The Pill

Combined Oral Contraception Pill (COC)

The combined oral contraception (COC) pill is usually referred to as simply “the pill” and contains artificial oestrogen and progestogen hormones. This pill works by preventing an egg from being released by the ovaries so the sperm cannot fertilise it. It also thickens the mucus in the entrance of the womb, which makes the sperm’s journey more difficult, and thins the lining in the uterus, to reduce the chance of the egg implanting.

There are different types of COC, like phasic and every day pills. The most common type is the monophasic 21 day pill which have the same amount of hormones in each tablet. With this contraception, one pill is taken at the same time each day for 21 days, followed by a pill-free week. When the pills are stopped for 7 days, there will usually be a monthly withdrawal bleed.

Advantages

  • 99% effective if taken according to instructions.
  • Often reduces bleeding, period pain and premenstrual symptoms.
  • Your fertility will return to normal once you stop using the COC pill.
  • Taken for 21 days then break for 7 days. You will have a period in this 7 day break, it may be lighter than usual.
  • Reduces the risk of cancer in the womb, colon and ovaries.
  • May help to improve acne.

Disadvantages

  • Missing pills, vomiting or severe diarrhoea may make the pill less effective.
  • You must remember to take the pill every day when you are not on the 7-day break.
  • Some medicines can make the pill less effective. Your doctor or nurse will explain this in greater detail.
  • The pill does not protect you from sexually transmitted infections, so you will need to use condoms as well.

Progestogen Only Pill (POP)

The progestogen only pill (POP) contains only one hormone, progestogen. It thickens the cervical mucus to prevent sperm from meeting the egg whilst also thinning the lining of the womb. In some women, ovulation also stops.

There are two types of progestogen-only pills. One must be taken within a 3 hour window of when you usually take it and the other must be taken within 12 hours. Choosing a convenient time, like at breakfast or just before bed, should help you to stick to taking it at the same time each day.

Unlike the COC pill, POPs need to be taken every day without a break. Once one pack has been finished, a new one can be started straight away.

Advantages

  • 99% effective if taken according to instructions.
  • Your fertility will return to normal as soon as you stop taking the POP pill.
  • It is an alternative if you can’t take oestrogen contraception.
  • Very low risk of serious side effects.

Disadvantages

  • Needs to be taken every day with no break.
  • Missing pills, vomiting or severe diarrhoea may make the pill less effective.
  • Periods may stop or be irregular, lighter or more frequent.
  • The pill does not protect you from sexually transmitted infections, so you will still need to use condoms.
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