How to change from the combined pill to the Progestogen-only pill

There is no one- size- fits- all when it comes to contraception, and the same is true when it comes to contraceptive pills. One person may absolutely love a certain contraceptive pill, whilst another may not get on with it at all. There are lots of different contraceptive pill options available, so if you didn’t get on with one contraceptive pill it doesn’t mean that another one won’t be a good fit for you. 

It’s important for you to feel comfortable and secure in your contraception, and it’s okay if the first thing you try isn’t the one you stick with. Many people try several different contraceptive pills and/or other methods of contraception before deciding which one works best for them.

There are two main types of contraceptive pill: the combined contraceptive pill which contains oestrogen and progestogen, and the progestogen-only pill which just contains progestogen.

There are many reasons you may be interested in switching from the combined contraceptive pill to the progestogen-only pill. Maybe you’re experiencing side effects and want to try something else, perhaps you want a contraceptive pill you take every day without breaks, or you might want to try a contraceptive pill which does not contain oestrogen.

Whatever your reasons, it’s generally straightforward to make the switch. We spoke to Deborah Evans, a pharmacist and sexual health advocate with over 30 years of experience, to find out more.

Whilst the contraceptive pill is often simply referred to as ‘the pill’, there are actually two types of contraceptive pill available: the combined pill and the progestogen-only pill.

The combined contraceptive pill contains both oestrogen and progestogen (which is why it’s called the combined pill), while the progestogen-only pill contains – you guessed it – progestogen-only. The progestogen-only pill is sometimes referred to as the mini-pill because it contains just one active ingredient. When taken correctly, both the combined contraceptive pill and the progestogen-only pill are over 99% effective at preventing pregnancy.

The progestogen-only pill is suitable for many people, including some who can’t take medications containing oestrogen. This includes smokers over the age of 35, people who are breastfeeding, some with high blood pressure and people who have a history of blood clots. 

Whether a progestogen-only pill has been recommended to you or if you’re just interested in trying something new, it’s good to know that there are a variety of ways to access this form of contraception. Some progestogen-only pills containing desogestrel, such as Hana®, are available to buy over the pharmacy counter with no need for a doctor’s appointment. 

You will have a consultation with the pharmacist to see whether the progestogen-only pill is suitable for you. You can also access Hana® online via Hanadirect.co.uk. If you prefer, you can still get a progestogen-only pill from a doctor.

If you are currently taking the combined contraceptive pill, but for whatever reason you’re looking to switch to a progestogen-only pill, you can usually do this fairly easily.  Read on to find out more.

If you’re interested in changing contraceptive pills, you should discuss it with a healthcare professional. Tell them about your experience on your last contraceptive pill, why you’re interested in changing and what you’re looking for from your next pill. This will give your pharmacist or doctor the information they need to help you make an informed decision.

“The pharmacist would want to have a conversation about why you want to change pills, because that can give us some insight. If someone said they wanted to stop taking the combined pill because of side effects or worries about breast cancer or a variety of other reasons, it’s helpful for the healthcare professional to know why so they can support that switch,” says Deborah.

Desogestrel contraceptive pills like Hana® should be taken every day, without a break between packs. You will need to take your pill at the same time every day. If you do miss a desogestrel pill, you have 12 hours in which to take it for it to remain effective. If it’s been longer than 12 hours, it counts as a missed pill and you may be at risk of an unplanned pregnancy if you have sex. Find out more about Hana® here.

“If you want to change from the combined hormonal contraceptive pill to a progestogen-only pill, then you should preferably start on the day after your last active tablet,” says Deborah. “So in other words, if you’ve come to the end of the pack of your pill, you can then start taking your new pill straight away the next day. In that case, you don’t need to do anything extra in terms of contraception.” 

When you take the combined pill, you usually have a 7-day break at the end of the pack, but some may be different, so always read the leaflet. If you take the progestogen-only pill, you will take the pill every day at the same time without a break between packs.

“If you’re having your break from the combined pill the week before starting again, when you start taking the progestogen-only pill you will need to use an additional barrier method of contraception – like condoms – for seven days after you start the progestogen-only pill to make sure you’re protected,” Deborah continues.