The combined contraceptive pill is an extremely efficient method of contraception – which is why roughly 100 million women are using it across the world. In the UK, there are about 3.5 million women who use them. That works out as roughly 1 in 3 of all women of reproductive age. In terms of age groups, this medication is especially popular in the 18 to 30 age group.
The pill is a combined oral contraceptive that contains a combination of oestrogen and progestogen. It's the most popular form of contraception because it regulates periods, makes them less painful, minimises ovarian cysts and provides symptomatic relief from endometriosis.
It needs to be taken every day for 21 days of your cycle, with a seven-day break. During this break, women will usually experience a withdrawal bleed. The excess lining of the womb is shed, as with a normal period, and you may experience some cramps and discomfort.
Zoely is the first monophasic pill to contain natural oestrogen. Before Zoely, Qlaira was the only pill available with natural oestrogen, although it wasn’t monophasic and does require a more stringent dosing regimen. Zoely, on the other hand, is an everyday pill, requiring the same pill to be taken for the majority of your cycle.
Yasmin (ethinylestradiol and drospirenone) is a popular combined oral contraceptive pill. It’s a monophasic birth control pill; you take it for 21 days of your menstrual cycle, followed by a seven day break, during which you will still be completely protected. Yasmin is popular because it doesn’t cause weight gain, a common side effect of many birth control pills, and can also improve the appearance of your hair and skin.
Dianette (cyproterone acetate and ethinylestradiol) is a combined oral contraceptive pill that is very popular because it can also be used to successfully treat bad acne and excessive body hair growth. It’s a monophasic birth control pill, which means that it’s taken for 21 days of your menstrual cycle, followed by a seven-day break, during which you will still be fully protected. Dianette pills have an anti-androgen effect, which helps with excessive hair growth.
Microgynon (ethinylestradiol and levonorgestrel) is currently the most prescribed combined oral contraceptive pill in Europe. It’s used by thousands of women daily to prevent against pregnancy but can also be used to treat endometriosis; a sometimes painful condition where womb cells grow on areas outside the womb. It is a monophasic birth control pill and comes in packs of 21. You take it for 21 days of your menstrual cycle, followed by a seven-day break.
Cilest (ethinylestradiol and norgestimate) is a popular combined contraceptive pill which can effectively prevent pregnancy and is also a proven treatment for endometriosis. This birth control pill is monophasic, which means that you need to take if for 21 days of your menstrual cycle, followed by a seven-day break before beginning a new course of pills. During the seven-day break, you will still be completely protected.
Loestrin (ethinylestradiol and norethisterone) is a combined contraceptive pill which is available in two doses: Loestrin 20 and Loestrin 30. This allows women who are more sensitive to the hormones in this contraceptive pill to take a lower, more comfortable dose of birth control. It’s a monophasic pill, which means it's taken for 21 days followed by a seven-day break, during which you are still fully protected.
Mercilon (ethinylestradiol and desogestrel) is very similar in composition to Marvelon and is sometimes prescribed as an alternative contraceptive pill. It’s a combined birth control pill which is monophasic, that means that you need to take it for 21 days followed by a seven-day break, before starting a new course of contraceptive pills. During this short break you will still be protected from becoming pregnant.
Marvelon (ethinylestradiol and desogestrel) is a combined contraceptive pill that’s very well tolerated by most women’s bodies. Marvelon is a monophasic birth control pill, which means that it is taken for 21 days of your cycle, followed by a seven-day break before you start the next course. During this seven-day period, you will still be fully protected even though you will experience a withdrawal bleed.
Ovranette (ethinylestradiol and levonorgestrel) is a commonly prescribed combined contraceptive pill which women can use to prevent pregnancy. Apart from its contraceptive qualities, it can also help alleviate endometriosis symptoms. Ovranette is a monophasic birth control pill. This means that you need to take it for 21 days and then take a break of seven days. You are still protected during this seven-day break, and simply start a new course after this short break.
Femodene is a combined oral contraceptive pill that is almost 100% effective if taken correctly. It improves acne, treats polycystic ovary syndrome and excessive body hair and doesn’t cause breakthrough bleeding. It also reduces PMS symptoms, and makes periods lighter, less painful and more regular. You need to take Femodene every day for three weeks, followed by a seven-day break. During this time you will experience a withdrawal bleed, but you’ll still be protected.
Logynon is a triphasic contraceptive pill, which means there are three different doses of hormones in one pack, shown by the different coloured pills. This allows your hormone levels to rise and fall in a natural way, reducing any cyclic side effects normally associated with combined contraceptive pills. Logynon also treats endometriosis and premenstrual dysphoric disorder - a condition where women suffer from severe depression symptoms, irritability and tension before their period.
Femodette is a third generation combined oral contraceptive pill that treats acne, polycystic ovary syndrome and excessive body hair and doesn’t cause breakthrough bleeding. It needs to be taken every day to offer almost 100% protection against pregnancy. If you forget one or two contraceptive pills, you’ll still be protected but forgetting three or more Femodette pills will stop this contraceptive from working effectively. If this happens, you must use another contraceptive for seven days.
Trinovum is a triphasic contraceptive pill; the three different doses of hormones mimic your body’s natural cycle and the way that levels of oestrogen and progestogen rise and fall. Being triphasic also means that the risk of side effects is reduced because Trinovum contains a reduced average hormone dosage. Trinovum is one of the few contraceptive pills that won’t reduce your libido, and it brings many benefits such as a reduced risk of headaches and depression.
Brevinor is a low dosage combined contraceptive pill, which reduces the risk of side effects. It also treats excessive body hair and acne and helps regulate periods, making them lighter and less painful. Brevinor is a second generation contraceptive pill, which means the risk of developing thrombosis is slightly reduced than when using third generation pills. You must take Brevinor every day for three weeks, followed by a seven-day break, during which you’ll still be protected.
Binovum is a biphasic contraceptive pill, which means that there are two doses of the hormones in the pack. This reduces the risk of developing side effects because the total amount of hormones the body is exposed to is less than with monophasic contraceptive pills. The pack makes it easy to see which order to take the pills in. Using Binovum gives you a reduced risk of developing painful breast tenderness and offers some protection for your genital organs against infections.
Qlaira (estradiol valerate and dienogest) is a newer combined contraceptive pill for oral use. It is the first contraceptive pill to use estradiol valerate as its synthetic oestrogen. Qlaira is a very effective method of birth control and can also reduce periods that are particularly painful or heavy. It is a 28 day pill with differing dosages that fluctuate along with the natural hormones in your menstrual cycle. This means you will be less likely to experience side effects.
Each combined contraceptive tablet contains a combination of oestrogen and progestogen. The individual names of hormones will vary from each pill, but they all work in the same way - by altering the environment of your reproductive system in such a way that it’s almost impossible for you to conceive.
To understand how this form of contraception will prevent pregnancy, it’s important to understand the process of conception. Once a month, your ovaries release a mature egg which travels down the fallopian tubes towards the uterus. While this happens, the lining of your womb begins to thicken as it prepares itself to host a fertilised egg. At the same time, the mucus in the cervix becomes thinner to make it easier for sperm to reach the womb.
This combined contraceptive stops all of these activities, which in turn prevents you from conceiving. The oestrogen in the pill stops your ovaries from releasing a mature egg, whilst the progestogen stops the womb lining from thickening and actually makes the cervical mucus thicker.
What are the advantages?
The pill regulates periods, makes them lighter and less painful and offers symptomatic relief from endometriosis. It is over 99% effective and you don’t need to interrupt sex to use it. It can also help to improve spotty skin, reduce excessive body hair and treat polycystic ovary syndrome. If used over a long period of time, the pill can cut your risk of developing ovarian, uterine or colon cancer.
There are other benefits to this treatment too. For example, in 2010, the Royal College of General Practitioners created a significant report that revealed Pill-users have a 12 per cent reduction in their chances of catching cancer. The study researchers looked at 46,000 women over a time span of 40 years and discovered that those who had taken the pill were less likely to die of stroke, cancer or heart disease. Findings also revealed that breast cancer rates are identical in women who have taken the pill and those who have not. This discovery – if it is definitely confirmed – goes a long way towards waning former fear about this treatment and breast carcinoma.
What about the disadvantages?
The oestrogen in combined pills can cause a range of side effects including nausea, 'spotting' (bleeding between periods), and breast tenderness, to name just a few.
The risk of developing blood clots is higher when using this form of contraception; for some women the risk is so high that their doctor will never prescribe them this treatment.
Some medications can stop the combined pill from working properly, and if you’re sick this treatment could stop working too. It also relies on you remembering to take a pill every day. These factors can render it ineffective.
What different types of combined pill are there?
There are nearly 30 different types available to women. The combined pill can be split into two different types: monophasic and multiphasic. Monophasic versions contain the same dose of hormones in each pill, and are usually the first kind of ones that women are prescribed. They allow you to regulate your period. The most common monophasic pills include: Brevinor, Cilest, Dianette, Femodene, Femodette, Loestrin, Marvelon, Mercilon, Microgynon, Ovranette and Yasmin.
Multiphasic versions have a varying hormone dosage: Biphasic pills contain 2 different strengths of hormones, triphasic ones contain 3 different strengths and multiphasic versions contain four or more different strengths. These pills mimic the natural fluctuation of hormones during your cycle, and administer a lower total dose of hormones to your body. These two benefits reduce the risk of experiencing side effects like spotting. The most common biphasic ones are Binovum; Logynon and Trinovum are the most common triphasic pills; and Qlaira is the most common multiphasic pills.
Can every woman use the pill?
If you’re over 18 you may be able to buy these treatments online; however, there are a number of medical conditions which may mean that it is unsafe for you to use these treatments. This varies according to each different combined pill, and involves only a small number of women. If you smoke, are severely overweight, have high blood pressure or a family history of thrombosis, you may not be able to use this medication. In many cases women who can’t use this treatment can use the progestogen-only pill instead.