The Combined Oral Contraceptive Pill (or the pill) is a type of female contraception.
This page explains how this pill works and tells you how to use it.
WHAT IS IT?
It is a pill you take every day to stop getting pregnant
The combined pill contains the hormones oestrogen and progestogen.
This pill is different to the progestogen-only pill.
HOW DOES IT WORK?
Oestrogen and progestogen stop eggs being made, so no egg is released from the ovary.
HOW WELL DOES IT WORK?
This pill is normally 92% effective. This means 8 in 100 people will get pregnant each year.
It can be 99% effective if it’s taken correctly and continuously.
Taking the pill continuously is when you take the 21 hormone pills, then start a new packet straight away. This means missing the non-hormone pills and skipping your period. This is the most effective way to take the pill.
WHEN DO I TAKE IT?
It is best to take this pill at the same time every day. You could set the alarm on your phone to remind you.
There are three different ways to take the pill. Here is a video featuring Family Planning Nurse Rose Stewart explaining how to choose what's right for you.
Have a period each month
Take the 21 hormone pills and then the seven non-hormone pills. You will get your period while you are taking the seven non-hormone pills. It may be lighter and less crampy than your regular period.
You will not be protected from pregnancy if you forget more than one pill in a week.
Have a period every few months
Miss the seven non-hormone pills most months and take the hormone pills continuously, every day. Take the seven non-hormone pills when you want to have a period.
No periods option
Take the hormone pills continuously, every day. Take the 21 hormone pills and then start a new packet, missing the seven non-hormone pills. This means you won’t get your period.
With this option, you are protected from pregnancy unless you forget more than eight pills in a row.
You can do this for as many packets of hormone pills as you like, and then you can take the non-hormone pills to have a period when you want to.
You might notice bleeding and spotting at first, but this usually goes away with time or you can take the seven non-hormone pills to have a period.
Watch our video on how to continuously take Norimin:
Watch our video on how to continuously take Ava 30 (or Levlen):
In the video below, watch a nurse and a doctor talk about how to take Levlen.
If you have just started taking the pill, you might find that you:
- feel sick (especially if the pill is taken on an empty stomach),
- have sore breasts
- have unexpected vaginal bleeding.
These usually get better with time, but if you’re worried about any changes, we recommend that you keep taking the pill and call us for advice.
Your period may be lighter than usual, but if you miss your period, keep taking the pill and call us for advice.
WHO CAN USE IT?
If you are healthy and do not smoke you can keep taking the pill safely for many years.
You should not use this pill if:
- you have had a heart attack, stroke or blood clot in your legs or lungs
- a family member has had a blood clot in their legs or lungs
- you are over 35 and smoke
- you are overweight
- you have migraines (very bad headaches)
- you use some types of medications or herbal remedies. The nurse will talk to you about this
- if you have your leg in plaster or you use a wheelchair.
CAN I GET PREGNANT AFTER I STOP TAKING THE PILL?
Yes, you will be able to get pregnant as soon as you stop taking the pill.
If you do get pregnant while taking the pill and want to continue with your pregnancy, there will be no extra risk for your baby.
WHAT ARE THE ADVANTAGES?
- Up to 99% effective
- Easy to use
- Doesn’t get in the way of sex
- You can choose to have lighter, less crampy periods or no period at all
- As soon as you stop taking the pill, you can get pregnant
- It reduces your risk of ovarian and endometrial (lining of the uterus) cancer by 50%
- Some pills can help with pimples/acne.
The research does NOT show a link between the pill and weight gain, headaches, breast tenderness, nausea or change in sex drive.
WHAT ARE THE DISADVANTAGES?
- You have to take it every day – even if you don’t have sex that day.
- You might have irregular bleeding in the first month or two. If the bleeding continues, keep taking your pill but make an appointment to see a nurse.
- You might get dark patches on your face.
ARE THERE ANY OTHER SIDE EFFECTS?
Serious side effects are rare. If you take the pill and you smoke, you will be more at risk of stroke or heart attack. If you don’t smoke you are unlikely to have these problems.
Some pills can increase the risk of blood clots in the legs from 2 in 10,000 women per year to 6 times that rate.
It’s very important that if you notice any of these symptoms, you should get help from a doctor or Family Planning straight away, because it could be a sign of serious problem:
- get sudden chest pain
- cough up blood
- find it hard to breathe
- have pain in the lower leg
- have a very bad headache
Some short term risk factors when using the pill are:
- Plane flights
- High altitude
- Temporary immobility (not being able to walk or move)
THE PILL AND CANCER
Research shows that even if there is a risk of breast cancer, it is small. Before you start taking the pill, the nurse will ask you if you or anyone in your family has had breast cancer.
If you’ve been on the pill for five or more years and you carry certain types of wart virus, you might be more at risk of cervical cancer. Whether you take the pill or not, you should get a cervical smear every three years.
Your risk of ovarian cancer lowers by 50% if you take the pill. Even 30 years after stopping the pill you will still have a lower risk.
This is cancer of the lining of the uterus. Your risk of endometrial cancer lowers by 50% if you take the pill. Even 15 years after stopping the pill you will still have a lower risk.
DOES THIS PILL PROTECT ME FROM STIS?
No. You need to use condoms and lubricant to protect yourself from sexually transmissible infections (STIs). If there is a chance you may have an STI, have a check-up.
Family Planning has clinics located throughout New Zealand. Use the clinic finder to find your nearest clinic.