WHAT IS THE COMBINED PILL?
The combined pill is usually just called the pill. It contains 2 hormones, oestrogen and progestogen. These are similar to the natural hormones that women produce in their ovaries. There are a number of different combined pills.
HOW EFFECTIVE IS THE PILL?
If you take the pill according to instruction it is over 99% effective. This means that less than 1 woman in 100 will get pregnant in a year. If the pill is not taken according to instructions more women will become pregnant.
HOW DOES IT WORK?
The main way in which the pill works is stop the ovary from producing an egg every month (ovulation).It will also thicken the mucus from the cervix . This makes it difficult for sperm to move through and reach an egg. It also makes the lining of your womb thinner so that it is less likely to accept a fertilised egg.
CAN ANYONE USE THE PILL?
Most women can use it but not everybody. It may not be used if
- you think that you are already pregnant
- if you smoke and are over 35
- if you take certain medicines
- if you have now, or had in the past blood clots in a vein or artery
- if you have a heart abnormality or circulatory disease including raised blood pressure
- very severe migraines or migraines with aura
- breast cancer
- active disease of the liver or gall bladder
- diabetes with complications
If you are healthy, don’t smoke and there are no medical reasons for you not to take the pill, you can take it until your menopause. At the age of 50, if you are still having periods, you may be advised to change your method of contraception.
WHAT ARE THE ADVANTAGES OF THE PILL?
- It does not interrupt sex!
- It makes your bleeds regular,lighter and less painful.
- It may help with pre-menstrual symptoms
- It reduces the risk of cancer of the ovary, womb and colon
- It may protect against pelvic inflammatory disease
- It may reduce your risk of fibroids, ovarian cysts, and breast disease that is not cancer.
WHAT ARE THE DISADVANTAGES OF THE PILL?
- You may get temporary side effects at first including headamches, nausea, breast tenderness and mood changes. If these do not stop within a few months changing the type of pill may help. most of these are in the nuisance bracket and will pass.
- The pill may increase your blood pressure.
- The pill does not protect you against sexually transmitted disease or infections so you may need to use condoms as well.
- Breakthrough bleeding ( unexpected bleeding on pill taking days) and spotting is common in the first few months of the pill use.
WILL I PUT ON WEIGHT IF I TAKE THE PILL?
No. Some women find that weight changes throughout the cycle due to fluid retention.
ARE THERE ANY RISKS?
For most women the benefits of the pill far outweigh the possible risks but these should all be discussed with your medical advisor. Essentially if you ever had a thrombosis or clot you should not take the pill. The risk of vein clot is greatest during the first year if any of the following apply to you:
- if you are very overweight.
- immobile for a long period of time or use a wheelchair.
- have severe varicose veins or a member of your immediate family had a veinous thrombosis before they were 45.
The risk of arterial clot is greatest if any of the following apply to you:
- if you smoke or are diabetic.
- have high blood pressure.
- are very overweight.
- have migraine with an aura.
- a member of your immediate family had a heart attack or stroke before they were 45.
Research about the risk of breast cancer and hormonal contraception is complex and contradictory. Currently research suggests that women who use hormonal contraception appear to have a small increases in risk of breast cancer compared to those who didn’t use hormonal contraceptives. However this should be all balanced by the medical advantages above, including cancer.
Research suggests that there is a small increase in the risk of developing cervical cancer if the pill is used continuously for more than 5 years. See a doctor straight away if you have any of the following:
- sudden problem with your speech or eyesight.
- unusual headaches or migraines that are worse than usual.
- a bad fainting attack.
- severe stomach pains.
- a weakness, numbness or bad pins and needles.
- painful swelling in your legs.
- coughing up blood and breathlessness.
- pain in the chest including any sharp pain which is worse when you breath in.
HOW DO I START THE FIRST PACK OF PILL?
If you start the pill on the first day of your period you will be protected from pregnancy immediately. You may also start the pill up to and including the fifth day of your period and you will be protected from pregnancy immediately. You can start the pill 3 weeks (21 days) after having a baby and will be protected straight away. If you start later than 28 days after baby you need to use an extra method of contraception for 7 days.
HOW IMPORTANT IS IT THAT YOU TAKE THE PILL AT THE SAME TIME?
It is very important that you take the pill as per the instructions. You should not take your pill more than 24 hours later than your chosen time. Make your regular time a habit in taking it.
AM I PROTECTED FROM PREGNANCY DURING THE 7 DAY BREAK OR THE PALCEBO WEEK?
Yes. You are protected if you have taken all the pills correctly and you start the next packet on time and if nothing else has happened that might make the pill less effective.
WHAT DO I DO IF I FORGET TO START THE NEXT PACKET ON TIME?
This may make the pill less effective. The chance of pregnancy after missing a pill depends on when pills are missed and how many pills are missed. Missing one pill anywhere in your pack or starting a new pack one day late is not a problem. Depending on which type of pill you take missing more than 1 pill or starting the pack more than 1 day late may affect your contraceptive cover.
WHAT ABOUT TAKING OTHER MEDICINE?
With the common antibiotics, continue taking your pill as usual and use another method of contraception such as condoms while taking the antibiotics and for 7 days afterwards.