Prescription for taking the Pill continuously

Jessiel

I'm looking for advice on how to get a prescription for the combined contraceptive pill to take continuously, i.e., skip the placebo pills or 4/7 days break. Currently, it's still an off-licence prescription and the GP I go to refuses to give me this, even though recent articles shows that it is unnecessary to have these breaks.

Many women online have posted that they take the pills continuously without breaks anyway. I'm wondering, if they are getting them as off-licence/off-label prescription from their GP or is there a well woman centre that would do this.

I'm also looking for the combined pill and not the mini-pill, Cerazette as I'm looking for my period to stop completely. I have PMS symptoms which I'm hoping that would reduce as well once I start taking the pill.

Any advice or information on how I can get the combined pill prescribed continuously.

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People have already replied to this on your other thread.

Mark Hamill

....... wrote: »

People have already replied to this on your other thread.

And if further responses can be posted on this thread, that would be great.

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I was on Cerazette, a mini pill (progesterone only) that had a 28 day prescription meaning no break day. So 6 month prescription lasted 6 * 28 days. I had no period with it - although this does not happen for all women. There is a generic version called Azalia. The Mirena coil will behave the same way as a progesterone only pill so for women who have no period with Cerazette they will likely have none with the Mirena coil either.

I find it unusual and alarming that neither a pharmacist or a GP was aware of the fact that you do not need to break from the regular pill, I was told this 15 years ago by my GP at the time.

If the GP is that out of date I would suggest changing to a better GP or going to a family planning clinic for pill type advice.

Changing to a new GP is easier said than done. We live in Navan and no other GP in Navan is taking on new patients.

Has anyone else had trouble getting a continuous prescription from a GP? Is make the trip to a family planning centre/ well woman centre our only choice?

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Mark Hamill wrote: »

And if further responses can be posted on this thread, that would be great.



Changing to a new GP is easier said than done. We live in Navan and no other GP in Navan is taking on new patients.

Has anyone else had trouble getting a continuous prescription from a GP? Is make the trip to a family planning centre/ well woman centre our only choice?

Can she not just ask the GP to prescribe one of the continuous ones?

They are called "everyday pills" - and she wants one with no breakthrough bleed. She could research herself which ones there are and then get GP to prescribe?

Or do an online doctor and get a prescription that way?

https://www.lloydsonlinedoctor.ie/ie/womens-health/womens-health-information/contraception-information/types-of-contraceptive-pill

She will get one 6 month prescription that way then she could go back to her doc with the packet and say "prescribe this from now on".

Navan isnt outer mongolia - could she not access GPs in Blanchardstown or other heavily populated areas?

Mark Hamill

....... wrote: »

Can she not just ask the GP to prescribe one of the continuous ones?

They are called "everyday pills" - and she wants one with no breakthrough bleed. She could research herself which ones there are and then get GP to prescribe?

Or do an online doctor and get a prescription that way?

https://www.lloydsonlinedoctor.ie/ie/womens-health/womens-health-information/contraception-information/types-of-contraceptive-pill

She will get one 6 month prescription that way then she could go back to her doc with the packet and say "prescribe this from now on".

We have researched, no pill is packaged for continuous daily taking out of the box, all either have placebos or tell you to take a break. "Everyday pills" just have placebo pills for 4/7 days, instead of completely stopping for a week, and you still get a bleed. From your link:
"Everyday pills are taken each day and depending on the particular brand of pill, contain some inactive or dummy pills in each packet. When taking an everyday pill you should not take a pill free break in between packets but you should still experience a withdrawal bleed."
Neither the GP or the Pharmacy we went to had any idea that there were continuous pills with no placebos or breaks.

....... wrote: »

Navan isnt outer mongolia - could she not access GPs in Blanchardstown or other heavily populated areas?

We could, and we will if we have to. We just wanted to see what other people have done in this situation, before we possibly changed GP to one an hours round trip away. My wife doesn't drive and we have a young daughter, a GP outside of Navan will be very inconvenient for us.


Has anyone used online prescriptions for continuous pill taking before? I just had a look at the Llyods and Superdrug Irelands online prescription services and it's not a consultation, just online form filling, so nothing about taking the pills without a break and so what happens if you finish your prescription early. You just goes through your medical history and it gives a standard 6-month prescription for whatever pill you selected at the start. If we go back 6 weeks early will we be able to get another prescription?

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Mark Hamill wrote: »

We have researched, no pill is packaged for continuous daily taking out of the box, all either have placebos or tell you to take a break.

No - this is incorrect. It may be the case for combined pills but not mini pill.

Cerazette (mini pill) is produced with 28 tablets per pack - designed to take every day - there are no placebo pills.

https://www.medicines.org.uk/emc/product/1698/pil

However - it doesnt guarantee that it will stop periods the way combined pills do, but it does for most women so it worth a try.

You seem to be looking for a 21 day combined pill that can be prescribed as a 28 day prescription. As far as I know doctors cant legally prescribe more than a 6 month dose in one go so you will always be missing 6 weeks if you take a 21 day pill in 28 day doses.

Is there any reason she wouldnt try a Mirena coil or a mini pill like Cerazette?

Jessiel

Cerazette (mini pill) is produced with 28 tablets per pack - designed to take every day - there are no placebo pills.

As I mentioned at the start of this thread, I am not looking for the mini pill. I am aware of that pill but that is not what I am asking or looking to get prescribed for.

You seem to be looking for a 21 day combined pill that can be prescribed as a 28 day prescription. As far as I know doctors cant legally prescribe more than a 6 month dose in one go so you will always be missing 6 weeks if you take a 21 day pill in 28 day doses.

Doctors can prescribe this as an off-license or off-label prescription. I am asking if anyone has any experience with their gp or any well-woman clinic that would do this. The reason for this is that taking a break from the combined pill is completely unnecessary. The WHO, HSE, and other practitioners have reported that you no longer need to do this (well you never had to do this in the first place). The seven-day break, and resultant withdrawal bleed, was designed into the pill in the late 50s in an attempt to persuade the Vatican to accept the new form of contraception, as an extension of the natural menstrual cycle.

Is there any reason she wouldnt try a Mirena coil or a mini pill like Cerazette?

The combination pill and the mini pill are two different pills. One is potentially more effective than the other. The combination pill has more benefits to me than the mini pill.

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Jessiel wrote: »

Doctors can prescribe this as an off-license or off-label prescription....

I presume that would be very much an individual GP decision - Im not aware of anyone I know doing it and nor have I ever had it done, when I was on the combined pill I did mention to the doc re the 7 day break and could more than 6 months be prescribed but she said that she could only prescribe 6 months at a time and to come back early for the next one if I ran out due to "running packs together".

Is the issue just that you would have to go back more often to get 6 months prescribed? Because you could get around that by simply going to your doc twice a year and then using an online doc for a third prescription and that would contain enough to carry you through the monthly "break" weeks?

What kind of benefits are you getting from the combined pill that you wouldnt get from the mini pill? There may be other options? I notice in your OP you mention you hope to improve PMS when you "start" taking the pill - are you not on it currently then (sorry - I thought you were and were used to it and thats why you didnt want to change).

Jessiel

I presume that would be very much an individual GP decision - Im not aware of anyone I know doing it and nor have I ever had it done, when I was on the combined pill I did mention to the doc re the 7 day break and could more than 6 months be prescribed but she said that she could only prescribe 6 months at a time and to come back early for the next one if I ran out due to "running packs together".

Yes, it is up to the GP and my current GP won't do this as he won't take any risk. Nonetheless, I am just wondering if there are other women out there who found a well woman clinic that would do this. I am not aware that I could come back early for the next one, though when we mentioned this to the GP he said that he would only give me the prescription if I take it as the manufacturer's prescribed intake. So, that's not an option.

I did not mention however that I have never taken the Pill before.

Is the issue just that you would have to go back more often to get 6 months prescribed? Because you could get around that by simply going to your doc twice a year and then using an online doc for a third prescription and that would contain enough to carry you through the monthly "break" weeks?

I might try this then, thanks for the hint.

What kind of benefits are you getting from the combined pill that you wouldnt get from the mini pill? There may be other options? I notice in your OP you mention you hope to improve PMS when you "start" taking the pill - are you not on it currently then (sorry - I thought you were and were used to it and thats why you didnt want to change).

Reduce symptoms of PMS, possibly short or no period and other benefits. I think the best option for me is taking the combined pill continuously, I just need to find a way how. I have not looked at any other form of contraception that would have the same benefits to this though. But if there's a similar one, I would look into it.

I am not on any pill yet or have tried any other form of contraceptive other than condoms.

Caranica

I use a mix of gp and online prescriptions so that I go through 15 or so packs a year (I normally take a break from time to time, just not every month) and it's not a problem.

OP your bigger issue right now is finding a pill that works for you, deal with that first. It can take some people months or even years to find one that doesn't cause side effects that you can't live with. Find that first and then look at the longer term.

Faith

If you’re looking to stop periods totally, along with very effective contraception, I’d advise getting the Mirena coil. Unless there’s an exceptional circumstance, it renders you basically infertile while it’s in, and the vast majority of women stop getting periods on it. It’s a big up-front cost but probably cheaper in the long run than ~13 packets of the pill each year plus 2-3 GP visits per year (and better for the environment with less packaging!).

Also, just to add, I’m not sure you’re working from the best information. The “mini” pill - I.e. progesterone only - is the one that is most likely to stop periods completely, not the combined pill. The mirena coil also has far fewer side effects for most women than the pill as the hormones are released locally and don’t have to travel through the entire digestive and circulatory system to get where they’re needed.

Jessiel

Caranica wrote: »

I use a mix of gp and online prescriptions so that I go through 15 or so packs a year (I normally take a break from time to time, just not every month) and it's not a problem.

OP your bigger issue right now is finding a pill that works for you, deal with that first. It can take some people months or even years to find one that doesn't cause side effects that you can't live with. Find that first and then look at the longer term.

Thank you, I think this might be the solution.
Also, you're right, I didn't think of the side effects it might cause, so yeah it might not even work for me, but here's to hoping.

Jessiel

Faith wrote: »

If you’re looking to stop periods totally, along with very effective contraception, I’d advise getting the Mirena coil. Unless there’s an exceptional circumstance, it renders you basically infertile while it’s in, and the vast majority of women stop getting periods on it. It’s a big up-front cost but probably cheaper in the long run than ~13 packets of the pill each year plus 2-3 GP visits per year (and better for the environment with less packaging!).

I'll look into this, thanks very much. To be honest, I'm also a bit anxious in getting this done. However, I will read up more about it.

Also, just to add, I’m not sure you’re working from the best information. The “mini” pill - I.e. progesterone only - is the one that is most likely to stop periods completely, not the combined pill. The mirena coil also has far fewer side effects for most women than the pill as the hormones are released locally and don’t have to travel through the entire digestive and circulatory system to get where they’re needed.

Actually, I've read in a lot of online articles that the combined pill is the one that stops or shortens periods and reduces PMS. I've also asked the pharmacist and the GP about this.

Thanks for the info about the Mirena Coil, I'll definitely look into it now.

Faith

I was anxious AF about getting the Mirena inserted, and it certainly wasn't a fun experience, but it was 100% worth it. I haven't even had to think about contraception in 3 years now. My advice would be: don't let anxiety put you off doing something that's in your best interests .

Foweva Awone

I've got the Mirena in about a year now. My periods haven't stopped, but they're shorter and less frequent. Most importantly for me, I've had zero side effects, which were always a problem with other forms of contraception. I've no need for contraception at the moment, but it's good to know that I don't have to even think about it for the next few years.

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Jessiel wrote: »

I am not on any pill yet or have tried any other form of contraceptive other than condoms.

I think this is probably a bigger issue for you right now. It can take time to find a pill that suits you. Most women go through a number of months/different pills before they settle on one that suits them.

Im not sure why anyone would go with combined pill over mini pill if the aim is contraception + no periods + pms help. Mini pill seems like a no brainer for this. Mini pill also helps with pms. Or the Mirena - but....

I totally hear you re the Mirena coil - I was far too squeamish to get it myself. Also the expense and then if it didnt work out and had to be removed I would have felt like Id wasted the money etc...

I mean, I can see the GPs point about not prescribing off label when the only added benefit is no periods and there are other pills (mini) that will do that that dont carry as high a risk as the combined pill (combined pill has small stroke risk, mini pill does not). Really the manufacturers need to start making 28 day combined pills along with directions for use - and perhaps this is in the pipeline but typically drug trials takes decades.

Jessiel

....... wrote: »

I think this is probably a bigger issue for you right now. It can take time to find a pill that suits you. Most women go through a number of months/different pills before they settle on one that suits them.

Someone else have already pointed this out and I've responded to them.

Im not sure why anyone would go with combined pill over mini pill if the aim is contraception + no periods + pms help. Mini pill seems like a no brainer for this. Mini pill also helps with pms. Or the Mirena - but....

I've already mentioned in this thread before that I've asked my GP, pharmacist, and researched online - the combined pill is more effective for this.

I've also stated in my last post that I'm going to look into the Mirena Coil.

I mean, I can see the GPs point about not prescribing off label when the only added benefit is no periods and there are other pills (mini) that will do that that dont carry as high a risk as the combined pill (combined pill has small stroke risk, mini pill does not).

The only reason why the GP won't prescribe it off-label is because they don't want to take any risk. The combined pill shortens period and may reduce PMS as I already mentioned before, the mini pill doesn't help with these. The reason that the mini pill would be a better option for someone is if they have health problems, such as a high risk of heart disease, blood clots, high blood pressure or migraines.

Obviously my GP prescribed me the combined pill because he see no problem for me to take it.

I'm aware of the risks involved. Both pills have risks. Nothing is without any risk, but that doesn't mean I won't try them.

Really the manufacturers need to start making 28 day combined pills along with directions for use...

There are brands that do 28 day combined pills (no placebo) , however, they are currently not sold in Ireland.

- and perhaps this is in the pipeline but typically drug trials takes decades.

If you've read recent articles about the Pill, (unfortunately I cannot post the link here),

Here's an excerpt from an article in Irish Examiner titled: Contraception: the way you take the pill has more to do with the Pope than your health

"Shortly before his death in 2015 I attended a lecture given by Carl Djerassi, the “father of the pill”. He remarked that the seven-day break, and resultant withdrawal bleed, was designed into the pill in the late 50s in an attempt to persuade the Vatican to accept the new form of contraception, as an extension of the natural menstrual cycle.

This is a problem. The seven-day break is a hazard that may increase the risk of pregnancy while taking the pill. This is because the level of contraceptive hormones in the body is the crucial factor in turning off ovulation, without which pregnancy cannot occur. It takes approximately seven daily doses of contraceptive pill to reach sufficient levels to turn the ovaries off. But the seven-day break allows these levels to fall again. If pill-taking is not resumed by the ninth day after stopping, ovulation will occur."

And this is why GPs need to be updated with the current research. But until then, I will look into other options.

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Jessiel wrote: »

The combined pill shortens period and may reduce PMS as I already mentioned before, the mini pill doesn't help with these.

It does. Both things.

A lot of people prefer it too because its less hormones. Actually I found I gained a lot of weight on it compared to combined pill but certainly the lack of period (which also mean no pms) was great.

Yeah I saw the pope article and thought it was kinda sensationalist given that the pill is prescribed in plenty of countries where Catholicism isnt the dominant religion. But who knows - the 50s - the world was a different planet.

afkasurfjunkie

....... wrote: »

It does. Both things.

A lot of people prefer it too because its less hormones. Actually I found I gained a lot of weight on it compared to combined pill but certainly the lack of period (which also mean no pms) was great.

Yeah I saw the pope article and thought it was kinda sensationalist given that the pill is prescribed in plenty of countries where Catholicism isnt the dominant religion. But who knows - the 50s - the world was a different planet.

I would imagine that big business is more to blame. No periods mean no need for sanitary towels or tampons. Couldn’t be having that. Much easier to blame the church.

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afkasurfjunkie wrote: »

I would imagine that big business is more to blame. No periods mean no need for sanitary towels or tampons. Couldn’t be having that. Much easier to blame the church.

Very true, it definitely has an effect on Big Pharma (as well as the sanitary ware industry).

No periods means no anti inflammatories, no pain killers. I found when I went on the pill initially that it was cheaper to be on the pill and the vast saving was on pain relief! Pain relief is expensive, more expensive monthly than the pill is (well back in the day it was).

Its an interesting discussion on the 21 versus 28 day combined pill. A number of women I know say they "like" getting the break bleed as it reassures them they are definitely not pregnant - even though its not a real period, but they know it means their pill is working.

So even if 28 day combined pills were available I am sure a lot of women would still go for the 21 day version. People also like the idea of "giving their body a break" - even if its not necessary.

Jessiel

....... wrote: »

It does. Both things.

Provide links that say this?

A lot of articles say mini pill does not completely stop periods, and others say they generally do, however, I'm just following what my GP and pharmacist have said. What is your qualification? Or have you any reliable sources on this?

Anyhow, one site states (zavamed dot com) that the "Combined pills with a higher amount of oestrogen in them have even stronger effects on PMS, but they also have a higher risk of side effects."

And

"The mini-pill only contains progesterone, which can make PMS symptoms worse, so it shouldn’t be used to control PMS."

This makes sense, and so if you can provide another article with reliable sources that says otherwise, then I'll look into it.

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Jessiel wrote: »

Provide links that say this?

Any particular reason for the tone? A please might be nice - even a smiley!

http://bfy.tw/MBXK

Jessiel wrote: »

A lot of articles say mini pill does not completely stop periods, and others say they generally do, however, I'm just following what my GP and pharmacist have said. What is your qualification? Or have you any reliable sources on this?

As I mentioned earlier, it completely stopped my period and according to my GP that is the case for many women. YMMV.

Jessiel wrote: »

Anyhow, one site states (zavamed dot com) that the "Combined pills with a higher amount of oestrogen in them have even stronger effects on PMS, but they also have a higher risk of side effects."

And

"The mini-pill only contains progesterone, which can make PMS symptoms worse, so it shouldn’t be used to control PMS."

This makes sense, and so if you can provide another article with reliable sources that says otherwise, then I'll look into it.

Ok - if you are happy with your own research then Ill bow out.

Jessiel

afkasurfjunkie wrote: »

I would imagine that big business is more to blame. No periods mean no need for sanitary towels or tampons. Couldn’t be having that. Much easier to blame the church.

Do you have any evidence to this claim? Regardless, blaming is not the mission here - finding a solution is.

If you have read the articles about how the Pill was created then you will understand the real reason behind this.

And just to add, there is a substitute to sanitary towels or tampons, called Mooncup - less waste and better for the environment.