Frequently asked questions
How does hormonal contraception work?
Hormonal contraception works by means of hormones that block ovulation and/or prevent an embryo from lodging in the uterus. To understand how this works, one must first give a short outline of the natural menstrual cycle. In the natural cycle, the hormone FSH ensures that a new egg cell matures, and the LH hormone ensures that there is ovulation. Both hormones are produced by the pituitary gland, a hormone gland in the brain. The maturing egg cell secretes oestrogen and the shell left over after ovulation then produces progesterone. Progesterone and oestrogen suppress the FSH and LH hormones, so that it is impossible for an egg cell to mature. If there is no fertilisation, the hormones progesterone and oestrogen decrease, which causes the FSH and LH hormones to increase again, so that a new egg cell can mature again. Contraceptives contain progesterone and some oestrogen too. They prevent a new egg cell from maturing and causing ovulation.
Broadly speaking, there are two types of hormonal contraceptives:
- contraceptives having two hormones, also referred to as the “combination method”. These contraceptives contain progestogen and oestrogen. The most important function of progestogen is to protect the woman against pregnancy. The oestrogen causes menstrual bleeding. There are many types of progestogen. There are three types of oestrogen: ethinylestradiol, oestradiol and oestradiol valerate. In the case of hormone related side effects, it can therefore be worth alternating with another type of progestogen or oestrogen. Methods using two hormones are: the pill, contraceptive plaster (EVRA) and contraceptive ring.
- Single-hormone contraceptives contain progestogen. The progestogen provides protection against pregnancy. The lack of oestrogen may cause the menstrual cycle to be unpredictable and irregular. Bleeding can occur more often, less often, for longer or for shorter periods or it may not occur at all. Methods involving one hormone are the contraceptive implant, the hormone coil (Mirena) and the hormonal shot.
What is the best contraceptive?
Choosing a means of contraception is personal. It will be related to your personal situation and preferences. Are you a man or a woman? Do you still want children or not? Do you find it important to have a menstrual cycle? Do you take a risk of STD/AIDS into account? Do you prefer a means with or without hormones? A doctor will discuss all these matters with you in a consultation and leave the decision up to you.
Forgot to take the pill
There is never allowed to be a period of more than 36 hours between two pills. In the case of the mini-pill, this may not be more than 24 hours. You will still be protected if you take the pill within 12 hours after the moment that you should normally have taken it. The week of pausing (menstruation) never lasts longer than 7 days (in a strip of 22 pills, never more than 6 days). You must still start the next strip, even you are still bleeding.
If you have forgotten the pill during the first 7 days of the strip: then you can still take the pill you forgot and continue using the strip. However, we do advise you to use additional contraception such as condoms for 7 days. If there has been intercourse during the period that you forgot to take the pill, we advise you to always take the morning-after pill.
If you have forgotten the pill between the 7th and 14th days of the strip: then you can still take the pill you forgot and continue using the strip. In this case, no additional contraception or morning-after pill is necessary.
If you have forgotten the pill between the 14th and the last days of the strip: then you can still finish the strip and continue with the next strip without any interruption, or you can stop and start a new strip after 7 days. In this case, no additional contraception or morning-after pill is necessary.
If you have forgotten to take the pill several times and/or in other cases of doubt (in the case of vomiting, diarrhoea or the use of certain medicines, for example), we advise you to consult a doctor.
It will not be detrimental to the baby if you fall pregnant because you forgot to take, or stopped taking, the pill.
How do you know that you are pregnant despite taking the pill?
You can always do a pregnancy test if you suspect that you are pregnant despite taking the pill. You can repeat the test if it is negative and you still have your doubts.
Is my pill safe if I need to vomit or have suffer from diarrhoea?
The pill is absorbed in the blood within three hours after it has been taken. Therefore, if you vomit within three hours after you have taken it, you must take a new pill. The same applies to diarrhoea. In the case of severe diarrhoea or vomiting, the pill is no longer reliable, and it is wise to use another additional means of contraception. In that case, apply the rules as if you forgot to take the pill.
May I skip the pause week for the pill?
The pause week for the pill is actually unnecessary. However, if you do not pause from the pill for a week, chances are that you will suffer from breakthrough (irregular) bleeding in due course. That is nothing to worry about but the moments at which they will occur are unpredictable. However, most women can take a number of strips without encountering any problems.
How do I know which pill is most suited to me?
That is often a question of trial and error. You start with one pill and if you do not have any complaints, you can continue using it. It may also be that you suffer from (many) side effects. If you have just started using the pill, it may be because your body must still get used to it. If you do not see any or enough improvement after three months, you can consult your doctor and change to another pill or contraceptive.
How reliable is the pill?
You must take the pill every day, preferably at the same time every day. Intervals between two pills may not exceed 36 hours. The pill is 99% reliable if you always take it in time. However, you must be careful when using medicines or if you are sick, as a result of which you need to vomit.
Can I get hold of the pill without my parents knowing?
Doctors are subject to professional secrecy and they therefore do not say anything to other people about consultations. The Amsterdam Abortion Clinic does not call home and does not send post without being requested to do so. The only problem can be the insurance company that sends an account to your home. If necessary, that can be discussed with the doctor or the chemist.
What is the difference between the various types of pills?
There are many different types of contraceptive pills. The greatest difference lies in the hormones used and/or in the number of hormones used. Most of them consist of 21 of the same pills and have a stoppage week of 7 days. In addition, there is also a 3-phase pill consisting of 3 different types of pills. Personal preference will determine which pill is most suitable and this is mostly a question of trial and error to see which one suits you best. You can consult your general practitioner for this, for example.
I do not want to take the pill (any more); what other alternatives do I have?
You can choose from very many other means of contraception besides the pill, such as the copper coil, hormone coil, EVRA plaster, diaphragm, condoms, sterilisation and the hormone shot. For a general idea on how the various contraceptives work and what benefits and drawbacks they entail, you can obtain more information here: Means of contraception
Are fun condoms safe?
Fun condoms are mostly made as a joke and not suited for safe intercourse. Only condoms complying with the safety and packaging requirements can be safe enough to use for intercourse. As a matter of fact, this should be mentioned on the packaging.
Can someone have a penis that is too large or too small for condoms?
No, there are different sized condoms. It may be a question of trying them out to see which condom fits most comfortably. A condom must fit tightly but too tight is also rather unpleasant. For more information, look on the websites of the following Condom Factory, Durex and the Condomerie.
Is having intercourse with a condom just as pleasant as having intercourse without a condom?
That is a difficult question because there are many differences of opinion. Many condom users find that they feel less, which can also be an advantage because it then takes slightly longer before the man has an orgasm. What’s more, putting on the condom may be encountered as a disturbing disruption. Research shows that people who always use condoms have fewer problems in this regard. One can conclude from this that experience in using condoms, in particular, plays an important role.
How often must a coil be replaced?
All coils must be replaced after 5 years. In the case of the T-Safe copper coil, it need only be replaced after 10 years.
How long does it take before you can fall pregnant after the coil has been removed?
You can fall pregnant from the moment the doctor has removed the coil.
Will I feel the coil during intercourse?
If it has been placed properly, neither you nor your partner will feel anything of the coil during intercourse.