What do I do if I forget to take a tablet? Assuming that you are less than 12 hours late in taking a tablet, just take the missed tablet and carry-on as per normal. Take the next tablet at the usual time, even if this means taking two tablets in one day. There will be no need for additional protection in this case. If you are more than 12 hours late in taking a tablet, take it as soon as you realize and then the next one at the usual time. It should now be brought to your attention that the protection in this cycle is somewhat reduced, and to prevent possible conception, you should use additional precautions until the onset of your menstrual period. What would happen in the case of vomiting and diarrhea? If you vomit within 4 hours of taking a tablet, take another one and use additional precautions for the next 7 days. Suffering with severe diarrhea within 12 hours of taking a tablet, could prevent it from being properly absorbed, therefore you should continue taking your usual tablets and in addition, use extra precautions during the attack and for 7 days following it. What effect would the use of other medications have on the Pill? If you are taking other medication on a regular basis, you should inform your doctor and use additional protection. Drugs such as anti-fungals, anti-inflammatories and anti-convulsants, speed-up the breakdown of hormonal ingredients in the pill, thus reducing the protection it provides. Broad spectrum antibiotics can alter intestinal flora, resulting in impairment to the re-circulation of oestrogen, after it has found place in the large bowel. This would then increase the chance of an unplanned pregnancy. The vast majority of drugs used to treat epilepsy will interfere with the Pill's effectiveness, through what is known as enzyme induction. These drugs hasten the performance of liver enzymes which destroy the hormones contained in the Pill, thus meaning that if you are taking long-term medication for this condition, it would be necessary to take a higher than average dose of the Pill to benefit from it's actions. Also falling into this group are tuberculosis sufferers being treated with a drug known as 'Rifampicin'. Is a break from the Pill necessary? Unless there are reasons for immediate discontinuation, your doctor advises you to stop or you are wanting to fall pregnant, there is no medical reason to suggest the need for a break from the Pill. In fact, many unwanted pregnancies are the result of women giving their bodies a 'break' from the Pill. Can I continue taking the Pill in the case of needing surgery? Advising your doctor that you are taking an oral contraceptive is often the first and most important step to be taken before undergoing surgery. He may suggest that the Pill be discontinued for six weeks prior to the operation and for two weeks after. The main reasoning behind this advice, is that the Pill could contribute to the risk of developing thrombosis - especially in those who are immobilized for more than a week following the operation. Other more simple operations, whereby you are able to regain mobility soon afterwards, may not require discontinuance of the Pill, however your doctor's advice should be taken into account. What does breakthrough bleeding mean? Breakthrough bleeding refers to bleeding whilst taking the 'hormones' instead of the inactive pills, or at times other than when you have your period. It is often the result of there being insufficient hormones present in the blood, to effectively control and contain the lining of the uterus (endometrium). It is not uncommon for first-time users to suffer with this, so in this case it would be wise to wait a few months to establish whether it settles down. If it doesn't, it may mean that the pill you are taking is obviously not 'strong' enough for you and/or your body is failing to absorb the correct amount of hormone. Are some Pills better than others? There are a number of different Pills available on the market, and to establish which is best suited to you, it would be necessary that your menstrual cycle, skin condition and medical history be assessed by your family planning nurse, doctor or pharmacist. Ideally those containing the least amounts of both oestrogen and progestogen should be used. Combined pills fall into three groups, namely: \tMonophasic: Each tablet contains exactly the same doses of oestrogen and progestogen. \tBiphasic: Contains two differing doses of hormones. \tTriphasic: There are three different levels of hormones in each pack. Is it possible to move my periods around to suit my lifestyle? Yes this is possible, although not at the top of the recommendation list. If you are taking a monophasic pill, then all you need to do to prevent having a period that month, is to skip the 'inactive' pills or 'pill-free interval' (PFI). This may not be as simple for those taking a triphasic pill, as it would result in wastage through having to take the same certain tablets for as long as you intend postponing your period. Who shouldn't use oral contraceptives? The Pill is particularly suitable for young, healthy, non-smoking sexually active women, and shouldn't be used by those who are pregnant or have abnormal bleeding. Before taking the Pill, it is important that you are checked for any conditions, that may mean you are not suited to take the Pill: \tHigh blood pressure \tMigraine sufferer \tActive or recent liver disease \tCancer of the uterus or breast \tThrombosis (blood clots) or leukaemia \tThose women over the age of 35 years who smoke and/or have a family history of diabetes, heart disease and stroke.