The Pill (combined oral contraceptive pill)
The combined oral contraceptive, commonly referred to as the Pill, contains two artificial hormones (oestrogen and progestogen) similar to the hormones produced by the ovary. It is taken to prevent pregnancy.
There are many types of the Pill available; however, they all come in a 28 day packet, with 21 hormone pills and seven sugar (placebo) pills. During these seven days, 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 ovulation so no egg is released
- thickening the mucus (sticky fluid) at the cervix so sperm can't get through
- changing the uterine lining so a fertilised egg can't grow
How effective is the Pill?
The Pill is about 99% effective if used correctly.
What are the benefits of taking the Pill?
The Pill can be used to manage menstrual problems. Bleeding can become regular, shorter, lighter and less painful. The timing of bleeding can also be controlled.
The Pill can reduce the chance of cancer of the uterus and ovaries, benign breast disease, endometriosis and ovarian cysts. It can also improve 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 Pills have few side effects. However, if the balance of hormones is not correct for your body you may notice:
- headaches (more than normal)
- nausea (feeling sick)
- sore breasts
- acne
- changes in mood, including feeling depressed
- chloasma - brown patches on face (rare)
- increased vaginal discharge or thrush
If you experience any of these side effects discuss them with a doctor as a change of the type of Pill may help.
Who should not take the Pill?
The Pill is safe for most women. However, women who have had a blood clot, stroke, heart attack, bad migraine, liver disease, breast cancer, major surgery, active viral hepatitis or high blood pressure should not use the Pill. Also, women over 35 years who smoke and take the Pill are at higher risk of blood clots.
Where can I get the Pill?
The Pill is available on prescription and can be obtained from SHine SA clinics or your doctor.
How do I take the Pill?
It is best to take your first 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.
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. Although you can skip the sugar pills, many women prefer to have a monthly bleed.
If you do not want a bleed you can skip the sugar pills; however, it is recommended that women have a bleed every four months. After you have finished taking the sugar pills you should start your next packet.
When starting the Pill you may notice:
- bleeding or spotting while taking hormone pills
- slight increase in appetite or weight
- slight nausea (try taking the pill with food or in the
evening) - sore breasts
Continue taking the pills. These problems should settle. If not discuss with a doctor as a change of Pill may help.
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 the leaflet below for further instructions.
Take the Pill after eating to reduce the risk of nausea.
Keep a spare pill packet with you in case of emergency.
If irregular bleeding occurs continue to take the pill.
Get advice if needed.
Stop the Pill immediately if you have:
- severe and sudden unexplained pain in the chest
- severe headaches
- sudden blurred vision or loss of sight
- unexplained lower leg tenderness, pain or swelling
If you experience any of these symptoms contact your doctor or SHine SA for immediate attention.
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 three 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 medications, like antibiotics. You may need to use other protection while taking the medication and for some time after.
If the Pill is not effective you can take emergency contraception. It's best taken as soon as possible, but can be taken up to five days (120 hours) after unprotected sex. See a pharmacist, doctor or SHine SA clinic.
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 (PDF) leaflet.