Unwanted 21

What is Unwanted 21?

Unwanted 21 is a combined contraceptive pill used to prevent women from becoming pregnant. It’s made by a company called Mankind. Its two hormones, ethinylestradiol (an estrogen) and levonorgestrel (a progestogen) help to regulate periods, as well as reduce your risk of getting pregnant.

It’s over 99% effective at preventing pregnancy when it’s used correctly (so taken at the same time every day, without any missed doses).

You’ll take it on a monthly cycle: one tablet each day for 21 days, and then take no tablets for the following seven days, before starting your next pack.

How does Unwanted 21 work?

Unwanted 21 protects you from getting pregnant in three ways. Each month, the ovaries release an egg (ovulation). The pill prevents this from happening.

Unwanted 21 also makes the mucus in the neck of the womb thicker, making it more difficult for sperm to move through the womb and reach an egg. The hormones in Unwanted 21 make the lining of the womb thinner, so it’s less likely that a fertilised egg will be able to implant itself into the womb and grow.

How effective is Unwanted 21?

If it’s used as it should be, Unwanted 21 is more than 99% effective (less than one in 100 women who use it will get pregnant in one year).

It’s important to note that this level of effectiveness is for when it’s used as prescribed.

Typically, when it’s used on a day-to-day basis, pills are occasionally missed, or not taken at the exact same time every day. This brings the effectiveness of Unwanted 21 slightly down to about 91% (nine in 100 women taking it per year usually get pregnant).

To reduce your risk of becoming pregnant, you should follow your doctor’s instructions.

How to take/use Unwanted 21

Unwanted 21 comes in strips of 21 tablets, each one marked with a day of the week.
Take one tablet for the marked day of the week at the same time every day. You will have to repeat this until you have used up all 21 tablets.

Swallow the tablet whole with water, and do not chew it. Once you have taken all 21 tablets in the strip, you then have 7 days where you take no tablets. This is sometimes known as a ‘gap week’.

So if you take the last tablet of one pack on a Friday, you will take the first tablet of your next pack on the Saturday of the following week.

Within a few days of taking the last tablet from the strip, you should experience a withdrawal bleed – like a period. This bleed may not have finished when the time comes to start your next strip of tablets. Provided you have taken your tablets as instructed and start the next strip of tablets on time, you don’t need to use additional contraception during the seven tablet-free days.

How long does it take Unwanted 21 to work?

Unwanted 21 can take around seven days to become effective, so when you start taking it, you should use another form of contraception whenever you have sex to begin with.

Because Unwanted 21 already has hormones in it, it’s not recommended that you use another hormonal method, such as a patch or ring, during this time. If you want to increase your level of protection, you should use a condom or a vaginal diaphragm whenever you have sex instead.

What should I do if I make a mistake when taking Unwanted 21?

If you miss a tablet by mistake, what happens next depends on how late you are in taking your tablet, as well as the point that you’re at with your strips.

If you’re less than 12 hours late in taking your tablet, the protection that Unwanted 21 offers you is not reduced. Just take the tablet as soon as you remember to, and continue to take any tablets that follow at the usual time.

If you’re more than 12 hours late taking a tablet, the protection that Unwanted 21 gives you may be reduced. The more tablets that you forget to take, the bigger the risk that the protection from pregnancy is restricted.

The risk of pregnancy is highest if you forget to take a tablet either at the beginning or at the end of a strip.

If you forget to take more than one tablet in a strip, you should contact your doctor and discuss this with them.

If you forget to take one tablet in the first week, take the first tablet as soon as you remember, even if it means taking two tablets at the same time. You should take any tablets that follow at the usual time and use an extra contraceptive, such as a condom, for the next 2-3 days.

If you have had sex during the week before you realised that you’d forgotten to take a tablet, or if you have forgotten to start a new strip following the seven tablet-free days, you should discuss this with your doctor, as there is a risk of pregnancy.

If you forget to take one tablet in your second week, take the tablet that you missed as soon as you remember, even if it means having to take two tablets at the same time. Take any tablets that follow this at the usual time. If you have taken the tablets as instructed for the last seven days, the protection that you have from becoming pregnant is not reduced.

If you did not use the tablets as instructed during the previous seven days, you should use additional contraception for the next seven days.

If you forget to take one tablet in the third week, there are two options.

You can take the tablet that you missed as soon as you remember, even if it means taking two tablets at the same time. Take any tablets that follow this at the same time, but instead of starting your seven tablet-free days, move straight on to your next strip.

Alternatively, you can stop taking tablets from the strip and start your seven tablet-free days (making a note of the day on which you forgot to take your tablet). If you want to start a new strip on your fixed start day, adjust the tablet-free days period so that it’s less than 7 days.

Following either of these two options will ensure that your protection from pregnancy isn’t reduced.

If you forget to take any tablets in a strip, and you don’t have bleeding in the first tablet-free week, this could mean that you’re pregnant. You should contact your doctor before moving on to your next strip.

Medically reviewed by

Dr Navkaran Singh Sandhu

Clinical Lead

on August 02, 2022.

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