Contraceptive pill

There are 2 types of contraceptive pill, the combined pill and the mini pill. Although the main purpose of both is to prevent pregnancy, they work in slightly different ways and contain different active ingredients. The right one for you will depend on several factors, including how well your body responds to oestrogen, your age, and whether you smoke.

Combined oral contraceptive pill

The combined pill, also commonly known as “the pill”, is a method of hormonal contraception that contains 2 types of hormones, oestrogen and progesterone. It generally works by stopping your ovaries from releasing an egg each month, also known as ovulation.

Some of the common combined pill brands include:

• Microgynon 30
• Yasmin
• Gedarel
• Marvelon
• Mercilon

Progesterone-only pill (mini pill)

The progesterone-only pill is more commonly called the mini pill because it only contains progesterone. It does not contain oestrogen, making it a more suitable option for anyone who cannot or chooses not to take oestrogen.

Common mini pill examples include:

• Cerelle
• Cerazette
• Noriday
• Norgeston

The similarities and differences between the combined and mini pill are included in this table.

There are many different pill brands to choose from, and finding the best contraceptive pill for you will depend on several factors. For example, some are better suited if you also have a health condition caused by hormones, such as endometriosis, while some may be more suitable if you want to take a pill every day without having a bleed.

➤ Our guide on finding the right contraceptive pill for you goes into this further, discussing a range of options based on your health, preferences, and current situation.

Both the combined pill and mini pill prevent pregnancy by:

• thickening the cervical mucus to make it difficult for sperm to reach an egg
• thinning the womb lining to stop a fertilised egg from implanting there

The combined pill and some mini pills also stop ovulation from happening. This is where one of your ovaries releases an egg each month, ready for fertilisation.

When taken correctly, both the combined pill and mini pill are more than 99% effective at stopping you from getting pregnant. This means that for every 100 people who take the pill, 1 will get pregnant each year.

However, when typical use is considered, which includes situations like forgetting to take your pill, or vomiting or having diarrhoea, the effectiveness of the pill is closer to 91%.

Taking the pill exactly as it is prescribed and at the same time each day will maximise its effectiveness and give you the highest level of protection against pregnancy.

You should take your pill at the same time every day, with water if required. It does not matter what time you take it as long as it’s around the same time. So, it is important to choose a time that suits you and that you are not likely to forget.

It’s best to start the pill for the first time on days 1 to 5 of your menstrual cycle, that’s day 1 to 5 of your period, as this means you will be protected against pregnancy straight away with almost every contraceptive pill. If you take it after this time, you will need to use an additional method of contraception, like condoms, for 7 days with the combined pill, and 2 days with the progesterone-only pill. Always check with your doctor and in the patient information leaflet to make sure.

Taking the combined pill

If you take a combined pill that has 21 pills in each strip, you should take 1 pill per day until you finish the strip. Then, you should have a 7-day pill-free break, where you take no pills, and you should have a withdrawal bleed similar to a period. On day 8 after your last pill, you should start a new strip.

Alternative options

Alternatively, you can take the combined pill back-to-back without a 7-day break, or with fewer breaks, but you should speak to your doctor before taking it this way.

If you take a combined pill that contains 21 active pills and 7 inactive or dummy pills, you should take them in the same way as a 21-day combined pill, but instead of having a 7-day break, you should take the inactive pills on these days. This helps some people remember to keep taking their pill, and you’ll still have a hormone-free break, which will cause a withdrawal bleed.

Taking the mini pill

The mini pill is taken every day without a break between packs. There are usually 28 pills in a pack. When you finish a pack, you will start a new pack the next day.

What should I do if I miss a pill?

If you miss a pill, you should take it as soon as you remember, even if it means taking 2 pills at the same time or on the same day.

Depending on which pill you are taking, how many pills you have missed, and in which week you missed the pill, you may not be protected against pregnancy. You should read the patient information leaflet that comes with your medication for instructions on what to do if you miss a pill.

Both the combined pill and mini pill can cause side effects, although not everyone will get them. In most cases, contraceptive pill side effects should improve or go away within 3 months, once your body gets used to the medication.

Common side effects of the combined pill

Some of the common side effects of the combined pill include:

• bleeding between periods or changes to your periods
• headaches
• feeling sick
• dizziness
• sore breasts
• high blood pressure

Common side effects of the mini pill

Some of the common side effects of the mini pill include:

• changes to your period
• acne
• mood swings
• weight gain
• changes to your sex drive
• headaches
• feeling sick

The contraceptive pill may not be suitable for everyone, so it’s important to discuss your medical history and any medications you are taking with your doctor. This will help them decide which type of pill is best for you.

Who cannot take the combined pill?

The combined pill may not be suitable for you if you:

• are allergic to any of its ingredients
• are or think you might be pregnant
• smoke and are over 35
• are overweight
• have a family history of blood clots, or you have had them yourself
• have had a stroke
• have a heart condition or high blood pressure
• have had breast cancer
• have liver disease
• get migraine with aura
• have gallbladder disease

Who cannot take the mini pill?

The mini pill may not be right for you if you:

• are allergic to any of its ingredients
• are or think you might be pregnant
• have unexplained vaginal bleeding
• have had breast cancer
• have had heart disease, artery disease, or strokes
• have or have had liver disease or liver tumours

The contraceptive pill and other medications

Some medications can make the pill less effective or potentially unsafe, such as:

• epilepsy medications
• tuberculosis medications
• HIV medications
• hepatitis C medications
• medications to treat other infections
• medications for treating increased blood pressure in the lungs
• St John’s wort

The contraceptive pill and blood clots

The combined pill contains oestrogen, so there is a slightly increased chance of blood clots, affecting up to 1 in 1,000 people. A doctor will check if you are more likely to get a blood clot while taking the pill, which can cause:

• deep vein thrombosis (DVT)
• heart attack
• stroke
• pulmonary embolism

You can find out more about blood clots and the contraceptive pill in our guide.

Combined pill and cancer

The combined pill can slightly raise your chance of getting breast or cervical cancer, although this returns to normal 10 years after you stop taking it. However, the combined pill may lower the chance of womb, ovarian, and bowel cancer.

The contraceptive pill is not the only method of contraception available. So, if the pill is not right for you or you’d prefer a non-hormonal type of contraception, here are some of the available alternatives:

Hormonal contraception

The following methods are alternative hormonal contraceptives to the pill:

1. The patch – The hormonal patch contains synthetic versions of oestrogen and progesterone, just like the combined pill. It is a small, square patch worn on the skin that delivers hormones into the bloodstream. When used correctly, the patch is more than 99% effective.
2. Vaginal ring – The vaginal ring is inserted directly inside the vagina and delivers oestrogen and progesterone, similar to the combined pill. It does not interfere with sex and is typically worn for 3 weeks before being removed for 1 week.
3. The injection – The injection contains progesterone and lasts for 8 or 13 weeks, depending on the type you are given. A healthcare professional will need to inject it for you, but Sayana Press can be injected by yourself at home after you have been shown how. The contraceptive injection is more than 99% effective when it is used correctly.
4. Intrauterine system (IUS) – Also known as the hormonal coil, the IUS is a small, T-shaped plastic device that is inserted into the womb by a doctor or nurse. It releases progesterone to stop you from getting pregnant. The IUS lasts for 3 to 8 years depending on the type, and is more than 99% effective.
5. The implant – The implant is a small, thin, flexible rod, placed under the skin of your upper arm by a doctor or nurse and steadily releases progesterone to stop you getting pregnant. It lasts for 3 years before needing replacement and is over 99% effective.

Non-hormonal contraception

If hormonal contraception is not for you or you would prefer not to use a contraception that contains artificial hormones, then there are several non-hormonal methods available, including:

1. Male condoms – Male condoms are worn on the penis and act like a barrier to stop sperm from entering the vagina and fertilising an egg. They are an affordable and effective contraceptive method and also protect against sexually transmitted infections (STIs).
2. Female condoms – These are also known as internal condoms because they are inserted inside the vagina before sex. They stop pregnancy by creating a barrier between sperm and the cervix.
3. Diaphragms and caps – The diaphragm is a soft, latex-free dome that is inserted inside the vagina to stop sperm from entering the cervix. Diaphragms and caps should be used with a spermicide for effective protection against pregnancy.
4. Intrauterine device (IUD) – Also known as the copper coil, the IUD is similar to the IUS because it is inserted through the vagina into the womb, but instead of releasing hormones, it releases copper to prevent pregnancy. Copper makes it difficult for sperm to reach an egg.

You can request the contraceptive pill online from reputable online doctor services, like Asda Online Doctor. Our doctors will assess your suitability by reviewing your answers to the health and lifestyle questions in our online consultation.

If approved, a prescription will be issued and your contraceptive pill will be delivered to your home address in discreet packaging. Alternatively, you can choose to collect it from your local Asda Pharmacy.

Can I switch to a different type of contraceptive pill?

Yes, it is possible to switch to a different type of contraceptive pill. If you are switching from one combined pill to another, you should start the new type the day after your last pill, if you take a 21-day pill and miss or take a 7-day pill break, or the day after your last active pill if you take a 28-day pill. So, you will skip your 7 inactive pills and start your new combined pill instead.

You can switch from one mini pill to another whenever you want to. You should stop taking your current pill and then continue with the new one at the same time each day. There is no need to have a break or finish your current pill strip before you switch.

If you are switching from the combined pill to the mini pill, you can start the mini pill the day after you finish your current strip of combined pills.

To switch from the mini pill to the combined pill, you can start the new combined pill at any time, but you will need to use another method of contraception, like condoms, for 7 days.

Can the contraceptive pill help with acne?

Yes, certain types of the combined pill may improve the appearance of acne because they regulate your hormone levels, especially androgens (male hormones), which contribute to breakouts.

Some combined pills work better than others for acne, such as those that contain drospirenone, like Lucette and Yasmin. While some, like Cilique, which contains norgestimate, may cause acne as a side effect.

Can the contraceptive pill stop periods?

Yes, the contraceptive pill stops normal periods, though you may still have a withdrawal bleed, which is like a period. For some people, bleeding stops altogether, while others get lighter or heavier bleeds, or spotting.

It is possible to delay your period (pill-free break bleed) with the combined pill by taking 2 strips back to back without a break. The combined pill can also help with painful periods, while both the combined pill and mini pill can relieve heavy periods.

Can I get pregnant on the contraceptive pill?

Yes, you can get pregnant on the contraceptive pill, but if it is taken correctly, it is more than 99% effective. The chance of pregnancy increases if you miss the pill, if you have vomited, or if you have diarrhoea shortly after taking the pill. Some medications, like anti-epileptic drugs and certain antibiotics, can interfere with how well the pill works.