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The combined oral contraceptive pill is frequently referred to simply as “the pill”. It comprises synthetic copies of the oestrogen and progesterone, two female hormones that are normally generated in the ovaries.
Pregnancy may occur if sperm contacts an egg (ovum). By preventing the release of an egg or by keeping the egg and sperm apart, contraception attempts to prevent this from occurring (ovulation).
The pill has a success rate of over 99% in preventing pregnancy when taken as directed. Less than 1 in 100 people who use the combination pill as contraception will become pregnant within a year, according to this statistic.
The recommended dosage is 1 pill per day for 21 days, followed by a 7-day respite during which you experience bleeding similar to a period. After seven days, you begin taking the medication once more.
Some medication kinds may allow for no breaks or brief breaks (a personalized regimen), which may lessen some negative effects. Discuss your alternatives with a doctor or nurse.
You must take the medication every day around the same time. If you fail to do this, forget to take a tablet, vomit, or experience extreme diarrhoea, you run the risk of becoming pregnant.
Some drugs may reduce the effectiveness of the tablet. If you are currently taking any other pills, speak to your doctor.
The combination pill may be helpful if you experience painful or lengthy periods, PMS (premenstrual syndrome), endometriosis, or other conditions.
Swings in mood, nausea, breast pain, and headaches are all minor side effects that typically go away after a few months.
There is no proof that taking the tablet would result in weight gain.
Serious adverse effects including blood clots and cervical cancer are quite unlikely.
If you are older than 35 and smoke, or if you have certain medical issues, you should not take the combination pill.
Use a condom along with the pill to prevent STIs, which the pill cannot prevent.
Although the evidence is conflicting and more research is required, there may be a connection between the pill and depression.
HOW TO TAKE THE 21 DAY PACK
- Take your first pill from the packet that has the appropriate day of the week indicated on it, or the first pill of the first color (phasic pills).
- Take a pill at the same time every day until the entire pack is gone.
- Seven days without taking any medications (during these 7 days you will get a bleed).
- Whether you are still bleeding or not, start your next pack of pills on the eighth day. The same day of the week that you took your first medication should apply to this.
HOW TO TAKE THE EVERYDAY PILL
- The first pill should be taken from the “start” part of the packet. This drug is going to be effective.
- Till the entire pack is used, keep taking a pill each day in the same sequence, preferably at the same time each day (28 days).
- You will experience bleeding for the first seven days after taking the inert pills.
- Regardless of whether you are still bleeding, start your next pack of pills once you have finished the first one.
Starting the combined pill
You can normally start taking the pill at any point in your menstrual cycle. There is special guidance if you have just had a baby, abortion or miscarriage. The guidance may also be different if you have a short menstrual cycle. Get advice from a doctor or nurse if you need it. You may need to use additional contraception during your 1st days on the pill – this depends on when in your menstrual cycle you start taking it.
Starting on the 1st day of your period
If you start the combined pill on the 1st day of your period (day 1 of your menstrual cycle) you will be protected from pregnancy straight away. You will not need additional contraception.
Starting on the 5th day of your cycle or before
If you start the pill on the 5th day of your period or before, you will still be protected from pregnancy straight away.
Starting after the 5th day of your cycle
You will not be protected from pregnancy straight away and will need additional contraception until you have taken the pill for 7 days.
If you start the pill after the 5th day of your cycle, make sure you have not put yourself at risk of pregnancy since your last period. If you’re worried you’re pregnant when you start the pill, take a pregnancy test 3 weeks after the last time you had unprotected sex.
What to do if you miss a pill
If you miss a pill or pills, or you start a pack late, this can make the pill less effective at preventing pregnancy. The chance of getting pregnant after missing a pill or pills depends on:
- How many pills you have missed (you have missed a pill when it’s more than 24 hours since you should have taken it)
- When you missed your pill (where you are in the pack)
What if I have missed 1 pill?
If you have missed 1 pill anywhere in the pack or started a new pack 1 day late, you’re still protected against pregnancy.
You should:
- Take the last pill you missed now, even if this means taking 2 pills in 1 day
- Carry on taking the rest of the pack as normal
- Take your 7-day pill-free break as normal, or if you’re on an everyday (ED) pill, take your dummy (inactive) pills
- You do not need to use extra contraception.
What if I have missed 2 or more pills?
If you have missed 2 or more pills anywhere in the pack or started a new pack 2 or more days late (48 hours or more), your protection against pregnancy may be affected.
You should:
- Take the last pill you missed now, even if this means taking 2 pills in 1 day
- Leave any earlier missed pills
- Carry on taking the rest of the pack as normal
- Use extra contraception, such as condoms, for the next 7 days
When you come to the end of your pill pack, after missing 2 or more pills:
- If there are 7 or more pills left in the pack after the last missed pill – finish the pack, take your 7-day pill-free break as normal, or take your inactive pills before you start your next pack
- If there are less than 7 pills left in the pack after the missed pill – finish the pack and start a new pack the next day; this means missing out the pill-free break or not taking your inactive pills
- You may also need emergency contraception if you have missed 2 or more pills in the first week of a pack and had unprotected sex in the previous 7 days.
What if I’m not sure what to do?
If you’re not sure what to do:
- Continue to take your pill
- Use another method of contraception, such as condoms
- Get advice as soon as possible
Risks of taking the combined pill
There are some risks associated with using the combined contraceptive pill. However, these risks are small.
Blood clots
The oestrogen in the pill may cause your blood to clot more readily. If a blood clot develops, it could cause:
- Deep vein thrombosis (clot in your leg)
- pulmonary embolus (clot in your lung)
- Stroke
- Heart attack
The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors before prescribing the pill.
Cancer
The pill can slightly increase the risk of developing breast cancer and cervical cancer. It can also decrease the risk of developing womb (uterus) cancer, ovarian cancer and bowel cancer.
However, 10 years after you stop taking the pill, your risk of breast cancer and cervical cancer goes back to normal.
Advantages and Disadvantages
Some advantages of the pill include:
- It does not interrupt sex
- It usually makes your bleeds regular, lighter and less painful
- It reduces your risk of cancer of the ovaries, womb and colon
- It can reduce symptoms of PMS (premenstrual syndrome)
- It can sometimes reduce acne
- It may protect against pelvic inflammatory disease
- It may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease
Some disadvantages of the pill include:
- It can cause temporary side effects at first, such as headaches, nausea, breast tenderness and mood swings – if these do not go after a few months, it may help to change to a different pill
- It can increase your blood pressure
- It does not protect you against sexually transmitted infections
- Breakthrough bleeding and spotting is common in the first few months of using the pill
- It has been linked to an increased risk of some serious health conditions, such as blood clots and breast cancer
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