Rhythm method - 76.0%
  • Ovulation predictor - 94.0%

The combined pill contains two hormones that the body produces naturally (oestrogen and progestogen). These prevent ovulation (the release of an egg from the ovary each month). The mucus in the neck of the womb (cervix) becomes thicker, making it harder for sperm to reach the egg. The lining of the womb also becomes thinner meaning that there is less chance of a fertilised egg being accepted.

It may take 2 to 4 weeks for the normal menstrual cycle to start back up again. However, this will depend on the individual. Some women who have been on the pill may take a couple of months longer to conceive than those who were not previously using contraception.

Ideally, you should wait to have one natural period before trying to get pregnant. (It is advisable to use an alternative method of contraception, such as condoms, during this time.) This can help you ensure that you are in the best of health for pregnancy, by starting folic acid supplements and stopping smoking, for example. It will help in dating the pregnancy.

It depends on what type of contraceptive pill you are taking, and how late you are in remembering it.

Combined contraceptive pill

If you are taking the combined contraceptive pill and are less than 12 hours late in taking it, do not worry. Take the last pill you missed now, and the rest of the pills as usual.

If you are more than 12 hours late:

  • take the last pill you missed now
  • leave any earlier missed pills, and
  • use an extra contraceptive method, such as condoms, for the next seven days.

If there are seven or more pills left in the pack after the missed pill, when you finish the pack leave the usual seven day break before you start the next pack.

If there are less than seven pills, when you finish the pack start your next pack the following day. Do not have the usual seven day break.

Progestogen-only Pill (POP)

If you are taking the progestogen-only pill (also called the ‘mini-Pill’) and are less than 3 hours late in taking it, do not worry. Take the last pill you missed now, and the next one at the normal time.

If you are more than 3 hours late:

  • you will not be protected against pregnancy.
  • continue to take your pills as usual but you must also use an extra method, such as a condom, for the next seven days. This may mean taking two pills in one day. This is not harmful.

Everyday pill

If you take the everyday pill and are more than 12 hours late:

  • use an extra contraceptive method for the next seven days, and
  • if there are less than seven active pills left in the pack, miss out all the inactive pills (the larger ones) and start taking the next active pill in a new pack.

You can ring your local Family Planning Clinic or your GP or your Gynaecologist for individual advice. You can also call the Contraceptive Education Service Helpline on 0207 837 4044.

Emergency contraception can be used up to 5 days after having unprotected sex.

The male contraceptive pill is not yet available in the UK. Its launch is expected in around 2005-6. It is likely to block sperm production with a combination of the sex hormones progestogen and testosterone, as either a single pill or a long-acting implant

It’s important to follow a healthy diet and lifestyle during pregnancy, to safeguard the health of your growing baby.

During pregnancy it’s wise to cut down on alcohol, and to give up smoking.

By avoiding certain foods, you can optimise your baby’s health during critical stages of development, and can reduce the risk of getting infections such as listeriosis or salmonella.

Ensuring that your immunisations are up to date will protect you both from the damaging effects of rubella. Making simple lifestyle changes such as wearing gloves whilst gardening, and asking someone else to empty the litter tray if you have a cat, can reduce the risk of contracting toxoplasmosis.

Folic acid (vitamin B9) is very important to the healthy development of a foetus. It can reduce the risk of neural tube defects such as spina bifida. The Department of Health recommends that all women take a daily supplement of 0.4mg of folic acid before they conceive and for the first twelve weeks of pregnancy while the baby’s spine develops.

Several conditions either increase the need for folate or increase the risk of folic acid deficiency. They include those being treated by anti-convulsant medication, patients on kidney dialysis, or those with conditions such as liver disease, malabsorption or certain types of anaemia.

You can get folic acid tablets from pharmacies, large supermarkets, health food stores and on prescription. Dietary sources of folic acid include green leafy vegetables, breakfast cereals and bread. Check with your doctor first if you are receiving treatment for any condition (such as epilepsy) that may not be compatible with folic acid supplementation.

Further information:

Antenatal care