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Contraceptive Pill Overview

It can be overwhelming when trying to choose the right birth control method for you. Many methods of contraception are available such as contraceptive patches, the implant, the coil, and hormonal contraceptive pills.

The two different types of contraceptive pill are the combined contraceptive pill and the progesterone-only pill (POP). There are advantages and disadvantages to each type and many brands exist in both categories. Knowing the difference between the types of pill and brands can help you when choosing the right pill for you. Neither pill can protect against sexually transmitted infections (STIs).

Different pills can contain different hormones or vary by the amount of hormone they contain. You may find that one pill gives you side effects whereas another doesn’t. Some people try different types and brands before finding the pill that suits them best. When taken correctly, both types of pill are more than 99% effective at preventing pregnancy.

Combined Contraceptive Pill

The combined oral contraceptive pill contains a combination of the two female hormones oestrogen and progesterone. Usually, one tablet is taken every day for 21 days before taking a 7 day break when you’ll have a bleed like a period. You then restart the pill after the 7 day break. Some doctors may prescribe the combined pill to be taken with a shorter break or no break at all. You can discuss your options with your GP.

This combination of hormones helps to prevent pregnancy in three ways:

  • Prevents an egg being released from the ovaries each month
  • Thickens the mucus in the womb, making it harder for sperm to reach the egg
  • Makes it harder for a fertilised egg to implant into the lining of the womb

 

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Many women prefer to be prescribed the same combined pill name or brand that they are used to. Below we have compiled a list of combined contraceptive pill names in the UK, showing the active ingredients in each:

Combined Pill Brands:

Brand Oestrogen Progesterone
Cilest Ethinylestradiol 35mcg Norgestimate 250mcg
Logynon Ethinylestradiol 30mcg Levonorgestrel 50mcg
Microgynon 30 Ethinylestradiol 30mcg Levonorgestrel 150mcg 
Gedarel 30 Ethinylestradiol 30mcg Desogestrel 150mcg
Mercilon Ethinylestradiol 20mcg Desogestrel 150mcg
Dianette  Ethinylestradiol 35mcg Cyproterone acetate 2mg
Yasmin Ethinylestradiol 30mcg Drospirenone 3mg

 

Combined Pill Advantages

The combined pill has some advantages compared to other contraceptive methods. It can usually make periods lighter, less painful and more regular. It can help if you suffer with heavy periods, endometriosis, or premenstrual syndrome (PMS). Current scientific evidence suggests that combined pills reduce the risk of cancer of the womb and ovaries. The evidence suggests that this reduced risk continues for decades after stopping the combined pill. It can also reduce the risk of colon cancer.

The combined pill can also be helpful to treat acne in some women. Brands such as Dianette, Clairette and Acnocin can be specifically prescribed to people with moderate to severe acne.

Combined Pill Disadvantages

When starting the combined pill, people can experience side effects at first such as nausea, mood changes, breast tenderness and headaches. For some people, these side effects may persist and they may benefit from changing to a different brand.

Current evidence suggests that taking the combined pill can increase the risk of blood clots. For this reason, it may not be suitable for women with an already increased risk of blood clots. This includes women with a personal or family history of blood clots, a very high BMI, over the age of 35, or women who smoke.

There is also an increased risk of breast cancer when taking the combined pill. It may not be suitable for women with a personal or family history of breast cancer to take. After 10 years of stopping the combined pill, the risk of breast cancer goes back to normal.

 

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Progestogen-only Pill (Mini Pill)

The progestogen-only pill, also known as the mini pill, only contains progesterone and doesn’t contain any oestrogen. This means that some of the problems encountered with the combined pill are avoided when taking the mini pill. It can be a suitable contraceptive for women who are unable to take oestrogen contraceptives like the combined pill.

The mini pill is more than 99% effective when taken correctly. One pill is taken every day with no break between packs. Each pack contains 28 pills.

There are two types of progestogen-only pill. The traditional progestogen-only pill and the desogestrel progestogen-only pill.

Traditional Progestogen-only Pill

The traditional mini pill works by thickening the mucus in the cervix to stop sperm reaching and fertilising an egg. With this pill, you must take it within 3 hours of the same time each day for it to be effective. If you’re more than 3 hours late taking it, it may not be effective at preventing pregnancy.

The active ingredient in traditional progestogen-only pills are levonorgestrel or norethisterone.

Active Ingredient Brand Name
Levonorgestrel 30mcg Norgeston
Norethisterone 350mcg Noriday, Micronor*

*Micronor has recently been discontinued.

Desogestrel Progestogen-only Pill

These pills contain the progesterone ingredient desogestrel. It works by thickening the mucus in the cervix but it can also stop ovulation. Desogestrel pills must be taken within 12 hours of the same time each day. A missed pill is defined as a pill taken more than 12 hours late. Many women find this easier than the traditional POP products because of the 3 hour window to take a pill. 

Below is a list of contraceptive pills in the UK that have desogestrel as the main ingredient:

Brand name Available over the counter
Hana Yes
Lovima Yes
Cerazette No
Cerelle No
Zelleta No
Feanolla No

 

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Progestogen-only pill advantages

One of the biggest advantages of the mini pill is that it doesn’t contain oestrogen. This means it’s often a safe alternative for women who can’t take the combined pill because of the oestrogen content. This includes women over the age of 35 and women who smoke.

The mini pill is also safe for breastfeeding mothers to take, whereas the combined pill is not recommended for breastfeeding mothers until 6 weeks after birth.

Progestogen-only pill disadvantages

The mini pill can cause periods to become less regular. Your periods may be lighter, more frequent or stop altogether, and some women experience spotting between periods.

Another disadvantage of the mini pill is that you need to remember to take it every day around the same time each day. Depending on the type of mini pill you’re taking, you may not be protected against pregnancy if you’re more than 3 or 12 hours late.