Reviewed by Usama Ali, MPharm (GPhC: 2224726). Last reviewed: April 2026.
Your pharmacist checks your medical history, recommends a pill, and posts it to you. If you start on day 1 of your period, you are protected straight away.
Most side effects settle within 2 to 3 months. The whole process takes about 10 minutes on the phone and your pill usually arrives within 1 to 3 days.
Starting the contraceptive pill for the first time begins with a short clinical consultation. You do not need to see a GP. Through the NHS Pharmacy Contraception Service, a pharmacist can assess you, recommend a pill, and supply it directly.
During the consultation, your pharmacist asks about your medical history, current medications, whether you smoke, your BMI, and whether you have any conditions that might affect which pill is suitable. For the combined pill, you also need a recent blood pressure reading (taken within the last 12 months). For the mini pill, a blood pressure check is not usually required.
These checks follow the UK Medical Eligibility Criteria (UKMEC), the same framework used by GPs and sexual health clinics. The aim is to make sure the pill is safe for you before you start.
Your pharmacist will recommend either the combined pill or the mini pill based on your health assessment. You do not need to decide before your appointment.
| Combined pill | Mini pill | |
|---|---|---|
| Contains | Oestrogen + progestogen | Progestogen only |
| How you take it | 21 days on, 7 day break | Every day, no break |
| Blood pressure needed? | Yes | No |
| Age range (PCS) | 16 to 49 | 16 to 54 |
| Protected from day 1? | Yes, if started on day 1 of period | Yes, if started on day 1 of period |
| Otherwise protected after | 7 days | 2 days (desogestrel), 2 days (Slynd) |
| Common first-choice | Microgynon, Rigevidon | Cerelle, Feanolla |
If you are unsure which type suits you, read our guide on which contraceptive pill is right for me. Your pharmacist will talk through the options during your consultation.
The ideal time to start is on day 1 of your period (the first day of full bleeding). If you start on day 1, you are protected against pregnancy straight away, regardless of which type of pill you take.
You can start at other times in your cycle, but you will need to use condoms or avoid sex until the pill becomes effective. For the combined pill, that means 7 days. For the desogestrel mini pill, it is 2 days. Your pharmacist will tell you exactly when protection begins based on when you start.
"We always explain this on the call," says Usama Ali, MPharm (GPhC: 2224726), pharmacist at Contraception Direct. "If your pill arrives mid-cycle and you want to start straight away, that's fine. You just need to know when you're protected and when to use condoms."
Take one pill at the same time each day. This is the single most important thing to get right. Setting a daily alarm on your phone helps. Some people take it with breakfast, others at bedtime. Pick whatever fits your routine.
For the combined pill, you usually take it for 21 days then have a 7 day break (during which you may get a withdrawal bleed). Some packs have 28 pills, where the last 7 are inactive. Either way, you take one pill every day.
For the mini pill, you take one pill every day with no break. Desogestrel pills (Cerelle, Feanolla, Zelleta) have a 12 hour late window. Slynd has 24 hours. Traditional mini pills (Noriday, Norgeston) have just 3 hours. Your pharmacist will explain the timing for your specific pill.
Starting the pill means introducing hormones your body is not used to. It is normal to notice some changes while your body adjusts. For most people, these settle within 2 to 3 months.
You might get some spotting or irregular bleeding, particularly in the first month. This does not mean the pill is not working. It is just your body getting used to the new hormone levels. Taking the pill at the same time every day can help reduce spotting.
Some people feel slightly sick in the first week or two, especially on the combined pill. Taking your pill with food or in the evening can help. If nausea continues beyond the first couple of weeks, mention it at your next review.
Common side effects when starting the pill include irregular bleeding or spotting, mild nausea, headaches, breast tenderness, mood changes, and bloating. Not everyone gets them. When they do occur, they are usually mild.
The FSRH combined pill guideline notes that around 1 in 5 people experience spotting in the first 3 months. This is the most common reason people worry the pill is not working, but it does not reduce effectiveness as long as you are taking it correctly.
If side effects persist beyond 3 months or are affecting your daily life, speak to your pharmacist. You do not need to put up with them. Switching to a different type or brand of pill often resolves the issue. Many people try more than one pill before finding what suits them.
| When you start | Combined pill | Desogestrel mini pill | Traditional mini pill |
|---|---|---|---|
| Day 1 of period | Protected straight away | Protected straight away | Protected straight away |
| Any other day | Use condoms for 7 days | Use condoms for 2 days | Use condoms for 2 days |
| After childbirth | Day 21 or later (not if breastfeeding in first 6 weeks) | Any time from birth | Any time from birth |
The pill does not protect against sexually transmitted infections. If you need STI protection, use condoms as well.
Missing a pill is common, especially in the first few weeks while you are building the habit. What you do depends on which pill you take, how late you are, and where you are in your pack.
For a quick answer based on your specific pill, use our missed pill tool. For a full explanation of the rules, read our guide on what to do if you miss a pill.
The short version: take the missed pill as soon as you remember. If you are within your pill's late window (24 hours for the combined pill, 12 hours for desogestrel, 3 hours for traditional mini pills, 24 hours for Slynd), you are still protected. If you are outside the window, take the pill anyway and use condoms until protection is re-established.
You can start the pill through your GP, a sexual health clinic, or a pharmacy through the NHS Pharmacy Contraception Service. All routes are free on the NHS.
With Contraception Direct, you book a free phone consultation with a pharmacist. The call takes about 10 minutes. If the pill is right for you, it is posted in discreet packaging and usually arrives within 1 to 3 working days. The service covers people starting the pill for the first time as well as those who need a repeat supply.
If you are not sure which pill is right for you, you do not need to decide before booking. Your pharmacist will talk through your options and recommend what suits your body and lifestyle. That is what the consultation is for.
Book a free phone consultation with a pharmacist. They'll check what's right for you, answer your questions, and post your pill in discreet packaging.
No GP needed. No prescription charge. Takes about 10 minutes.
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