Oral contraceptives

The Pill is one of the most reliable methods of contraception. If you take it as instructed, it gives you almost 100% protection against pregnancy. You can get the Pill (and all contraceptives) free from your doctor, family planning clinic or sexual health clinic. You will have a medical check up before you start to make sure it's right for you and you will be invited for further check-ups at regular intervals.

There are 2 main types of Pill, the combined Pill and the progestogen-only Pill (mini-pill).

The combined pill

Most women who take the Pill are on the combined Pill. It contains 2 hormones, an oestrogen and a progestogen which prevent your body from releasing an egg each month. It makes your periods more regular, reduces period pains and cramps and gives you lighter periods. Unlike some other methods of contraception, it's simple because all you have to do is take a pill once a day.

Although the combined Pill may not be suitable for a small minority of women with certain conditions, healthy non-smokers can take it right up to the menopause. Your doctor or nurse will take your full medical history before prescribing the Pill.

Some women may have side effects when they first start taking the Pill, but usually these subside after about 12 weeks. Side effects can include bleeding between periods, headaches and breast tenderness.

Rarely, a few women will suffer serious side effects, such as thrombosis, but this is very uncommon.

Some brands of combined Pill contain a higher dose of oestrogen. If you are on this type of pill and are suffering from side effects, it might be helpful to ask your doctor if you can switch to a low-dose oestrogen Pill. No one pill suits everyone so it is worth discussing different options with your doctor.

The Pill also has been proven to have important health benefits. For example it offers considerable protection against ovarian cancer and womb cancer.

How effective is the combined Pill compared to other methods?

The progestogen-only Pill (mini-Pill)

This version of the Pill contains only one hormone, a progestogen. It works in a different way from the combined Pill, by thickening the mucus at the entrance to the womb which makes it difficult for sperm to get through. It also changes the lining of the womb so that it will not accept a fertilised egg. In some women it also prevents ovulation.

You take one pill every day until all the pills in the pack are finished. Then you start a new pack the next day. This means taking pills during a period and no gap between packs. It's really important to take the progestogen-only Pill at the same time each day or it may not work. If you can't stick to this regime, then it's probably not the best type of contraception for you. The margin for error is around 3 hours with the older type and 12 hours with the newer progestogen-only pill.

Periods may be irregular, with some bleeding between periods, especially for the first few months. On the other hand, some women have no bleeding at all.

If you want to be certain every month that you are not pregnant and this type of pattern would worry you, the mini-Pill may not be the best option.

How effective is the progestogen-only Pill compared to other methods?