How do I choose the right contraceptive pill for me?

There are lots of reasons you might choose to use the contraceptive pill. Some commons examples are:

• preventing you from getting pregnant 

• improving acne caused by hormones 

• making periods less painful or less heavy 

• delaying a period 

When deciding on the best contraceptive pill for you, there are a few factors you and your doctor should consider:

• Age: The mini pill is usually recommended if you’re over 35

• Weight: Being very overweight can increase your risk of getting blood clots when on the combined pill

• Smoking: Smoking can increase your risk of getting a blood clot if you’re on the combined pill

• Your health and medical history: The combined pill may not be right for you if you have (or have had) certain conditions like diabetes, high blood pressure, migraines with aura, breast cancer, heart disease, blood clots, liver disease or a family history of these conditions. All contraceptive pills also contain lactose so are not suitable if you are lactose intolerant

• Your lifestyle and how you want to take the pill: You take each type and brand of pill in slightly different ways so you need to find one that suits you

• Possible side effects: Common side effects of the pill include headaches, being sick (vomiting), mood swings and breast pain. For most women, any side effects go away after a few months 

• Risks versus benefits: Your doctor will consider any risks of taking the pill and help you weigh this up against the benefits of taking it

You can also get more guidance if this is your first time on the pill or you’re just looking to change your contraceptive pill.

Back to top

What types of contraceptive pills are there?

The 2 main types of contraceptive pills are the combined pill and the mini pill. The combined pill contains forms of 2 female hormones – oestrogen and progesterone, while the mini pill only contains progesterone. 

Both pill types come in different brands with varying types and amounts of oestrogen and/or progesterone.

Combined pill 

All combined pill brands contain 21 active pills which you take over a 28 day cycle.

Some brands have just these 21 pills, so you take the pills in the packet then take no pills for 7 days, then start the next pack. Other brands have 21 active pills and 7 dummy pills, so you just take the pill every day and do not have to remember when to restart the next pack.

Different combined pill brands contain different doses of hormones:

• Standard dose: all 21 pills in the pack contain the same amount of hormones

• Lower dose: all 21 pills contain a lower amount of hormones. Some people might choose a lower dose to avoid side effects

• Cycling dose: the pills in the pack contain different doses depending on the week. You have to take the pills in the right order to get the right dose at the right time, so the pill can work effectively

Mini pill

The mini pill contains only the progesterone hormone and may be suitable for people who cannot take the combined pill. You take the mini pill every day, with no break between each pack of pills. 

Pill types

Each type of pill contains different amounts of hormones.

Back to top

What are the side effects of taking the contraceptive pill?

The possible side effects of each 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. A few common side effects you may experience on the contraceptive pill are: 

• acne 

• headaches 

• mood changes 

• high blood pressure 

• vaginal bleeding between periods 

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. 

Back to top

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. 

Back to top

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

Back to top

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. 

Back to top

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 the combined pill 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.

Back to top

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.

Back to top

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. 

Back to top

What other contraceptives can I use?

Apart from contraceptive pills, other forms of contraception you can use are: 

• female condoms 

• contraceptive diaphragm 

• cervical cap 

• contraceptive implant 

• contraceptive patch 

• contraceptive ring 

• IUD or IUS (the coil)

• contraceptive injection 

• sterilisation 

• natural family planning 

Back to top

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]

Back to top