Contraceptive pills: frequently asked questions

Your questions answered

How does the pill work?

The pill works by stopping ovulation, meaning that your ovaries won’t release an egg each month so hence fertilisation cannot take place. Aside from this, the hormones in the pill also cause the mucus surrounding the cervix to thicken and thin the lining of the womb. These actions prevent sperm from entering through the vagina and stops an egg from implanting itself into the wall of the womb should fertilisation occur. 

Is the pill effective?

The pill is a very reliable method of contraception. It’s over 99% effective when it’s used properly—forgetting to take it, starting it late or having sickness and diarrhoea can make it less effective. 

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Is the pill safe? 

The pill is generally safe to take if you are in good health without any underlying conditions which can increase your risk of experiencing high blood pressure or blood clots. Before prescribing it to you, your doctor will assess your medical history to make sure it’s suitable for you. They will also measure your blood pressure to check it’s at a healthy level. You will usually need to have your blood pressure checked regularly, at least once a year, while you are taking the pill. 

When was the pill introduced?

The pill was made available as a contraceptive in 1961. Its release was groundbreaking at the time and allowed women to take control over their sex lives.

When is the pill not effective?

The pill can become ineffective if you forget to take it, vomit after taking it or if you are prescribed certain types of medications. The herbal remedy St. John’s wort also interferes with the way the pill works.

What does the pill do to your body?

The pill basically overrides your natural menstrual cycle to stop you from ovulating. This means you will have an artificial cycle while you are taking the pill, resulting in a lighter monthly bleed. When you take the pill, it releases artificial versions of estrogen and progesterone, which can cause side effects. These commonly include: 

  • Nausea
  • Headaches
  • Abdominal pain 
  • Weight gain
  • Mood changes
  • Breast pain and tenderness 

It is also common to experience breakthrough bleeding at first. This is where you bleed continuously between periods. This stops after the first month or two, and the other side effects tend to ease off after your body gets used with the additional hormones. 

Will the pill stop my periods?

The pill overrides your natural cycle and stops you from ovulating. You will still have a monthly bleed similar to your period, but it will be lighter. 

Will I still be protected against pregnancy during the pill-free week? 

If you have taken your pills correctly for the first three weeks of your cycle, you will still be protected against pregnancy during the break between pill packs. Make sure you start the next pack on time, even if you are still bleeding. 

Will the pill protect me from STIs?

No, taking the pill alone will not protect you from sexually transmitted infections, only condoms can do this. It’s always recommended to use a condom with a new partner, or if you have multiple partners.

Who can take the pill?

There are certain circumstances that prevent you from being able to take the pill. These are: 

  • Pregnancy 
  • Being very overweight 
  • Smoking over the age of 35
  • A history of blood clots
  • A history of breast cancer 
  • Ever having had a heart attack, stroke or angina
  • Heart disease 
  • High blood pressure
  • Diabetes with complications 
  • Liver or gallbladder disease 
  • Migraines with aura (visual disturbances) 

If none of these apply to you, then the pill is safe for you to take. 

 

When should the pill be taken?

The combined pill is taken every day for 21 days, and then you have a 7-day break before starting the next pack. You can take it at any time during the day as long as you stick to the same time each day.

How do I start the pill?

You should start taking the pill on the first day of your period. If you’re unable to do so, you can take it later in your cycle, but you won’t be protected against pregnancy for the first seven days.

 

What do I do if I miss a pill?

If you miss a pill, take it as soon as you remember. This might mean you have to take two at once, which is fine. You should also use an additional barrier method of contraception in the following 7 days. If you have less than 7 pills left in your pack, skip the pill-free week and begin the next pack right away. If you’ve missed more than one pill and have had sex in the days leading up to this, see your doctor or pharmacist right away to access emergency contraception. 

What happens if I take my pill late?

If you take your pill later than usual then it’s not usually anything to worry about. It’s not considered a missed pill until it’s been 24 hours since you were due to take it. However, if you are taking the mini pill, it must be taken within a 3-12 hour window otherwise you won’t be protected against pregnancy. Follow the steps for a missed pill in this circumstance. 

What should I do if I vomit while on the pill?

If you vomit in the 3-4 hours after taking the pill, take another one as soon as you can. You can then keep taking the rest of your pills as usual. If you keep vomiting, treat it as a missed pill. 

How soon can I use the pill after having a baby?

You will need to wait at least three weeks after giving birth before starting the combined pill. After childbirth, you are at an increased risk of blood clots so your doctor will check this out before prescribing it to you. If you are breastfeeding, you’ll need to wait for six weeks. If you would prefer the mini pill, you can start using it at any time. 

How can I change pills?

Lots of women try different types of the pill before finding one that works for them. If you are currently taking a form of the combined pill, wait until you reach the end of the pack and begin your new pill the next day. When swapping from the mini pill, you can do this at any time. Stop taking the mini pill and start your new one right away but ensure you use an additional form of contraception for the first seven days. 

How long can I take the pill for?

If you are healthy and the pill is not causing adverse effects, then you can take the pill for as long as you need to.

Can the pill make you depressed?

Altered moods, including depression, are a possible side effect of taking the pill. Not all women who take the pill will experience this, and if you have previously suffered from depression, you may be at a higher risk. Speak to a doctor if feelings of depression persist for two weeks or more.

 

Can the pill make your skin worse?

The combined pill can help to reduce the appearance of acne. However, the progesterone-only pill can cause acne or make it worse.

Why does the pill cause weight gain?

Weight gain only affects some women who take the pill. This can happen due to the increased intake of estrogen, which can cause fluid retention or increase your appetite. Weight gain caused by fluid retention is temporary and tends to disappear after a month or two.

Will the pill affect my sex drive?

Some women find that taking the pill affects their sex drive. In most cases, it will lower it, but for some women, it may increase. 

What are the risks of taking the pill?

Taking the combined pill increases your risk of a blood clot. This, in turn, can trigger a stroke or heart attack. There is also a possible link between the pill and breast cancer. 

Will the pill affect my fertility?

The pill does not have a long term effect on your fertility. As soon as you stop taking the pill, your fertility will return.

Will the pill still work if I’m taking antibiotics?

In most cases, the pill will still work if you are taking antibiotics. However, two types of antibiotics can stop the pill from working. These are Rifampicin and Rifabutin which are used to treat tuberculosis, Legionnaires disease and meningitis. 

Can I smoke if I’m taking the pill? 

It’s not recommended to smoke if you take the pill. Smoking can increase your risk of high blood pressure, blood clots, heart attacks and strokes. This means that the increased risk of blood clots with taking the pill is further heightened. 

If I miss my period while I’m on the pill, does this mean I’m pregnant?

It’s very unlikely that you will become pregnant while taking the pill. If you have taken your pills correctly and don’t have your period during the pill-free week, this does not mean you are pregnant. If you miss two periods in a row, then you should see your GP just in case. 

Which contraceptive pill is best for me?

There are two types of contraceptive pill: the combined pill and the mini pill. The combined pill is suitable for women in good health and is not recommended for those with high blood pressure, a history of cancer or heart problems or women over 35 who smoke. The mini pill contains only progesterone and is safe for most women to take. Take a look at this infographic for more information.

Which contraceptive pill is best for acne?

The combined contraceptive pill can also help to treat acne by regulating the hormones which create excess oils (sebum) in the skin’s surface. The mini-pill does not help acne and can sometimes make it worse.

What’s the difference between the combined pill and the mini pill? 

The combined pill is a combination of both oestrogen and progesterone hormones. The mini-pill is also known as the progesterone-only pill as it only contains the progesterone hormone, and it doesn’t pose the same health risks as the combined pill. 

How soon can I get pregnant after coming off the pill?

After you stop taking the pill, you can get pregnant at any time as your fertility returns right away. It can take a couple of months for your natural menstrual cycle to return so you may find it takes several months of trying for a baby before you get pregnant. 

Can I use the pill as emergency contraception? 

The pill cannot be used as emergency contraception. If you have had unprotected sex, you will need to take the morning-after pill or have an IUD fitted. 

What other types of contraception are there? 

There are many other forms of birth control available. The vaginal ring and patch both work in the same way as the combined pill. Diaphragms, sponges, caps and condoms are all non-hormonal barrier methods of contraception. Condoms also protect against STIs. Long term reversible contraceptives include the injection, implant and IUD and IUS. 

Will the pill regulate my periods?

The combined pill does regulate your period. After you reach the end of a pill pack, you’ll have a 7-day gap before starting the next one which is when you have your monthly bleed. The mini pill works slightly differently. It can cause irregular periods, and for some women, their periods stop altogether. 

Will the pill help with period pain?

Another benefit of the pill is that it does help to ease period pain. Because the womb lining is thinner, the muscles don’t have to contract as much to shed the lining and allow it to leave the body as a period.

Can I delay my period by taking the pill? 

You can delay your period by skipping the 7-day break between pill packs. This means you won’t have a period for an additional 21 days. It’s not recommended to do this for more than one month in a row.

Does the pill help endometriosis? 

The pill is one of the first treatments given for endometriosis. It helps to manage the condition by controlling your menstrual cycle, stopping excess endometrial tissue from growing outside of the womb. You’ll usually take the pill continuously for 3-4 months at a time in this situation.

What are the advantages of the pill?

Aside from preventing unwanted pregnancy, the advantages of taking the pill include: 

  • Lighter periods
  • Regular periods
  • Lack of PMS and period pain
  • Reduces acne 
  • Doesn’t interrupt sex
  • It may reduce the risk of ovarian or womb cancer
  • It helps to control endometriosis 
  • It can help to prevent pelvic inflammatory infections 

What are the disadvantages of the pill?

The disadvantages of taking the pill include: 

  • Unpleasant side effects
  • Remembering to take it every day
  • Increased risk of high blood pressure
  • Increased risk of blood clots
  • Protection may be reduced if you throw up

 

Can I take the pill if I’m under 16?

The pill is available for adolescents under 16. The nurse will need to ensure you understand how the pill works and that you are not in danger of being abused or harmed. They will not tell your parents unless they think there is a risk of you being harmed, or harming yourself. 

 

Where can I get the pill?

You can get the pill from a GP, sexual health clinic or family planning clinic. You can also order online with Dr Felix where we stock all available brands within the UK. 

View our full range of contraceptive pills.

Sources: 

NHS > The Combined Pill
NHS > When Can I Use Contraception After Having a Baby?
The Healthline > Birth Control and Weight Gain: What You Need to Know
The Independent > Popping the Pill
 

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