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Combined pill

What is it?

The combined pill, sometimes also called ‘the Pill’, contains the hormones oestrogen and progestogen. Different types of ‘the Pill’ contain differing types and amounts of hormones. Most packs contain 21 pills. With the 21-pill pack, a pill is taken daily for 21 days followed by a seven day break, during which you’re likely to have a bleed similar to a natural period. After the seven day break in pill-taking a new pack is started.

Some pills come in packs of 28 pills, which contain different combinations of tablets which contain hormones, and tablets that contain no hormones (also called placebo tablets). The placebo pills may help you to remember to take your pill every day and when to start a new pack.

The Pill needs to be taken at a regular time each day for it to be effective.

This method does not protect you against sexually transmitted infections (STIs), so you may need to use a condom as well to help protect you against most STIs.

The Combined Pill How does it work?

The two hormones in the combined pill, oestrogen and progestogen, work by:

  • Stopping the ovaries releasing an egg
  • Thickening the mucus of the cervix to act as a barrier to sperm
  • Stopping a fertilised egg settling by keeping the lining of the womb thin

The Combined Pill How effective is it?

The pill is more than 99% effective when used correctly and this depends on women taking their pills exactly as instructed by their doctor or nurse.

What are the benefits?

  • Does not interrupt sex
  • May help to make your 'periods' more regular
  • Easily reversible if you want to get pregnant

The Combined PillWomen may not be able to/may not want to use it if they:

  • Are overweight (BMI of 30 kg/m2 or over)
  • Are aged 35 years or over and are a current smoker or stopped smoking less than a year ago
  • May not remember to take a pill every day

Women should not use it if they:

  • Are allergic to any ingredients within the Pill
  • Have had blood clots in any vein or artery
  • Have ever had a heart attack or angina
  • Have ever had a stroke or slight temporary stroke
  • Have ever had a migraine/bad headache with changes in vision or numbness in any part of the body (migraines with aura)
  • Have high blood pressure
  • Have diabetes with damaged blood vessels
  • Have an illness which runs in your family and affects your blood fat levels or the clotting of your blood
  • Have ever been told they have or might have breast cancer or cancer of any of their reproductive organs
  • Have ever had liver tumours or liver disease (with abnormal liver function)

The Combined Pill Possible side-effects?

As with all medicines side effects can occur but not all women will experience side-effects. Side effects may include:

  • Breast tenderness, headaches, feeling sick and mood changes
  • Breakthrough bleeding and changes to periods
  • Acne
  • Weight increase
  • May increase blood pressure
  • Small increased risk of blood clots
  • Small increased risk of breast cancer/cervical cancer

The Combined Pill What if......?

I miss a pill?

Missing pills or starting a packet late can make ‘the Pill' less effective. The chance of getting pregnant after missing a pill depends on how many you missed and when you missed them. Missing more than one hormone containing pill, and missing hormone containing pills at the beginning or end of your packet increase the risk that contraceptive effectiveness will be reduced. This is because during the break from taking the hormone containing pills, your ovaries are not getting the effect from ‘the Pill', so your ovaries might release an egg.

If you miss a pill/s the information leaflet inside your pill packet will contain advice on what to do if you miss a pill – but if you are uncertain or have concerns, see your doctor or nurse.

Remember: Contact your doctor or nurse if you have any concerns or are worried / unsure about anything to do with your contraception.

Have you decided which might be the right contraception for you? If not check out the other choices, if you have, jump to Step3: How do I change?

© 2015 Merck Sharp & Dohme Ltd. All rights reserved.

Job code: WOMN-1160817-0000

Date of preparation: September 2015

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