Your choices: a guide to contraception¹

The Pill

You've probably heard of the pill. It's been around since the 1960s and is still the most popular form of female contraception. Although there are lots of different sorts of pill with different associated benefits they can be grouped into two types: the combined oral contraceptive pill and the progestogen only pill (sometimes called the "mini-pill"). We'll explain the difference below.

The Combined Pill

What is it?

As its name suggests, the pill is a small tablet that you swallow. It contains two hormones: oestrogen and progestogen which are like hormones that occur naturally in your body. It's a highly effective contraceptive, but you need to make sure you follow the instructions on the packet very carefully because if you miss a pill you may not be fully protected and you could get pregnant.

Depending on the type of pill, it can also help you with other things like reducing the amount of spots you get, controlling cramps and fluid retention, so it's worth taking some time talking to your doctor or nurse to make sure that you get a contraceptive pill that works best for you and your lifestyle.

How does it work?

It works in three ways:

1. It stops you from producing an egg
2. It helps your body to form a barrier against sperm
3. It helps prevent any eggs that you may produce from settling in the womb

How effective is it?

The pill is more than 99% effective when used correctly. However a lot of women forget to take their pills or don't follow the instructions fully so you need to make sure you understand how to take the pill and take other precautions if you forget to take it.

Advantages

• Does not interrupt sex
• Can lead to lighter, less painful, regular bleeds
• Easily reversible if you want to get pregnant
• May protect against the risk of cancer of the ovary, colon and womb²
• Can help to reduce symptoms of premenstrual tension (PMT)
• Can reduce the risk of fibroids and ovarian cysts
• May help with acne

Disadvantages

You might get some side effects from the pill. These are usually temporary and will stop after a short time. These side effects can include:

• Headaches, feeling sick, breast tenderness and mood changes
• Breakthrough bleeding (unexpected bleeding on pill-taking days) and spotting
• In very rare cases some women may develop other problems, like developing blood clots

Can anyone use it?

The pill might not be suitable for all women and there may be reasons why you cannot take the pill, such as a history of blood clots or high blood pressure, severe circulatory disease or heart disease. You also shouldn't take the pill if you are breast feeding. Your doctor or healthcare professional will be able to assess your suitability and give you advice.

Progestogen-only pill (POP or mini-pill)

Unsurprisingly, the progestogen-only pill only has one hormone in it - progestogen, so if you can't take a pill that contains oestrogen this could be a good option. You take one pill at the same time each day without a break.

How does it work?

It works in three ways:

• It helps your body to form a barrier against sperm
• It may stop you from producing an egg
• It helps prevent any eggs that you may produce from settling in the womb

How effective is it?

The progestogen-only pill is more than 99% effective when used correctly. This means that fewer than one woman in 100 using this method for a year will get pregnant.  

Advantages

• Does not interrupt sex
• Suitable for breast feeding women
• Can be used if you are a smoker and over 35
• Easily reversible

Disadvantages

• Some women will get side-effects. These are usually temporary and go away after a short time, but can include:
  • Changes in periods (there can be a range of different changes)
  • Some women develop cysts on their ovaries - but these are very rarely serious and don't usually require any treatment
  • Can increase the chance of an ectopic pregnancy but this is still less common than if no contraception is used
  • Can decrease your sex drive
  • Can lead to breast tenderness and some weight gain
  • Can increase acne

Can anyone use it?

The progestogen-only pill may not be suitable for all women and there may be reasons why you cannot take the pill, such as if you've had a heart attack, liver disease, stroke or breast abnormality (including breast cancer within the last five years). You also shouldn't take the pill if think you might be pregnant. Your doctor or healthcare professional will be able to assess your suitability and give you advice.