How do I choose the right contraceptive pill for me?

As a simple rule, there is no “best” contraceptive pill. They all have different pros and cons, and what’s right for you will depend on your age, general health and lifestyle. The best course of action is learning about the different types of contraceptive pills, their benefits, and speaking to a doctor who can help you find the best contraceptive pill for you. 

It’s also important to remember that you don’t need to stay on the same pill forever. If you start taking a particular pill, and find discomfort with any side effects or would like to change to a pill with different benefits, you can - with the proper guidance from a doctor. 

Helping you find the right pill for you

Our doctors are always on hand to advise when it comes to finding the right pill for you. We can provide you with all the information you need and review your health and lifestyle to make safe and suitable recommendations.

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What types of contraceptive pills are there?

There are two main types of contraceptive pill, the combined pill and the mini pill. Both of these types of pills are over 99% effective in preventing pregnancy, but they differ in ingredients and who they’re suitable for.

Some contraceptive pills can do more for your health than just preventing pregnancy, and these benefits will play a role in helping you decide which pill is right for you. Some can help with heavy or painful periods, while others can reduce the symptoms of acne or PMS. 

The mini pill

The mini pill (progesterone only-pill, or “POP”) does not contain oestrogen and only contains the hormone progesterone. And because of this, we usually recommend it to women who can’t have oestrogen for any health or personal reasons. Oestrogen can also affect your blood pressure, so the mini pill is a better choice for people with high blood pressure, smokers (especially if over 35), and anyone with a family history of blood clots. 

Advantages of the Mini Pill

• It doesn’t contain oestrogen, so it’s useful for women who cannot take oestrogen (such as breastfeeding women, or women with high blood pressure)
• It’s safer for smokers, especially if over 35
• It can help with PMS symptoms and painful or heavy periods

Disadvantages of the Mini Pill

• With some mini pills, you have a shorter window in which to take the pill each day to ensure effectiveness
• It may cause temporary side effects in the first few months, such as headaches, breast tenderness, weight change and spots
• Your periods may become irregular or stop altogether whilst you are taking the mini pill. Spotting in between periods is also common with the POP
• Missing a pill, vomiting or severe diarrhoea after taking the pill can make it less effective
• Medications to treat HIV, epilepsy and TB, as well as St. John’s Wort can make the pill less effective
• Doesn’t help improve acne

The combined pill

The combined contraceptive pill or ‘the pill’, as it’s often referred to, contains two synthetic versions of the hormones progestogen and oestrogen, which are produced naturally by your body. 

Most combined pills contain the same amount of hormones in each pill, delivering a consistent dose of progesterone and oestrogen every day. These are called monophasic pills. 

Some combined pills are known as “phasic” pills. These pills have different amounts of hormones every week, which mimic natural changes in your hormone levels throughout your cycle. For some women, this can lead to fewer or more manageable side effects, but they are a little trickier to use than monophasic pills.

Advantages of the Combined Pill

• It can make periods lighter, more regular and less painful
• It may help PMS symptoms
• Certain brands can help with acne
• Studies have found that it reduces the risk of ovarian, uterine and colorectal cancer
• Can help with problems associated with polycystic ovarian syndrome

Disadvantages of the Combined Pill

• Side effects including headaches, nausea, mood changes, and breast tenderness are common in the first few months of taking it
• It can increase your risk of breast and cervical cancer
• Has been reported by users to cause depression, although no official link has been made
• It can increase your risk of deep vein thrombosis (DVT) and other blood clots
• Missing a pill, vomiting or severe diarrhoea after taking the pill can make it less effective
• It may not be suitable if you’re a smoker (especially if you are over 35 years old), if have a family history of breast cancer, have cardiac problems or are overweight
• Medications to treat HIV, epilepsy and TB, as well as St. John’s Wort can make the pill less effective

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What brands of the contraceptive pill are there?

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What are the side effects of taking the contraceptive pill?

The possible side effects of each type of contraceptive pill are the same, no matter which brand you use. But the side effects each person may have will vary from person to person. 

Combination birth control pills can cause side effects such as:

• Breakthrough bleeding or spotting — more common with continuous-dosing or extended-cycle pills

• Breast tenderness

• Elevated blood pressure

• Headaches

• Nausea

• Bloating

Side effects of the mini pill include:

• Irregular menstrual bleeding

• Acne

• Breast tenderness

• Decreased sex drive (libido)

• Depression

• Headaches

• Nausea

• Ovarian cysts

Although many people feel like they get heavier on the pill, there’s no clear evidence that the pill can cause changes in your weight. 

Generally, one pill is not more likely to cause a specific side effect compared to another, and the side effects experienced may differ between people. But the mini pill tends to cause irregular bleeding for the first 3 months, after which most people stop having periods at all.

Doctors usually suggest trying a pill brand to see if it suits you. And then trying others if it does not. 

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What are the risks of taking the contraceptive pill?

There are serious risks that have been linked with taking the pill, such as: 

• certain cancers 

• blood clots 

• heart attacks and stroke

Yasmin is a combined pill which has a higher risk of blood clots. Combined pills Levest, Microgynon, Rigevidon and Ovranette have a lower risk of causing blood clots, in comparison. Pills with a higher amount of oestrogen have been linked to a higher risk of blood clots, but other factors like the amount and type of progesterone in the pill, lifestyle choices and medical history also affect these risks. 

Your doctor will discuss all possible risks with you before you start taking the contraceptive pill. A doctor will not start you on certain types of contraceptive pills if the risk is too high. 

Speak to a doctor as soon as possible if you're taking the contraceptive pill and have:

• Abdominal pain
• Breast lump
• Chest pain
• Depression
• Difficulty speaking
• Eye problems, such as blurred or double vision or loss of vision
• Fainting
• Jaundice — yellowish discoloration of the skin
• New or worsening headaches
• Seizures
• Severe allergic skin rash
• Severe leg pain or swelling
• Severe mood swings
• A missed period or other signs of pregnancy

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How effective is the contraceptive pill?

When taken correctly at the same time daily, the pill is over 99% effective at preventing pregnancy. This means about 1 in 100 people who use the pill will get pregnant in a year, so there is still a very small chance of getting pregnant even if you use the pill as instructed. 

In reality, people do not always take the pill correctly, so its effectiveness is actually about 91%. Some of these reasons are:

• forgetting to take the pill 

• taking it at the wrong time of day 

• being sick or having diarrhoea 

• taking other medicines that make the pill less effective

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How do I take the contraceptive pill?

You should take your contraceptive pill at the same time every day. But, exactly how you should take the pill will depend on its type and brand. For example:

Some pills have a strict time frame of when you need to take them every day, while others have a more flexible way of taking them. When going on the pill, you should discuss with your doctor which option is best suited to your lifestyle. 

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How long does it take for the pill to start working?

Generally, the contraceptive pill should work effectively after taking it for 7 days, no matter which day of your period you start. 

For most of the combined pills and the mini pill, if you start on day 1 to 5 of your period, the pill should start working immediately without the need for an additional form of contraception. 

If you start outside these days, you should use another form of contraception, like condoms, for the first 7 days of taking the combined pill, or the first 2 days of taking the mini pill.

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Where can I get the contraceptive pill?

You can get the contraceptive pill for free from your GP, or online from providers like Superdrug Online Doctor.

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How does the contraceptive pill work?

The main ways the contraceptive pill works to prevent pregnancy are by:

• stopping your body from releasing an egg from your ovary into the womb (ovulation) each month

• making the mucus in your cervix (the neck or entrance of your womb) thicker, so it becomes more difficult for a sperm to pass through and fertilise an egg

• making the inner lining of your womb thinner, so it's harder for any fertilised egg to attach to your womb and grow

The hormones in the contraceptive pill can cause many side effects but may also help with improving acne, or making periods lighter and less painful. Some people take the pill for these reasons alone, and not for preventing pregnancy. 

It’s always best to discuss your options with your doctor first before you start the pill, to help you choose the best contraceptive pill for you. 

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What other contraceptives can I use?

When it comes to contraceptives, the pill isn’t your only option. There are many different forms of contraceptives each with their own advantages and disadvantages.

Hormonal Implant - A hormonal implant is a small tube placed under your upper arm's skin. It releases a hormone called progesterone to stop you getting pregnant. The implant is up to 99% in preventing pregnancy and is effective for 3 years.

Intrauterine device (IUD or copper coil) - An intra-uterine device is a type of birth control that's inserted through the vagina and cervix into the uterus to prevent pregnancy. The coil is up to 99% effective in preventing pregnancy and lasts for as long as it's in place.

Hormonal Coil (IUS) - Like the copper coil, but the IUS releases hormones which prevent you getting pregnant, and can also make your periods less painful, lighter, and shorter.

Depo-Provera Hormonal Injection - The hormonal injection is an injection of hormones you receive 8 or 13 weeks (depending on which type) to protect you from pregnancy. During this time, you are up to 99% protected against pregnancy.

Hormone Patch - The hormone patch is a small square patch worn on the skin. It contains similar hormones to those used in contraceptive pills, except you absorb them through your skin. When used correctly, the hormonal patch is up to 99% effective in preventing pregnancy.

Vaginal hormonal ring - The vaginal hormonal ring is a small ring that's inserted into your vagina. It contains the hormones oestrogen and progestogen, which are the same type of hormones used in contraceptive pills. When used correctly, the vaginal hormonal ring is between 99% effective in preventing pregnancy.

Diaphragm - The contraceptive diaphragm is a form of birth control that doesn't contain any hormones. It is a soft latex-free dome with a flexible rim made from silicone that's inserted into the vagina to form a barrier that stops sperm from reaching the cervix to prevent pregnancy.

Cervical cap - The cervical cap is a dome-shaped cup made of silicone you place inside your vagina with its rim fitted around the base of your cervix. This forms a barrier that stops sperm from reaching your uterus. However, you should always use it in combination with spermicide for it to be fully effective. When used correctly, it's up to 96% effective in preventing pregnancy.

Male condom - The male condom is a covering worn over the penis during sex to stop sperm from getting inside the vagina and fertilizing an egg. It's an affordable and effective method for preventing STIs and pregnancy. When used correctly, condoms are up to 98% effective.

Female condom - Also known as the "internal condom," the female condom is a lubricated "sheath" you insert into your vagina before having sex. It works by blocking sperm from reaching the cervix. When used correctly, it's up to 95% effective in preventing pregnancy.

Withdrawal (the "pull out" method) - This is an unreliable method of contraception, where the man will remove (pull out) his penis from the vagina before he ejaculates. Doing this is risky, and  can still cause pregnancy, as some sperm may be released before the man ejaculates. The withdrawal method does not protect you against STIs. 

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Contraceptive Pill FAQs

Can the pill make me bleed between periods?

Bleeding between periods is a possible side effect of some of the contraceptive pills, especially the mini pill. Apart from discomfort and inconvenience, this is not usually a sign of something wrong and isn’t harmful to your health. However, bleeding between periods is usually a temporary side effect, and typically gets better in the first few months as your body gets used to the pill. So if it doesn’t stop after a couple of months, or is very heavy or worrying, you should see your doctor straight away to rule out any other causes. For more information, you can read our doctors’ advice on how the pill can affect your bleeding.

I didn’t get my period while taking the pill. Am I pregnant?

The pill is over 99% effective, so if you are taking it correctly then you are very unlikely to get pregnant. If you miss your period, it does not necessarily mean that you are pregnant. Some pills, especially the mini pill, can cause you to delay or skip your period, or stop having them at all. Read our doctors’ advice on how to tell if you are pregnant on the pill, and what you can do about it.

Can I switch to a different pill?

There are lots of different contraceptive pills, so if you find that the pill that you are on isn’t right for you, then there are plenty of other options to choose from. However, before switching to a different pill, you should talk with a doctor about which pill to switch to, and how to switch pills safely. For more information, read our doctors’ advice on how to switch contraceptive pills.

Does the pill cause weight gain?

While some women report they gained weight whilst taking the pill, there is no clinical evidence that pill causes weight gain. However, oestrogen can cause you to retain more water, progesterone can increase your appetite, both of which can lead to weight gain. For more information, read what our doctors have to say about weight gain and the pill.

How long will it take to get pregnant after taking the pill?

Taking the contraceptive pill has no long term impact on your fertility, so your fertility levels should return to normal shortly after stopping the pill. It is possible to get pregnant as soon as you stop taking the pill, though some women may find it takes a few months for their periods to return to normal.

How do birth control pills work?

While there are many different types of pill, they all work to prevent pregnancy in the same way. The hormones in the contraceptive pill prevent pregnancy by stopping your ovaries from releasing an egg (ovulation), increasing the thickness of the fluid around the neck of the womb to prevent sperm from reaching an egg, and making the lining of the womb thinner to make it harder for any fertilised eggs to implant. Read for more information on how the pill works.

How effective is the pill?

All contraceptive pills are equally effective, and are more than 99% effective in protecting you against pregnancy. However, things like missing a pill, and vomiting or having diarrhoea shortly after taking it can make it less effective. Taking this into account, the pill is about 91% effective in practice.

What should I do if I miss a pill?

If you miss a pill, the first thing you should do is take it as soon as you remember and take your next pill as normal, even if it means taking two pills at the same time. Depending on the type of pill you are taking (combined or mini pill), or where in your cycle you missed a pill, you may not be protected from pregnancy any more and would need to use additional contraception. Read our doctors’ guide on what to do if you miss a pill.

Can I take antibiotics on the pill?

Most antibiotics don’t interact with the pill, and won’t make it less effective. However, there are a few less common antibiotics that do, so you should always tell your doctor that you are taking the pill if they prescribe you antibiotics. In addition, some antibiotics can have an indirect impact on the effectiveness of the pill, such as causing vomiting or diarrhoea. If you are taking antibiotics regularly, or are planning on taking them, then speak to your doctor first to make sure they do not interact. For more information, read our doctors’ guidance if you should take the pill and antibiotics.

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Sources

Combined pill (2020) Contraception Choices [accessed on 6 July 2020]

Contraception – combined hormonal methods (2020) NICE [accessed on 5 July 2020]

Contraception – progestogen-only methods (2020) NICE [accessed on 5 July 2020]

Contraceptives, hormonal (2020) NICE [accessed on 6 July 2020]

How effective is contraception at preventing pregnancy? (2020) NHS [accessed on 6 July 2020]

Mini pill (2020) Contraception Choices [accessed on 6 July 2020]

Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age (2014) Cancer Research [accessed on 6 July 2020]

Switching or Starting Methods of Contraception (2020) FSRH [accessed on 6 July 2020]

The progestogen-only pill (2018) NHS [accessed on 5 July 2020]

Your contraception guide (2018) NHS [accessed on 6 July 2020]

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