The Combined Pill – Everything you need to know

The magic pill which is 99% effective in preventing pregnancy

The combined pill is often one of the first contraceptives that girls start on. It is extremely popular due to its accessibility and simplicity, as well as it’s many different varieties. Many girls often turn to the pill not only as a contraceptive but often to help control hormones. This magic pill might be small, but certainly packs a punch when it comes to controlling acne, periods and hormones – so definitely isn’t just a one-trick pony!

What is it?

The combined pill, also known as ‘The Pill’, is an oral contraceptive that must be taken daily. It contains artificial versions of women’s hormones oestrogen and progesterone. There are many different brands of pill, made up of three main types which all differ slightly.

Monophasic pills:

Each pill has the same amount of hormones in it. One pill is taken each day for 21 days and then no pills are taken for the next 7 days.

Multiphasic pills:

One pill is taken each day for 21 days, but each pill provides different levels of hormones. No pills are taken for the next seven days. Phasic pills need to be taken in the correct order.

Every day (ED) pills:

There are 21 active pills (containing hormones) and seven inactive pills (also known as ‘dummy’ pills, containing no hormones) in a pack – they are identifiable through different colours. One pill is taken each day for 28 days with no break between pill packets. ED pills need to be taken in the right order.

How does the combined pill work?

The pill prevents pregnancy in three ways – by stopping ovulation, by making the fluid in your cervix thicker (which makes it more difficult for sperm to enter the womb), and by preventing the lining of your womb thickening enough for an embryo to grow in it. If the pill is taken correctly (meaning you don’t miss any), it is 99% effective.

Minor side effects of the pill can include mood swings, nausea, tenderness in breasts and headaches. Despite what people may say, 46% of The Lowdown users report no change in weight and only 25% state they had gained weight after being on the combined pill. There is a very low risk of serious side effects such as blood clots and cervical cancer. The pill does not protect against STIs, but luckily the trusty condom can be used alongside this contraceptive to avoid any sexually transmitted illnesses.

Graph showing 46% of Lowdown users said the Combined Pill had no effect on their weight

How do I use it?

The combined pill needs to be prescribed and is not something available over the counter. Before you are prescribed the pill, your doctor or nurse will do some tests to ensure you are safe to go on it. They will check your medical history, make sure you’re not pregnant, and take your blood pressure. Most women can start the pill at any time in their period cycle. Unless you start the combined pill on the first day of your period, you won’t be protected from pregnancy straight away – make sure you read the packet carefully and use condoms or other methods until you are covered. There are special instructions for starting the pill if you’ve just had a baby, abortion or miscarriage.

You will normally be given a prescription for a couple of months and will need to go back to your doctor for regular check-ups (i.e blood pressure).

It’s important to take the pill around the same day every day – for example, first thing in the morning, or before you go to bed at night. It can often be helpful to associate it with something else in your routine, i.e when you have breakfast, or after you’ve brushed your teeth. You could also keep it somewhere that you look everyday, i.e makeup bag. But if you do have the memory of a fish, you could just set an alarm on your phone to ensure there’s absolutely no way you could forget to take your pill!

What happens if I miss a pill?

If you miss a pill or pills, or you start a pack late, this can make the pill less effective. The chance of getting pregnant after missing a pill or pills depends on when the pills are missed and how many pills are missed.

If you vomit within two hours of taking the pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and then the next pill at your usual time. If you continue to be sick, keep using another form of contraceptive until you’ve taken the pill again for seven days without vomiting. Very severe diarrhoea (six to eight watery stools in 24 hours) may also mean that the pill won’t work properly. Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea, and for two days after recovering. Check out more information here.

How do I stop?

Stopping the pill is super easy – you literally just stop taking it. However, be aware that as soon as you stop, you are no longer protected from pregnancy. If you have periods, you may prefer to wait until you reach the end of your current pill packet before stopping, so you can keep your cycle more regular.

Combined pill VS Mini pill

The main difference between these two pills are the hormones present in them. The Combined Pill contains two hormones, oestrogen and progestogen, while the mini pill only contains progestogen. As well as this, they are different in how they are used. The combined pill is designed to be taken once a day for 3 weeks, with 7 days pill-free break, the mini pill is to be taken once a day every day – with no break. As there is no break on the mini pill, it is unlikely that you will have a period – which, depending on what you’re looking for in a contraceptive, could be good or bad.

Pros and cons

Pros

  • The pill doesn’t stop your period completely (which is a positive for some females)
  • It doesn’t interrupt sex
  • It can reduce your risk of cancer of the ovaries, womb and colon
  • It can reduce symptoms of PSM
  • It can sometimes reduce acne

Cons

  • Some medicines and antibiotics can change the way your body digests the pill (check with a doctor or nurse if you are unsure)
  • You can forget to take it
  • Vomiting or diarrhoea can make the pill ineffective
  • With any combined type of hormonal contraception, there is a slightly increased risk of developing blood clots in your veins and arteries
  • It doesn’t protect against STIs

Who should use it?

  • Females that suffer from heavy bleeding
  • Females that don’t want their periods to stop
  • Females that suffer from acne
  • Females that are able to remember to take it every day

Who shouldn’t use it?

  • Females with a family history of blood clots
  • Females that have or have had breast cancer
  • Females that have diabetes with complications or have had diabetes for the past 20 years
  • Females over 35 that smoke

Where can I get it?

Contraception is free to everyone on the NHS. The pill is available in contraception clinics, sexual health clinics, GP’s surgeries and some young people’s services (Sexual Health Line on 0300 123 7123)