The Combined Oral Contraceptive Pill

The combined pill is the most common form of contraception used in the UK.

The combined pill contains two types of hormones - oestrogen and progesterone - which are similar to a woman's natural hormones.

The different brands of pills contain different types and quantities of oestrogens and progesterone.

You can be prescribed the combined pill by your GP or local family planning clinic.

How effective is the combined pill?

  • The combined pill is over 99% effective if taken correctly - this means that if 100 women took the combined pill for one year, less than 1 of them would get pregnant.
  • However, there would be more pregnancies if the methods are not followed correctly.
  • It is more effective if you are taught by a family planning doctor or nurse.

How does the combined pill work?

  • The main method of action is by preventing the ovaries from releasing an egg each month
  • It also:
    • causes thickening of your cervical mucus so sperm cannot get through
    • thins the lining of your womb so that there is less chance a pregnancy could implant and progress
  • The pill is taken continuously for 3 weeks:
    • it is usually started at the beginning of your cycle (day 1)
    • after 3 weeks, you do not take any pills for 7 days during which you will have your period
    • You then start a new pack and start again
  • If you are prescribed an everyday (ED) packet of pills, then you will not need to have a 7-day break

If you have any concerns or questions, please do not hesitate to contact your GP or family planning clinic.

Contraindications to the combined pill

It may not be suitable for you to use the combined pill. This may be the case if you have/are:
  • Cardiovascular (heart) disease
  • Diabetes
  • Obesity
  • High blood pressure
  • Headaches or migraines
  • Previous, current or a family history of breast, endometrial or cervical cancer
  • Unexplained vaginal bleeding
  • Liver diseases
  • a smoker above the age of 35 years
  • High cholesterol
  • Pregnant

Advantages of the combined pill

The combined pill:
  • regulates your periods
  • usually makes your periods lighter and less painful
  • does not interrupt sex unlike condoms
  • helps to reduce colon, uterus and ovarian cancer, as well as benign breast conditions
  • can be used to avoid a withdrawal bleed if inconvenient if you can put 2 packs back to back - please discuss this with your GP or family planning doctor

Disadvantages and Risks

  • Must be prescribed by a doctor or trained professional
  • Must be taken regularly at the same time each day
  • There is no protection against sexually transmitted infections (STIs).
  • There are slightly higher risks of developing a blood clot, breast and cervical cancer - you can speak to your GP or family planning doctor for more information and advice regarding the risks involved.
  • Remember your pill will not be effective and you may require additional contraception if you are taking certain medication (for example, epilepsy drugs) or antibiotics - please discuss this with the professional who is prescribing the combined pill
  • Can cause side-effects :
    • Nausea
    • Bloating
    • Headaches
    • Breast pain
    • Breakthrough bleeding or spotting, especially when you first start using it
    • Reduced libido (sexual desire)

Further sources on information

You can find further reliable information on the leaflet produced by the Family Planning Association:
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