The mini-pill with a 12-hour window rather than three — and usable where the combined pill is not.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
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Registered with the Care Quality Commission
Desogestrel is a progestogen-only pill — the "mini-pill". It contains no oestrogen, which is what makes it usable in situations where the combined pill is not.
It works mainly by preventing ovulation, and also by thickening cervical mucus. That is worth knowing, because older progestogen-only pills worked mostly on mucus alone and were less forgiving.
That difference is why desogestrel has a 12-hour missed-pill window rather than three hours — a meaningful practical advantage over traditional mini-pills.
Migraine with aura is the commonest reason for choosing it, since the combined pill is contraindicated there because of stroke risk.
Started on day 1 to 5 of your period, it works immediately. Started at any other time, use additional contraception for 48 hours.
Less than 12 hours late: take it and carry on — you are still protected.
More than 12 hours late: take it as soon as you remember, carry on, and use condoms for the next 48 hours. Consider emergency contraception if you have had sex in the preceding days.
Vomiting within two hours of a pill, or severe diarrhoea, may mean it was not absorbed. Treat it as a missed pill.
Unlike the combined pill, it does not increase blood clot risk meaningfully, which is the central reason for choosing it.
The list is considerably shorter than for the combined pill, which is the point of it. Migraine with aura, clot history, controlled high blood pressure and smoking over 35 are all fine with desogestrel.
Ordinary antibiotics do not reduce the effectiveness of the pill. That advice changed years ago and is still widely repeated — only enzyme-inducing antibiotics such as rifampicin matter.
Blood pressure and weight at review, and a conversation about bleeding pattern and whether it still suits you. No routine blood tests.
Yes — contraception is well suited to remote consultation, and desogestrel is one of the more straightforward prescriptions.
What the consultation covers: blood pressure and weight, migraine history, smoking, family history of clots, current medicines, and whether there is any chance of existing pregnancy.
Desogestrel is available from some pharmacies without prescription, which may be quicker for a straightforward continuation.
What we will always mention is that the pill is not the most effective contraception available. Implants, coils and injections are more effective precisely because they do not depend on remembering anything daily. If you want the most reliable option, we will say so rather than simply supply what was asked for.
Desogestrel is a cheap generic. Contraception is free on the NHS — from your GP, a sexual health clinic, or some pharmacies — and we will point that out rather than charge you for something available free.
Where paying privately makes sense is speed and convenience, or continuity while travelling.
A twelve-month supply can be issued at once, which is more convenient and improves continuation.
It can be stopped at any time, and fertility returns quickly — usually within days. There is no need to "clear it from your system" before trying to conceive.
Give it three to six months if you can. It settles for most people. Persistent bleeding beyond six months, or new bleeding after a settled pattern, should be assessed rather than assumed to be the pill.
Up to 12 hours. That is the main advantage over older mini-pills, which allowed only three.
Yes, and it is harmless. A substantial minority stop bleeding altogether, and many people prefer that. If there is any chance of pregnancy, test.
No — ordinary antibiotics do not. Only enzyme-inducing ones such as rifampicin do. This advice changed years ago but is still commonly given.
Yes — that is one of the main reasons it is chosen. The combined pill is contraindicated with aura because of stroke risk; desogestrel is not.
Progestogen-only pills have not been shown to cause meaningful weight gain in trials. The injection is the one with a genuine association.
Within days of stopping. Unlike the injection, there is no delay.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
On this page
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Told when a test isn’t needed
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£40 for 20 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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