Contraceptive Pill

The contraceptive pill is a type of contraception used by women who do not want to get pregnant. They come as tablets and have hormones that cause changes in your body to help prevent pregnancy.

If used correctly, they’re over 99% effective at preventing pregnancy. People sometimes forget to take their pill or do not take it at the same time every day. This makes the pill less effective, and so you’re more likely to get pregnant.

Even if you do not take your pill perfectly, it’s more effective at preventing pregnancy than condoms and diaphragms. But it’s not as good as long-acting, reversible methods of contraception like the IUD (intrauterine device), IUS (intrauterine system), implant and injections. No contraceptive is 100% effective at preventing pregnancy.

It’s important to remember that contraceptive pills do not protect you against STIs (sexually transmitted infections). So, you should use extra protection, like a condom, if you have sex with someone and you do not know their sexual history.

The contraceptive pill works by releasing hormones into the body which causes some changes that help prevent pregnancy.

They work by:

• thickening the mucus at the entrance to the womb, making it harder for sperm to travel through and reach an egg
• thinning the lining of the womb so it’s harder for a fertilised egg to attach and grow into a baby (only some pills)
• stopping an egg from being released from an ovary (where eggs are produced) in the first place (only some pills)

There are a few different types of contraceptive pill.

• Combined pills: which come as monophasic 21-day pills (the most common type), phasic 21-day pills or every day pills
• Mini pills: the progesterone-only pill

Combined contraceptive pills contain two lab-made sex hormones, oestrogen and progesterone. These lab-made versions are like the natural hormones produced by your ovaries.

They usually come in packs of 21 pills and you take one pill every day for 21 days. When you finish a pack, you have a 7 day pill free break before starting the next pack.

You can also request the combined pill as a 28 day pack. With this kind, you take one pill every day for 28 days, but 7 of the days are dummy, inactive pills that don't contain any hormones. This type is called an everyday pill.

There are a few different ways you can take the combined pill. We recommend speaking to a doctor or nurse about which one might be best for you.

There are many different brands of the combined oral contraceptive pill. They are all very similar but contain different amounts and types of oestrogen and progesterone.

Combined pills include:

• Brevinor
• Cilest
• Cilique
• Femodene
• Gedarel
• Katya
• Levest
• Loestrin
• Logynon
• Lucette
• Marvelon
• Mercilon
• Microgynon
• Millinette
• Norimin
• Norinyl-1
• Ovranette
• Qlaira
• Rigevidon
• Sunya
• Synphase
• Triadene
• Triregol
• Yasmin

The mini pill is also known as the progesterone-only pill (POP). It’s different from combined pills because it does not contain oestrogen. It only contains one hormone: progesterone.

The mini pill works by thickening the mucus at the entrance to the womb. This makes it harder for sperm to travel through and reach an egg. Some mini pills contain a type of progesterone called desogestrel. This also helps prevent pregnancy by stopping your ovaries from releasing an egg (ovulation).

Packs usually come in multiples of 28 pills, and every pill in the pack contains the same amount of hormone.

Mini pills include:

• Cerelle
• Cerazette
• Norgeston
• Noriday

Phasic pills are a type of combined contraceptive pill. The amount of hormone in each pill in the pack changes during your cycle in phases.

There are a few types of phasic pill:

• Biphasic pills change your hormone level once during the pack. The biphasic we offer contains the same amount of oestrogen each day. Halfway through your cycle, the amount of progesterone is increased.
• Triphasic pills contain 3 different doses of hormones. About every 7 days, the hormone combination changes. But it depends on the brand whether the oestrogen and progesterone levels change. The pills are usually colour-coordinated, so you can tell which dose you’re taking.
• Quadraphasic pills are like triphasic ones. They just include 4 different dosage combinations instead of 3.

Because the hormone levels change throughout the pack with phasic pills, it’s important to take them in the correct order.

You can also get monophasic or non-phasic pills. Each pill has the same amount of oestrogen and progesterone. This means that your hormone levels stay the same throughout the pack.

Studies haven’t found any difference in side effects, bleeding patterns, or how well you’re protected against pregnancy between monophasic and phasic pills. Doctors usually prescribe monophasic pills first, rather than phasic pills.

Biphasic pills include:

• Synphase (biphasic)
• Triadene (triphasic)
• Logynon (triphasic)
• Triregol (triphasic)
• Qlaira (quadraphasic)

Low oestrogen pills are a type of combined contraceptive pill with a smaller amount of oestrogen in them.

Low oestrogen pills include:

• Sunya
• Millinette
• Loestrin 20
• Gedarel 20/150
• Mercilon

A lower dose of oestrogen may make it more likely for you to get breakthrough bleeding. But it can help you if you avoid oestrogen-related side effects of the pill, like:

• breast tenderness
• feeling sick (nausea)
• bloating
• fluid retention

Studies have shown that women who use a contraceptive pill with less than 30mg of oestrogen have a lower risk of blood clots in their lungs (pulmonary embolism). The risk of heart attack and stroke also seems to increase with higher doses of oestrogen.

The contraceptive patch works in a similar way to combined oral contraceptive pills. The patch sticks to your skin instead of being a tablet that you swallow. It releases hormones into your bloodstream via your skin.

Like the pill, the patch works by:

• stopping the ovaries from releasing eggs (ovulation)
• thickening the mucus at the entrance to the womb
• thinning the lining of the womb to make it harder for a fertilised egg to attach and grow into a baby

The contraceptive patch ZAVA offers is Evra. Side effects and risks of taking Evra are like the combined pill.

A doctor can help you choose a contraceptive pill that’s right for you. Everyone is different, so you might react differently to someone else taking the same pill. You might have to try different ones before finding one that works best.

It’s possible to switch your pill if you feel another brand would suit you better than your current pill. ZAVA can help if you want to switch between different combined pills or between the combined pill and the contraceptive patch.

If you’d like to switch between the combined pill or patch, and the mini pill, you should speak to your local GP or a nurse for more advice. We can also help by messaging you through your account. You’ll also find out how to change from one pill to another in both your new and old pill packets.

If there isn’t a contraceptive pill that suits you, there are still other types of contraception to choose from. Find out more about other kinds of contraceptives.

Common side effects of the combined contraceptive pill include:

• Headaches
• Mood swings
• Nausea
• Dizziness
• Low sex drive
• Sore or tender breasts
• Changes to your bleeding pattern, especially in the first 3 months

Common side effects of the progesterone only pill include:

• Changes to bleeding patterns
• Low sex drive
• Acne
• Headache
• Breast pain
• Nausea

Even though weight gain is listed as a potential side effect of both combined pills and mini pills, this is temporary and caused by water retention. Research doesn’t show that the pill causes permanent weight gain, or that the mini pill causes depression or mood changes.

Side effects can vary depending on the type and amounts of hormones used in each combined pill or mini pill, so you should always read the information leaflet that comes with your pill for more information on potential side effects.

There are some health risks linked to using contraceptive pills. They should be safe for you if you get your medication from a regulated service like ZAVA, a GP or sexual health clinic. They’ll check your medical history to make sure it’s right for you and recommend another choice if needed.

Cancer: there’s a small increased risk of breast and cervical cancer in women using combined pills compared to those who don’t. But 10 years after you stop taking the pill, your risk level goes back to normal. On the other hand, the combined pill can lower your risk of womb (uterus) cancer, ovarian cancer and bowel cancer.

A link between breast cancer and the mini pill has not been proven or disproven. If there’s a risk, it’s likely to be very small and disappear after a time once you stop taking it.

Blood clots: contraceptive pills that contain oestrogen can slightly increase your risk of blood clots if you’re already at risk of them. This risk is higher with some types of combined pills than others, depending on the type of progesterone hormone they contain.

Blood clots can cause:

• deep vein thrombosis (DVT): a blood clot in the leg
• pulmonary embolus: a blood clot in the lung
• stroke
• heart attack

Although the risk of developing a blood clot is small, your doctor will check to see if you have any specific risk factors that can make a clot more likely. Risk factors include if you:

• are over 35 and smoking (or if you have quit in the last year)
• are over 50
• are overweight
• have a history of migraines
• have high blood pressure
• have a close relative who has had a blood clot under the age of 45
• have had a blood clot, stroke, or heart attack before
• have a heart condition called atrial fibrillation or angina
• are immobile
• have a hereditary (inherited from your parents) blood clotting condition

The list above doesn’t include every risk factor out there. When starting or reordering contraceptives, you should always give your doctor or nurse information on any old or new medical conditions. You should also tell them about any medication you’re taking, including over the counter or herbal remedies. Some medication can react with your pill or patch, making it less effective or safe.