The combined pill

The Combined Contraceptive Pill is often just called 'The Pill'. There are lots of different types and you might have to try one or two before you find the right one for you.

The Combined Pill contains two types of hormone called oestrogen and progestogen. It will come in a packet of small tablets. There are 27 different types of combined pill available. All of them are designed to stop you getting pregnant and some of them might reduce spotty skin, or help with painful or irregular periods as well. No pill will protect you against sexually transmitted infections, though, so you might want to use condoms too.combinedpills01_crop

The other type of contraceptive pill you can get is the Progestogen Only Pill (POP). That doesn't have oestrogen in it. Click here if you want more information on the POP.

Spend a bit of time looking here and finding out more about the Combined Pill and if you have any questions, you can get in touch with Ask Brook. Ask Brook is confidential. That means we won't tell anyone you contacted us unless we think you're in really serious danger.

How does the Combined Pill work?
How do you use the Combined Pill?
Good things about the Combined Pill
What should I watch out for with the Combined Pill
How effective is the Combined Pill?
What makes the Combined Pill less effective?
Who can use the Combined Pill? 

How does the Combined Pill work?

The combined pill stops ovulation, which means a woman will not release an egg to be fertilised. It also thickens the mucus around the cervix, which makes it harder for sperm to get through, and makes the lining of the womb thinner so that a fertilised egg would not be able to implant. 

How do you take the Combined Pill?

You take one pill every day for 21 days until you finish one pack. Then you have a 7-day break when you don't take any pills or take placebo (dummy) pills instead. You will be protected against pregnancy during this week.

You will probably get a bleed at some point during the 7-day break. This is not a proper period - it is called a 'withdrawal bleed' and it can start at any point during the 7-day break. This bleeding is caused by you not taking hormones during the 7-day break.

You are not necessarily protected against pregnancy the first time you take a pill. If you want to make sure you are protected against pregnancy, you must follow the guidelines for starting the combined pill.

If you start taking the combined pill anytime between the first and fifth day of your period you will be protected against pregnancy straight away (unless your periods come every 23 days or less in which case you may not be protected and should seek further advice or use condoms for the first 7 days). If you start taking the pill at any other time in your menstrual cycle it will take 7 days before it starts to work. So you'll need to use condoms for the first 7 days.

This information does not apply to the Combined Pill Qlaira. If you use this pill you should contact the doctor or nurse who prescribed it if you are not sure how to take it.. 

Good things about the Combined Pill

  • Does not interrupt sex.
  • No evidence that it causes additional weight gain.
  • Reduces the risk of cancer of the ovary and womb.
  • Fertility returns to normal immediately after stopping.
  • Can help reduce spotty skin on face and body.
  • Bleeding may be lighter and period pain or Pre-Menstrual Syndrome (PMS) or Pre-Menstrual Tension (PMT) is less likely. 

What should I watch out for with the Combined Pill

  • Does not protect against sexually transmitted infections (STIs).
  • Can cause temporary side effects like headaches, nausea, breast tenderness and mood swings.
  • There is a low risk of breast cancer (which disappears after you stop talking the pill) and cervical cancer.
  • A very small number of women may develop a blood clot which can block a vein. If you have ever had a thrombosis, you should not use the pill.  

How effective is the Combined Pill?

This pill is over 99% effective if it is taken properly. This means that less than 1 in every 100 women who use the combined pill will get pregnant each year. It is less effective if it is not taken according to the instructions. 

What makes the Combined Pill less effective?

  • Taking it more than 24 hours late.
  • Vomiting within two hours of taking it.
  • Very severe diarrhoea for more than 24 hours.
  • Common antibiotics do not affect the combined pill but some prescription medicines, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John's Wort, can.
  • EllaOne (a new type of emergency contraception) can reduce the effectiveness of hormonal contraception.

If you have missed a pill or think you may not be protected, click here for more information. 

Who can use the Combined Pill?

The combined pill is not suitable for all women. A doctor or nurse will ask you questions about your own and your family's medical history, weigh you and take your blood pressure, just to check it will be suitable for you. If it is, they will probably prescribe you about 3 months' worth of pills to take home, and explain how to take them correctly.

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