The combined pill is a small tablet you swallow daily that contains hormones oestrogen and progestogen. The pill prevents pregnancy in three ways – by stopping ovulation, making the fluid in your cervix thicker (which makes it more difficult for sperm to enter the womb), and preventing the lining of your womb thickening enough for a fertilised egg to implant into it.
Your doctor or nurse will do some tests to make sure that you can take the contraceptive pill. They check your medical history, make sure that you’re not pregnant, confirm your height and weight and take your blood pressure.
Most women can start the pill at any time in their menstrual cycle. If you start your pill within 5 days of starting your period you will be protected from pregnancy straight away (if you have a short cycle then speak to your doctor or nurse). At any other time in your cycle you will need to use condoms or avoid sex for 7 days before you are covered. Make sure you read the packet carefully and speak to a health professional if switching from another contraception method.
There are special instructions for starting the pill if you have just had a baby.
The pill can be started immediately after an abortion or miscarriage. abortion or miscarriage.
Take the pill around the same time every day – for example first thing in the morning, or before you go to sleep at night.
If it helps, keep your pill packet somewhere you use or look at everyday (like your makeup bag) to remind you to take it, or set an alarm on your phone.
Most types of combined pill are designed to be taken for 21 days followed by a 7 day break. During this break you experience a withdrawal bleed (like a period). For most brands you can choose to shorten this break or miss it out altogether (and avoid a withdrawal bleed). Some specific pill brands may have different instructions so check the packet.
You will normally be given a prescription for the pill for three months initially and then for longer after this. You will need to go back to your doctor for regular check ups (e.g. blood pressure tests) and should let your doctor know if there are any changes in your medical history.
How to stop taking the pill
Coming off the pill is easy – you just stop taking it. As soon as you stop taking it, you’re no longer protected from pregnancy.
If you want to stop the pill but do not wish to become pregnant then you might want to consider switching to another form of contraception before you stop taking your pill.
Check out our combined pill survey results to see how long it took most women’s cycles to return to their definition of ‘normal’ after they stopped taking the pill, and read up about their experiences.
Things that can go wrong
Missing or forgetting to take birth control pills has happened to all of us. Check out the NHS guide on what to do, depending on how many you’ve missed and where you are in your cycle. If you’re in any doubt, make sure you use a condom or don’t have sex until you’re protected and speak to your doctor or nurse.
There are a few things that can stop combined pills from working properly – make sure you watch out for these and check your pill information leaflet or speak to your doctor if you have any questions:
Vomiting and diarrhoea will impact on how the pill is absorbed into your body. If you’re sick within two hours of taking the pill you’ll need to take another pill straight away and the next pill at the usual time. If you’re sick or have severe diarrhoea for longer than this, check your pill packet for what to do next – and use condoms or avoid sex if you have any doubts.
Some medicines and antibiotics (like rifampicin and rifabutin, St John’s wort and anti-epilepsy drugs) can reduce the effectiveness of the pill so speak to your doctor if you start any new medicines.
Side effects that some women experience with the combined pill include headaches, breast tenderness, nausea, mood swings and changes in sex drive. These are usually temporary and settle after a few months.
Irregular bleeding or spotting is common in the first few months.
The combined pill may increase your blood pressure
With any combined type of hormonal contraception that contains oestrogen there is a slightly increased risk of developing blood clots in your veins and arteries. We are developing a full guide to the medical research on the serious and potentially life threatening side effects of contraceptives here.
Use of the combined pill is also associated with small increased risks of breast cancer and cervical cancer. These reduce with time after stopping.