Pill-checks – NHS requirements
Routine medical care for women taking the oral contraceptive pill includes annual check-ups with a doctor or nurse. During these check-ups, blood pressure and weight are normally measured and a cervical smear will be carried out, if it is due.
Enquiries will be made to see if the pill being taken is still the best contraception option, and whether changes need to be made, because of side effects, symptoms such as irregular or difficult periods, or simply because of increasing age. Women over 35 often prefer a mini-pill (progesterone only), and women over 35 years who smoke should not normally take a combined pill (pill containing oestrogen).
Some women are at higher risk and may need pill checks more frequently than 12 months. This applies to women with a history of high blood pressure or diabetes, women who have had previous problems with the pill and women with co-existing medical problems.
Risks associated with contraceptive pills
An oral contraceptive pill is, for most women, a simple convenient and effective way to prevent pregnancy and control periods. As with any medication, there are potential side effects, some of which could be serious. Large numbers of women take contraceptive pills and there are numerous studies looking at the long-term risks, particularly for rates of cancer of the womb, ovaries and breast. The data is complex. In summary: for most women, who do not have a family history of cancer, the overall cancer risk is not increased by the pill.
Regular pill checks are in addition to any reviews which may be required for symptoms such as irregular bleeding, infections, and symptoms which may be related to taking the pill. These might include skin problems, weight gain, bloating and headaches.
Face-to-face pill checks with a doctor or nurse are important and should not be skipped by women using online services.
Women obtaining repeat supplies of oral contraception online, are usually required to confirm that they have had their regular pill-check and that they will keep their GPs informed. Dr Fox online clinic has a system in place for informing GPs and will not supply repeat contraception to women who fail to provide GP contact details.
Combined pill and mini pill
There is an increase in the risk of thrombosis (blood clots) in women taking pills containing oestrogen, particularly if they are overweight and/or smoke. Some of these women are best switched to a mini pill, which contains a low dose of progesterone, as opposed to standard combined contraceptive pills which contain oestrogen and progesterone.
Some women take contraceptive pills primarily for symptoms control, rather than for contraception. Irregular periods can usually be regulated by a pill. Acne in women sometimes improves with pills such as Dianette. Both symptoms are often found in women who have polycystic ovary syndrome. This is a relatively common condition associated with irregular periods, acne, weight gain and reduced fertility.
Alternative contraceptive methods
An oral contraceptive pill is not always the most suitable method of contraception, particularly for younger women who have had previous failures of contraception. Depot formulations, which are given by injection or are inserted under the skin and have an effect lasting from 3 months for some and up to 5 years for others, obviate the need to take regular medication. Other women, who may need contraception only occasionally, may prefer condoms or diaphragms, which have the additional benefit of reducing infection risk.
Women who prefer not to use regular contraception, and who are at risk of pregnancy from unplanned intercourse, sometimes carry standby emergency contraception (morning after pills), although it is best not to rely on this method of contraception on a regular or frequent basis.