What is the Best Contraceptive Pill for Me?

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 18 Jul 2023

The contraceptive pill can be an effective and convenient way to protect yourself from unwanted pregnancy. It’s important to use at least one reliable form of contraception if you’re sexually active and don’t want to get pregnant.

Still, when it comes to picking the best contraceptive pill for you, there’s an overwhelming number to choose from on the UK market. It’s not always clear how to pick a pill that will suit you, and that’s what we’re here to try and help with.

As an established and highly-rated online doctor service, ZAVA can give you a rundown of the pills you can pick from and why you might choose one over the others. Our advice is always checked by our in-house doctor team, so you can trust that what we’re telling you is clinically accurate.

Contents
Blister of the best and most prescribed contraceptive pill brands
 

Let's find the best contraceptive pill for you

If you’re here, then you probably have some idea that not all pills are a good fit for everyone. You could pick at random, using trial and error to find the right one for you, but that can be frustrating and time-consuming. Instead, doing a bit of research can narrow down your options and give you the best chance of choosing a winner.

It may help to see what other people in the UK have chosen in the past. Here’s a graph showing which contraceptive pills were bought most often in the UK in 2015.

bar chart with the leading contraceptive pills prescribed in England in 2015: Microgynon 30, Desogestrel 75mcg, Rigevidon, Cerazette 75mcg, Cerelle 75mcg.

So what should you consider when making your choice? Well, there are a few different factors that can make a contraceptive pill more or less suitable. Keep in mind the following questions when choosing a pill:

  • whether they are safe for someone with your medical history (see the rest of this section for details)
  • how good you are at remembering to take pills every day at the same time (see our section on ‘mini pill vs combined pill’ for details)
  • whether or not you want to take your pill continuously (see our section on ‘mini pill vs combined pill’ for details)

Oestrogen restrictions

Based on your current and previous medical history, some pills may not be safe for you to take. For example, pills containing oestrogen, also known as combined pills, may not be right for you if you:

  • are over 35 and a smoker
  • have high blood pressure
  • have a history of blood clots
  • have migraines with an aura
  • have a history of heart problems
  • are overweight
  • are breastfeeding

If any of the above apply to you, then your best choice might be one of the mini pills that are available. These don’t have oestrogen in so the health risks listed above don’t apply.

Extra benefits of oestrogen

On the other hand, if you don’t have any of the pre-existing conditions listed above, but you do get:

  • premenstrual syndrome
  • polycystic ovary syndrome
  • acne
  • heavy periods
  • endometriosis

Then, you might find a combined pill is a better choice because in these cases the oestrogen can actually improve your symptoms.

The pill after giving birth

Also, if you’re currently breastfeeding and it’s been less than 6 weeks since you gave birth, then combined pills may not be a suitable option, but mini pills are. This is because the oestrogen in the combined pill can come through in breast milk and affect your baby. Small amounts of progesterone do come through breast milk on the mini pill but this won’t affect your baby’s development.

Remember that a doctor, nurse or online doctor service like ZAVA can help you pick the best pill for you. They will ask about your health and lifestyle to suggest a pill they believe will be a good fit.

How does the contraceptive pill work?

Combined pills and mini pills work slightly differently, but they both include man-made hormones that make it much less likely you’ll have an unwanted pregnancy. This is done by making changes to your body which make it harder for sperm to reach an egg or harder for a fertilised egg to grow.

Combined pills work by:

  • stopping ovaries from releasing eggs
  • thickening the mucus at the neck of the womb
  • thinning the lining of the womb

Mini pills work by:

  • stopping ovaries from releasing eggs, but not always
  • thickening mucus at the neck of the womb
  • thinning the lining of the womb
  • slowing down eggs travelling to the womb

Mini pill vs Сombined pill

Since both the mini and combined pills are effective it can be tricky to know which ones to go for. The table shows how they compare to one another.

Mini pill Combined pill
Hormones?

Just progesterone

Both oestrogen and progesterone

Chance of side effects?

Higher for progesterone-only ones

Higher for oestrogen-related ones

Taken continuously?

Yes

Can be, but usually aren’t

Extra restrictions?

No

Yes, for people with certain health conditions

Extra added benefits?

No

Yes, for acne and period-related problems

Available over the counter?

Only Hana and Lovima

No

OK while breastfeeding?

Yes

Yes, but not for 6 weeks after giving birth

Is the mini pill for you?

There are a few reasons why you might pick the mini pill over the combined pill, including:

  • you have a health condition that makes the combined pill unsafe for you
  • you want to avoid oestrogen-related side effects
  • you want to get your pill over-the-counter
  • you are currently breastfeeding and it’s been less than 6 weeks since you gave birth

If you’re taking one of the mini pills Cerazette, Cerelle, Hana or Desomono then you only have a 12-hour window for taking your pill before it stops working. Other mini pills only have a 3-hour window before they stop working.

If you want a bigger window of opportunity to take your pill each day, you should think of starting a combined pill. If combined pills aren’t right for you because of your medical history, then go for Cerazette or Cerelle instead. See our page on forgetting the pill for more information.

Mini pills are meant to be taken continuously. They are prescribed for non-stop use, and this is how they are suggested to be used by their manufacturers.

Is the combined contraceptive pill for you?

The reasons you might choose the combined pill over the mini pill include:

  • it gives extra benefits to acne and period-related health conditions
  • it has a bigger window of opportunity for taking your pill, in case you’re prone to forgetting
  • you want to avoid progesterone-only side effects

Combined pills can keep working even if you’re up to 24 hours late taking a dose every now and then. Although, they will stop working if you miss too many in a row.

Combined pills are usually taken for 3 weeks straight and then you take a week off and have a breakthrough bleed, a bit like a normal period. Some combined pills even come with a week of medication-free pills for you to take so you can keep track easier.

You can take combined pills continuously, but this is usually considered ‘off licence’. But, the evidence shows that it’s just as safe to take combined pills without stopping.

Dr Babak Ashrafi, Clinical Lead for Service Expansion at ZAVA.

Not only is taking the combined pill continuously as safe and effective as taking it with the 7-day break, there is a significant improvement to menstrual bleeding. Research shows an average of 10.7 fewer bleeding days in the first 3 months when taking the combined pill continuously.

What is the best contraceptive pill for anxiety and depression?

All combined pills are less likely to affect depression and anxiety because of the oestrogen they contain. Avoid mini pills if you can.

Both the oestrogen and progesterone combination in combined pills and the progesterone alone in mini pills can cause side effects related to depression and anxiety. So, for those who are prone to mental health issues, to completely avoid any risk of mood swings, depression or anxiety as a side effect you would have to choose a non-hormonal contraceptive.

But, if you want to use a contraceptive pill and want to know what will give you the lowest chance of causing depression and anxiety or making them worse, then the best choice is probably a combined pill.

Research shows that the oestrogen in the combined pill might offset some of the mental health side effects caused by progesterone. So, progesterone-only contraceptives like the mini pill are more likely to make depression or anxiety worse.

Dr Babak Ashrafi, Clinical Lead for Service Expansion at ZAVA.

What is the best pill for mood swings?

Like with depression and anxiety, all combined pills are less likely to cause mood swings because of the oestrogen they contain. Avoid mini pills if you can.

Research shows that combined pills with anti-androgenic progesterones (drospirenone or desogestrel) can help make mood swing side effects less intensive. Pills with these progesterones in include:

What is the best contraceptive pill for acne in the UK?

The best pills for acne are combined pills. Progesterone-only mini pills can make acne worse. Combined pills can improve acne because of the oestrogen they contain so high-oestrogen pills may give the biggest improvement, like:

Like with mood swings, acne is more likely when taking progesterone alone. This means that it’s best to avoid mini pills if you have acne or you’re worried about getting it. In fact, not only is acne less likely as a side effect of the combined pill, it can actually be improved by taking it.

➤ See our page on the contraceptive pill and acne for more information.

What is the best contraceptive pill for weight loss?

No contraceptive pills cause weight loss. Contraceptive pills can’t help people lose weight, no matter which hormones they have or what the dose is. Some contraceptive pills cause temporary mild weight gain as a side effect, but this will only last while you’re using them. This is because the hormones in the pill can cause you to retain water.

Since the water retention is caused by oestrogen, especially with low progesterone, the best way to avoid water retention is a low-oestrogen pill or mini pill. Yasmin and Eloine can also be good choices for avoiding water retention since their progesterone, drospirenone, acts as a diuretic, meaning it helps you lose the extra water through peeing.

➤ See our page on the contraceptive pill and weight gain for more information.

What is the best contraceptive pill for over 40s

The best pills for people aged 50 to 55 are mini pills. The mini pill also has a lower risk of blood clots which can be more likely for women over 40.

All combined and mini pills can be safe for people over 40, as long as they don’t have pre-existing conditions that make them unsafe (see our section ‘let's find the best contraceptive pill for you’ for details). The combined pill is not suitable for people over 50 and the mini pill is not right for anyone over 55.

Combined pills also come with some extra benefits during perimenopause. See the section below on ‘the best contraceptive pill during perimenopause’ for details.

What is the best contraceptive pill during perimenopause?

The best pills for perimenopause can be high-oestrogen combined pills, because they have some added benefits for women over 40, especially related to perimenopause:

  • Norinyl-1, 50 micrograms
  • Logynon, 30 to 40 micrograms
  • TriRegol, 30 to 40 micrograms
  • Cilique, 35 micrograms
  • Lizinna, 35 micrograms
  • Synphase, 35 micrograms

The oestrogen in combined pills can help improve bone density and reduce hot flushes which can both be caused by perimenopause. Like with acne, high oestrogen pills might show the biggest improvement.

Be aware though, combined pills come with a slightly increased risk of blood clots and many older people already have an increased risk.

What is the best contraceptive pill if I have PMS or PMDD?

Premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) are conditions that cause a number of unpleasant symptoms at certain times during the period cycle. Some contraceptive pills can improve these symptoms for some people.

Since it’s oestrogen that can help with the symptoms of PMS and PMDD, the best choice of pill may be a combined pill. Combined pills with more oestrogen can have a stronger positive effect on PMS and PMDD symptoms but they also come with a higher risk of oestrogen-related side effects.

What is the best contraceptive pill for PCOS?

The combined pill containing both oestrogen and progesterone can help improve polycystic ovary syndrome (PCOS). The best kinds of combined pill for PCOS are ones with lower oestrogen doses and progesterones that are less likely to have an androgenic effect (increase in male hormones). Progesterones with less androgenic effect include those containing drospirenone or desogestrel, like:

  • Gedarel
  • Lucette
  • Marvelon
  • Mercilon
  • Yasmin

What is the best contraceptive pill for endometriosis?

There is some evidence showing that mini pills may be slightly better at improving endometriosis than combined pills. Unlike with PCOS, it seems like progesterone pills that are more androgenic (increase in male hormones) work best for improving endometriosis, including:

  • Levonorgestrel
  • Gestodene

So the best choice of pills for endometriosis will be mini pills containing one of the progesterones listed above, like Norgeston.

Or, if you want a combined pill then choose one that includes levonorgestrel, gestodene or desogestrel.

Which is the best contraceptive pill for heavy periods?

All contraceptive pills can improve heavy periods. This is because they all contain progesterone which thins the lining of the womb, making periods lighter.

Although you can take any pill to improve periods, the mini pill is usually the first choice. This is because the mini pill is taken continuously and so there is no need for a break period that can cause bleeding. Although combined pills can also be taken continuously, they usually aren’t. See the section on ‘mini pill vs combined pill’ for more information.

Contraceptive pill side effects and risks

All pills can cause side effects but they are mostly mild and go away after a while. Different pills have different oestrogens and progesterones and different people react differently to them.

It’s impossible to know how you will react to different hormones so the only way to find out is to try and see. If you do get side effects from one pill, a doctor or nurse can help you switch to a pill with different hormones to see if that helps.

If you want to avoid oestrogen-related side effects, like:

  • breast tenderness
  • nausea
  • headaches

Choose a mini pill like:

  • Cerazette
  • Cerelle
  • Hana
  • Norgeston
  • Noriday

Or a low-oestrogen combined pill, like:

  • Eloine
  • Femodette
  • Gedarel 20
  • Mercilon
  • Millinette 20
  • Sunya

Combined pills can have anywhere from 20 to 50 micrograms of oestrogen in but mini pills don’t have any. Low or no oestrogen pills come with a lower risk of oestrogen-related side effects but they also have less of the positive effects on acne or period-related health problems.

If you want to avoid progesterone-only side effects, like:

  • mood swings
  • acne

Choose any combined pill. Some side effects of progesterone are worse when progesterone is used by itself. This means that they are more likely in mini pills because the oestrogen in combined pills makes them less likely.

➤ For more information see our page on contraceptive pill side effects.

So which contraceptive pill is best for me?

The best contraceptive pill will be one that:

  1. is safe for you based on your medical history
  2. suits your lifestyle based on how strict your routine has to be and whether you want to take breaks
  3. matches up with what you expect in terms of extra benefits and side effects

For example, if you want a pill that will improve acne, you’re worried about gaining weight, and you don’t want a break in your cycle, then you could think about using Microgynon continuously. Microgynon has oestrogen which can improve acne, but it doesn’t have too much. Although mini pills are normally for continuous use, you can do this with Microgynon too.

Another example would be if you’re over 35 and smoke but you’re worried about forgetting your pill and you get heavy periods, Cerelle or Cerazette would be good choices. They are both suitable for women over 35 who smoke and although they have a smaller window of opportunity than combined pills, it’s still larger than other mini pills at 12 hours. Plus, mini pills can help with heavy periods, especially when taken continuously.

Frequently asked questions

Which contraceptive pill is best for skin?

In the same way that they improve acne, high-oestrogen combined pills can reduce your skin’s oiliness. This is because the oestrogen helps balance the androgenic effect of the progesterones that cause oily skin, which then also leads to acne.

What is the best contraceptive pill with the least side effects?

No one pill has the lowest risk of side effects. Different pills come with different possible side effects and affect people differently based on the hormones they contain.

Most pill side effects are mild and can go away on their own. If you’re worried about side effects before starting the pill, talk to a doctor.

Where can I get the contraceptive pill?

You can buy contraceptive pills from a doctor, nurses, sexual health clinics or an online doctor service like ZAVA. You can also get two mini pills over-the-counter in UK pharmacies; Hana and Lovima.

Ordering from ZAVA has a few advantages:

  • you can save time going online
  • you get your treatments deliver direct to you
  • there’s no need for a face-to-face appointment

How long does birth control take to work?

It depends what pill you’re taking. Some can work right away if you take them at the right time in your cycle. Others can take up to 7 days to start working effectively.

Is the pill the best contraceptive method?

The pill can be one of the most effective types of contraception when taken properly and can prevent over 99% of unwanted pregnancies. But since people don’t always take it properly it’s only around 91% to 92% effective when you look at everyone who uses it.

The pill is one of the most convenient forms of contraception since:

  • available over-the-counter in the UK
  • it doesn’t need to be implanted or removed like implants and coils
  • doesn’t require an injection like the contraceptive injection
  • doesn’t have to be used before sex, like condoms

Also, since it contains hormones it can have extra benefits over non-hormonal contraceptives.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 18 Jul 2023





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