About the combined oral contraceptive pill
The combined oral contraceptive pill is usually just called ‘the pill’. It contains two female hormones: oestrogen and progestogen. These are similar to those produced naturally by women in their ovaries.
If the pill is taken according to instructions it is over 99% effective. This means that less than one woman in 100 will get pregnant. However, the typical use is 91% and one of the key reasons is women forgetting to take their pill. This is why many women choose a long acting method of contraception like the IUD, IUS or contraceptive implant because they can “fit and forget”.
How it works
The hormones in the pill prevent the ovaries from releasing an egg each month (ovulation). They also make it harder for sperm to get into the womb and reach an egg.
Bleeding and spotting outside of your normal period times is common in the first few months of using the pill.
How to use it
How you take a pill may vary with the type you have been prescribed, so always read the information leaflet that will come with your pills and always follow the advice given by your clinician.
In general, you take a pill every day for 21 days, stop for seven days (this is when you have a bleed) and start again after the seven days are over. However, if you’re worried that you might forget to restart your pill, talk to your GP or sexual health clinic as there are other options, such as every day pills and tailored usage plans, which can help to prevent this from happening.
It’s important to take the pill at the same time every day. You could get pregnant if you don’t. You could also get pregnant if you miss more than one pill, vomit or have severe diarrhoea. If you’re worried that you might not be protected for any of these reasons, using a male or female condom will help to reduce your risk of getting pregnant .
Who can use it?
Many people use the pill every day and continue taking it right up until the menopause. However, some people cannot use the pill so you will need to answer some questions about your medical history and your family’s medical history. You should mention any illness or operations you have had.
In general, you are not advised to take the pill if you:
- Are pregnant
- Smoke and are 35 or older
- Stopped smoking less than a year ago and are 35 or older
- Are overweight (i.e. BMI over 35)
- Take certain medicines (ask your clinician about this)
You should also not take the pill if you have (or have had):
- Thrombosis (a blood clot)
- A heart abnormality or heart disease, including high blood pressure
- Severe migraines, especially with aura (warning symptoms)
- Breast cancer
- Gallbladder or liver disease
- Diabetes with complications or diabetes for the past 20 years
There are many advantages to taking the pill, it:
- Does not interrupt sex
- Usually makes your periods more regular, lighter and less painful
- Can reduce mood swings and the symptoms that occur before your period
- Can sometimes reduce acne
- Reduces your risk of cancer of the ovaries, womb and colon
- May reduce the risk of fibroids, ovarian cysts and noncancerous breast disease
It’s also worth bearing in mind that the pill:
- Does not protect you against sexually transmitted infections (STIs). Consistently using male and female condoms is the best way to protect against STIs
- Needs to be taken every day (may not suit people who are not good at remembering)
- Can cause temporary side effects including headaches, feeling like you need to vomit, breast tenderness and mood swings. If these do not disappear after a few months, you may need to change to a different pill or contraceptive method. Taking your pill at night time can help with feeling like you need to vomit
- Can increase your blood pressure
- Has been linked to an increased risk of some serious health conditions, such as thrombosis (blood clots) and breast cancer. The risk of thrombosis is low and your doctor or nurse will check if your risk before prescribing the pill. Research is on-going into the link between breast cancer and the pill
Generally women do not put on weight with the combined pill and research studies show that women are unlikely to experience weight gain.
Where to get it
Most types of contraception are free in the UK, and are available to all women and men through the NHS. Places where you can get contraception include:
- Most GP surgeries – talk to your GP or practice nurse
- Sexual health clinics like those run by Virgin Care, which offer free contraceptive and STI services. If you’d like to, you can check if there is a Virgin Care service near you and book an appointment now
- Community contraception clinics
- Some genitourinary medicine (GUM) clinics
- Some young people’s services, like those run by Brook
- The Family Planning Association’s has an excellent Guide to the Combined Pill. This contains information on the different types of pill, how to take them and frequently asked questions
- NHS Choices has lots of information about contraception with specific pages on the combined pill
- Brook has more information and advice on contraception written for people under 25, including the combined pill