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Contraception health centre

Which contraceptive pill is best for you?

By
WebMD Feature
Medically Reviewed by Dr Rob Hicks

The pill is one of the most popular forms of contraception in the UK.

However, choosing which pill is right for you can be a bit of a minefield. There are around 30 types currently available in the UK.

These can be split into two main types: the combined pill, which is usually just referred to as the pill, and the progestogen-only pill (POP), or mini pill.

Combined pills

Combined pills are the most common and combine the hormone oestrogen and a synthetic form of the hormone progestogen.

"The main way the pill works is to stop the ovaries from releasing an egg each month ( ovulation)," says Natika Halil from the Family Planning Association.

She says: "It also thickens the mucus from your cervix, which makes it difficult for sperm to move through it and reach an egg. And it makes the lining of your uterus (womb) thinner so it is less likely to accept a fertilised egg."

Most combined pills use the same form of oestrogen - ethinylestradiol - but different types of progestogens. The strength of the oestrogen and progestogen can vary too. Depending on how much oestrogen is in the product, the pill will be referred to as low strength or standard strength. When possible, a low-strength pill will be prescribed to help reduce the risks of possible side effects.

Most combined pills come in 21 or 28 day packs. With a 21-day pack, all of the pills are active. You don't take any pills for the last 7 days of the cycle. It's up to you to remember when to start the next pill pack. With a 28-day pack, you take 21 active pills followed by seven inactive placebo pills.

Combined pills are also available in three different phase-types: monophasic, biphasic and triphasic.

  • Monophasic: All of the 21 active pills contain the same level of hormones.
  • Biphasic: The 21 active pills contain two different doses of oestrogen and progestogen.
  • Triphasic: The 21 active pills contain three different doses of hormones. The dose changes every 7 days.

Advantages of the combined pill

  • Usually makes your bleeds regular, lighter and less painful
  • May help with premenstrual symptoms
  • Reduces the risk of cancer of the ovary, uterus and colon
  • Improves acne in some women
  • May reduce menopausal symptoms
  • May reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease.

 

Disadvantages of the combined pill

  • You may get temporary side-effects at first including headaches, nausea, breast tenderness and mood changes. If these do not change within a few months, changing the type of pill may help
  • The pill may increase your blood pressure
  • Breakthrough bleeding and spotting is common in the first few months of use
  • They are not usually suitable for women with a history of blood clots, migraine, heart or liver disease.

 

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