The Pill (combined oral contraceptive pill)
The combined oral contraceptive, commonly referred to as the Pill, contains two artificial hormones - oestrogen and progestogen - these are similar to the hormones naturally produced by women. It is taken to prevent pregnancy.
There are many types of the Pill available; however, they all come in a 28 day packet, most with 21 hormone pills and 7sugar (placebo) pills. During these 7days, the lining of the uterus comes away and there is a withdrawal bleed, which is like a period.
How does the Pill work?
The Pill works by:
- stopping the release of an egg by the ovary (ovulation)
- making the mucus (sticky fluid) at the opening of the uterus thicker so sperm can't get through
- changing the lining of the uterus so a fertilised egg can't take hold
How effective is the Pill?
The Pill is about 99% effective if used correctly.
How do I get the Pill?
The Pill is available on prescription, which can be obtained from your doctor, SHine SA clinics, Women's Community Health clinics or The Second Story youth health service.
How do I take the Pill?
It is best to begin taking the Pill within the first five days of your period starting, so that pregnancy protection is immediate. Each pill in the packet is labelled with a day of the week. Take one of the hormone pills that comes immediately after the sugar pills. This pill should match the day of the week you start taking it.
If you start after the first five days of your period you need to use other forms of contraception for seven days before you will be protected.
Take the remaining hormone pills daily before taking the sugar pills. While taking the sugar pills you should get a withdrawal bleed. After you have finished taking the sugar pills you should start taking the hormone pills in your next packet.
If you skip the sugar pills and take the hormone pills continuously you should not get a bleed.
Tips for good Pill taking
- Take the Pill every day at a time that’s easy to remember.
- If you forget your pill you can take it up to 24 hours from the usual time to remain safe, but it may cause irregular bleeding. See Missed pills for instructions.
- Keep a spare pill packet with you in case you need it.
- If you have any side effects, including irregular bleeding, continue to take the Pill. If it hasn’t settled in 2–3 months get advice from your doctor or SHine SA.
- Do not stop taking the Pill unless you want to get pregnant.
When is the Pill not effective?
The Pill may not be effective if:
- two or more pills are missed (i.e. more than 48 hours since the last pill was taken)
- vomiting occurs within two hours of taking the hormone pill
- you have very severe diarrhoea
See the leaflet below for further information about missed pills.
Always check with your doctor or the Sexual Healthline if you are taking other medications (e.g. some antibiotics). This can also include herbal medicines like St John's Wort. You may need to use other protection while taking the medication and for some time after.
What are the benefits of taking the Pill?
- Periods become more regular, shorter, lighter and less painful.
- The timing of bleeding can be controlled.
- The Pill can reduce the chance of cancer of the uterus and ovaries, benign breast disease, endometriosis and ovarian cysts.
- The Pill usually improves acne.
- It’s easily reversible. The majority of women can become pregnant within six months of stopping the Pill.
What are the possible side effects?
The current low dose Pill has few side effects. You may notice:
- irregular bleeding
- headaches (more than normal)
- an increase in appetite (eating more means you will put on weight)
- nausea (feeling sick) – try taking the Pill with food or in the evening
- sore breasts (supportive bra can help)
- changes in mood, including feeling depressed
Continue taking the pills. Most side effects settle after 2–3 months of taking the Pill. If they persist, see your doctor or SHine SA clinic as a change of the type of Pill may help.
Who should not take the Pill?
The Pill is safe for most women. In particular, the risks of taking the Pill are less than the risks of being pregnant.
The Pill is not suitable for women who:
- have had a stroke, heart attack, blood clot or high blood pressure
- have certain types of migraine, diabetes or liver disease
- are over 35 years and smoke
- are extremely overweight
The Pill does not protect against sexually transmitted infections (STIs). Practise safer sex. Condoms reduce the risk of STIs.
For more information...
Further information is available in The Pill leaflet.