Changing contraceptive pill

Reviewed by Dr Bhavini Shah

Thinking you’d like to switch your contraception? Lots of women change their birth control. But you have to be careful to switch correctly, so you can make sure you’re still protected from pregnancy. So, we’re here to help with a handy guide on switching between different types of contraception and hopefully help you make the transition smoothly.

Why you might be thinking about changing birth control pills 

You might be thinking about changing pills because you’ve had a reaction to the pill you’re on, for example: 

• a flare up of acne 
• breakthrough bleeding 
• you’re blood pressure has gone up 
• you’ve started to get migraines

You might find that actually you’ve not had a bad reaction to a pill at all, but you’re finding it hard to remember each day. This is also completely normal, and you might be better off trying the patch or ring, or even a long-acting reversible contraceptive (LARC) like the implant.

This article is about switching between combined contraceptives and progestogen only pills (mini pills). But if you’d like to find out more about LARCs, you can read our article about long-term hormonal contraception.

Side effects of birth control pills 

You might want to try another type of contraception because you’re experiencing common side effects of contraceptive pills. These can include: 

• Tender breasts
• Irregular bleeding
• Headaches
• Nausea 
• Skin irritation 

These can also be some of the biggest concerns when choosing and using certain types of pills. 

Switching from one combined contraceptive to another combined contraceptive

Combined contraceptives contain oestrogen and progestogen and can either be in the form of a pill like Rigevidon or Lucette, or they can also be a patch (Evra Patch) or a vaginal ring (NuvaRing).

All combined contraceptives work in the same way. They stop your ovaries from releasing an egg, they thin the lining of the womb, making it harder for a fertilised egg to implant and they thicken the mucus in the cervix. This makes it hard for sperm to move through your cervix and reach an egg.

When can I switch my pill?

Because you’re switching to the same type of contraceptive, you might think it’s a straight switch. But depending which week you’re in of your pill, patch or ring, you might need to switch in different ways.*

If you’re in week 2-3 of your pack or days 1-2 of the break: 

• You can switch straight away to the new combined contraceptive 
• You’ll be protected straight away 

If you’re in week 1 or days 3-7 of the break and you didn’t have unprotected sex during the break: 

• You can switch straight away to the new combined contraceptive 
• You’ll need to use condoms or not have sex for the first seven days of the new combined contraceptive

If you’re in week 1 or days 3-7 of the break and you had unprotected sex during the break: 

• Wait until you’ve taken your current contraception for seven days in a row 
• After those seven days you can switch to the new combined contraceptive 
• You’ll be protected straight away

Switching from one mini pill to another mini pill 

Mini pills only contain progestogen, that’s why they’re often called progestogen-only pills or POPs for short. Mini pills work by thickening the mucus in your cervix, making it hard for sperm to get to your womb. They also thin the lining of the womb, making it hard for a fertilised egg to implant.

Some mini pills contain an artificial hormone called desogestrel. These mini pills also stop your ovaries releasing an egg.

If you’re switching between two mini pills you can switch straight to your new mini pill*. You won’t need any additional contraception.

Switching from a combined contraceptive to mini pill

If you’re your changing birth control pills, patch or ring from a combined method to a mini pill, the way you switch depends on where you are in your cycle.*

When can I switch from combined contraceptives to a mini pill?

If you’re in week 2-3 of your pack or days 1-2 of the break: 

• You can switch straight away to the new combined contraceptive 
• You’ll be protected straight away

If you’re in week 1 or days 3-7 of the break and you didn’t have unprotected sex during the break: 

• You can switch straight away to the new combined contraceptive 
• You’ll need to use condoms or not have sex for the first two days of the new combined contraceptive

If you’re in week 1 or days 3-7 of the break and you had unprotected sex during the break: 

• Wait until you’ve taken your current contraception for seven days in a row 
• After those seven days you can switch to the new combined contraceptive 
• You’ll be protected straight away

Switching from a mini pill to combined contraceptive

If you’re going from a mini pill to a combined pill, the patch or ring, you can change to your combined contraceptive straight away*.

If you’re taking a mini pill which contains desogestrel you won’t need any extra contraception. If you’re taking a mini pill that doesn’t have desogestrel in you’ll need to not have sex or use condoms for the first seven days of the new contraception.

Methods of switching birth control pills 

Depending on the type of pill you’re currently taking and the one you’re switching to there are different methods you should follow. If you’re unsure, speak to your GP or healthcare provider. There are a few things you should do to prevent accidental pregnancy, when switching pills which include: 

1. Leave no gaps

You shouldn’t leave a gap between your old form of contraception and new. In some cases you can start taking the new pill straight away, without finishing the old pack. 

2. Allow for an overlap 

Taking two contraceptive pills at the same time isn’t usually recommended. Most of the time you can begin to take your new pill straight away. However, your doctor will let you know if you need to overlap your pills. 

3. Use backup protection

When switching pills the safest way to protect yourself from STIs and an unwanted pregnancy is by using condoms. Depending where you are in your pill cycle when you make the switch you may be protected immediately. However this may not be in the case. If in doubt, speak to your GP when you switch contraception and use a condom during sex.  

Which contraceptive pill is best for me? 

Finding the right contraceptive pill for you is important. Your GP or healthcare provider will be able to talk you through the options available to you. 

Benefits of switching to the combined pill

The combined pill contains the hormones, oestrogen and progestogen. It’s 99% effective at preventing pregnancy. This pill can help with PMS, heavy and painful periods. 

This pill isn’t suitable for those at risk of developing blood clots as it can increase your blood pressure. You’ll need annual blood pressure and BMI checks. Find out how to take the combined pill here. 

Benefits of switching to the mini pill

The mini pill is an option if you can’t take the combined pill. It’s also suitable for those over 35 who smoke. This type of pill needs to be taken at the same time every day for it to be over 99% effective. There’s no break between packs but you may experience irregular bleeding. 

Switching from the pill to another contraceptive method

If you regularly forget to take your pill or want to not have to think about contraception for a while. You might be looking for a more long-term method of contraception, including: 

The contraceptive patch

The patch is worn on your skin. It contains the hormones oestrogen and progesterone which are absorbed by your body through your skin. Changed weekly, the patch is 99% effective at preventing pregnancy when used correctly. 

The vaginal ring

If you’re comfortable inserting contraception into your vagina, the vaginal ring could be an option. Placed inside the vagina for 3 weeks of the month, the ring releases hormones to prevent pregnancies. Like the combined pill you will need annual blood pressure and BMI checks while using the ring. 

The implant

Inserted under the skin in your upper arm, the contraceptive implant is 99% effective at preventing pregnancy. It can be inserted for up to 3 years and may affect your periods, as well as causing other side effects like acne. 

The coil 

There are two types of coil, the non-hormonal copper coil (IUD) and the hormonal coil (IUS). Both coils offer long-term contraception that’s effective and low maintenance. They need to be fitted and removed by a healthcare professional. 

Switching your pill with Online Doctor

If you’re using our contraception service, please send us a message in your Patient Record if you’d like to switch your contraception.

If you’re not using our service, but would like to change your contraception, it’s always a good idea to speak about it with your GP or a sexual health nurse. Or you can start a contraception consultation with us, and one of our clinicians will review your request, to make sure the new contraception is right for you.

*This advice is based on you taking or using the contraception correctly leading up to the switch. If you’ve not been taking your contraception correctly, please speak to your GP or send us a message in your Patient Record, just to make sure you’re still protected against pregnancy when you change contraception.

Conclusion

Finding the right method of contraception can be tricky, especially when it comes to contraceptive pills. You might be looking to alter your periods or get rid of acne, as well as prevent pregnancies. Ideally you should wait three months when trying a type of contraception to let any side effects or hormonal changes settle. You can read about contraceptive pill brands in our guide and speak to your GP or health care provider to discuss your options. 

References

https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/
https://www.fsrh.org/standards-and-guidance/fsrh-guidelines-and-statements/switching-or-starting-methods-of-contraception/
https://pcwhf.co.uk/wp-content/uploads/2019/09/fsrh-guidance-switching-or-starting-methods-of-contraception-august-2019-1.pdf
https://www.nhs.uk/conditions/contraception/which-method-suits-me/