Contraception – the combined pill

About the pill

There are 2 types of oral contraception available in Australia – the combined pill, known as ‘the pill’, and the progestogen only pill.

The pill contains the hormones oestrogen and progestogen. These are similar to hormones that are produced by the ovaries. The progestogen only pill contains only progestogen.

Both are taken daily, and are available on prescription. They are very effective forms of contraception if used correctly.

Effectiveness of the pill

If used correctly the pill is at least 99% effective at preventing pregnancy. Allowing for mistakes, it is 93% effective.

What stops the pill from working?

The pill may not work if:

• you miss a pill or it is taken more than 24 hours late
• you vomit within 3 hours of taking it
• you have very severe diarrhoea
• you are taking some medications or natural remedies. (Check with your doctor, nurse or pharmacist.)

How to use the pill

You use the pill by swallowing one pill around the same time every day.

There are many different brands of the pill. Most come in a 28-day pack that includes both hormone and sugar pills. Speak to your doctor, nurse or pharmacist for advice about which brand is most suitable for you.

You will usually have your period (bleeding from your vagina) while taking the sugar pills. You can skip your period by missing the sugar pills and continuing to take the hormone pills each day.

How the pill works

The pill works by stopping the ovaries from releasing an egg each month.

It also thickens the fluid around the cervix (opening to the uterus or womb) to prevent the sperm from entering.

When you start the pill for the first time, or after a break from the pill, it can take up to 12 days to start working to prevent pregnancy. This depends on whether you start with the hormone pill or sugar pill.

Speak with a doctor, nurse or pharmacist about the best way to start taking the pill.

Where to get the pill

Your doctor can provide a script for the pill which you can take to the pharmacy.

Some brands may be more expensive than other brands. Some brands will be cheaper if you have a healthcare card.

Benefits of the pill

The pill can:

• be used to skip your period
• make your periods become lighter, more regular, and less painful
• improve acne
• reduce your chance of getting cancer of the uterus (womb), ovaries and bowel
• help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.

Once you stop taking the pill your fertility quickly returns to normal.

Side effects from taking the pill

Possible side effects for a small number of people who take the pill can include:

• irregular vaginal bleeding
• nausea
• sore or tender breasts
• headaches
• bloating
• changes to your skin
• mood changes.

These side effects often settle with time. The pill has not been shown to cause weight gain.

Serious health problems and the pill

The pill causes a very small increase in your risk of deep vein thrombosis (blood clot), heart attack or stroke. It may also lead to a tiny increase in your risk of breast cancer. The risk of developing breast cancer due to vaginal ring or pill use in people aged under 35 years is 1 in 50,000 per year.

When the pill is not a good option

The pill may not be a good option for you if you:

• find remembering to take a daily tablet difficult
• have certain types of migraine or headache
• are very overweight
• have a close family member who has had a deep vein thrombosis
• are taking certain types of medication which might stop the pill from working (check with your doctor, nurse or pharmacist)
• have had some health conditions such as high blood pressure, deep vein thrombosis, heart or liver disease (check with your doctor, nurse or pharmacist)
• are over 35 years and smoke
• have been treated for breast cancer
• are unable to move around for a long time (for example, because of surgery or disability).

If you miss a pill

If you miss a pill:

• Take the missed pill as soon as you notice (this may mean taking 2 pills on the same day).
• Continue to take your pills as normal.
• Use condoms for the next 7 days.
• If you have had sex without a condom in the 7 days before missing a pill, you may need emergency contraception or you may need to skip your next sugar pills and start a new pill pack in the hormone section. This depends on where you are up to in the pill packet (check with your doctor, nurse or pharmacist).

If you get pregnant while taking the pill

The pill won’t harm the pregnancy. It is safe to continue the pregnancy (and stop the pill) or to have an abortion.

Taking the pill after having a baby

If you are breastfeeding, do not use the pill until your baby is 6 weeks old, as it may reduce your supply of breast milk and may increase your risk of thrombosis. After 6 weeks you can use the pill but other types of contraception might be better choices (check with your doctor, nurse or pharmacist).

If you are not breastfeeding, you can start using the pill once your baby is 3 to 6 weeks old (check with your doctor, nurse or pharmacist).

Taking the pill and pregnancy

You can stop the pill at any time and your fertility will quickly return.

Further information about the pill

The pill:

• does not protect you from sexually transmissible infections (STIs). The best way to lessen the risk of STIs is to use barrier protection such as internal and external condoms with all new sexual partners
• can sometime be supplied in small quantities by your pharmacist, without a prescription. If you run out of pills and cannot see a doctor for a new script, speak to a pharmacist. They can often give you a small supply of pills without a script. If possible show them your old pill packet.

Where to get help

• 1800 My Options Tel. 1800 696 784 – for information about contraception, pregnancy options and sexual health in Victoria
• Your GP (doctor)
• Pharmacist
• Community Pharmacist Pilot – receive some treatments at a local pharmacy without needing to see a doctor for a prescription in Victoria
• Many community health services and some public hospitals will have a family planning clinic, a sexual health clinic or a women’s health clinic
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: (03) 9660 4700, Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly