Factsheet
The Pill
Date 11 February 2008
WHAT IS THE PILL?
The combined pill, usually called simply 'The Pill', contains two hormones, oestrogen and progestogen. The Pill stops a woman's ovaries from releasing an egg cell each month, which means that a pregnancy cannot begin. This makes it one of the most effective methods of birth control.WHO CAN TAKE THE PILL?
Most women can take the Pill, but you should not take it if:- you have had a deep venous thrombosis (blood clot), stroke or heart attack
- you have severe liver problems
- you have a migraine with aura (migraine with visual disturbances starting before the headache)
- you have unusual bleeding from your vagina that has not been diagnosed.
- you are breast feeding
- you have high blood pressure, diabetes, gall bladder disease, active liver disease, kidney disease, some blood problems, tuberculosis, severe depression, or you are on some other medications
- you have had cancer of the breast or cervix
- you are over 35 and smoke
Other pills you may have heard of are the minipill or progestogen only pill (POP) or the emergency pill (ECP). The minipill consists of progestogen only. It is not quite as reliable as the combined pill, but is useful for women who cannot take oestrogen. The emergency contraceptive pill is taken to prevent pregnancy after you have had intercourse (penis in vagina sex) without using contraception. Family Planning NSW has fact sheets on both of these pills.
TYPES OF PILLS
There are many types of Pills. Each woman needs to talk with a doctor, nurse or other health provider to decide which Pill is best for her. With some types, every pill in the packet has the same amount of hormones. With others, the amount changes through the month. But they all work the same way to prevent pregnancy.21 AND 28-DAY PACKS
The Pill comes in 21-day or 28-day packs. Both packs have 21 hormone pills. With the 21-day pack you have a break of seven days between each pack. The 28-day pack has seven pills that have no hormones (dummy sugar pills) so your body has the seven-day break while you keep taking a pill every day. With both packs you will have your period during the seven days without hormone pills.STARTING THE PILL
You should start your first Pill packet when you have a period. The instructions that come in the packet will tell you exactly how to take it. With some Pills you start with a hormone pill on the first day of your period and are protected from pregnancy straight away. With other Pills you will need to use some other contraception like condoms, as well as the Pill, until you have taken seven of the active, hormone pills in your packet. Be sure to ask your doctor, nurse or other health provider exactly when you are covered on the particular Pill you have been prescribed. You may want to keep on using condoms with the Pill because they help to protect you from sexually transmitted infections (STIs).IF YOU MISS A PILL
If you are LESS than 24 hours late taking a pill, take it as soon as you remember, and then take the next one at the usual time. You will still be protected against getting pregnant.If you are MORE than 24 hours late, or have missed MORE than one pill, take a pill when you remember, and the next pill at the usual time. Then keep on taking the pills as usual, but use other contraception (eg condoms) as well, for the next seven days.
IF YOU HAVE LESS THAN SEVEN HORMONE PILLS LEFT IN YOUR PACK, continue to take the remaining pills in the pack as soon as you remember, but do not have the break or take the dummy sugar pills. Go straight on to the hormone pills in the next pack. You should still use other contraception as well (eg condoms), or don't have vaginal sex, for seven days after the missed pills. If you are on a Pill that has different types of hormone pills in the packet, doing this can cause unexpected bleeding. Ask your doctor, nurse or other health provider for advice on how to stay safe from pregnancy without getting this unexpected bleeding.
IF YOU MISS MORE THAN ONE PILL IN THE FIRST SEVEN DAYS OF A NEW PACK OF PILLS OR START A NEW PACK MORE THAN 24 HOURS LATE and you have had sex in the pill break you should consider emergency contraception. You will need to use other contraception such as condoms for the next seven days.
Talk to your doctor, nurse or other health provider or ring the Healthline on 1300 65 88 86 as soon as possible if you are concerned about missed pills.
WHEN THE PILL MIGHT NOT WORK
If you have diarrhoea or vomiting, the Pill might not get into your system properly and you could get pregnant. It is best to follow instructions for missed pills just to be sure.Some antibiotics and other drugs (even natural therapies) may stop the Pill from working. If you are taking anything, ask your doctor, nurse or other health provider about this. If you are not fully protected, use other contraception as well as the Pill while you are taking the medication and for the seven days after stopping it.
Remember to tell your doctor you are taking the Pill, as sometimes it can cause problems with other medications.
THE PILL AND YOUR HEALTH
Most women feel fine while they're on the Pill, but it is common to have some side effects at first. You could have irregular bleeding in between periods, sore breasts and nausea (feeling sick) for the first couple of months. This usually settles down by your third packet of pills. Some women find the bleeding pattern improves if they take the Pill at exactly the same time every day.Other side effects such as putting on weight, less desire for sex, and feeling irritable are rare. They may be due to the Pill, but can also be caused by other things in your life. If you are worried, talk to your doctor, nurse or other health provider. They may suggest you try another type of Pill, or you may need to change to a different method of contraception.
THE PILL AND THE SUN
The oestrogen in the Pill sometimes causes patchy brown discolouration to appear on the face, especially if you spend a lot of time in the sun. If this happens when you are on the Pill you should always wear a hat and cover up as much as possible. You will need to use a Factor 30+ sun cream on any exposed skin when you are in the sun. If this doesn't help you could try a progestogen-only contraception such as a minipill or the injection or implant. The brown discolouration can take months to fade, even if you stop taking the Pill.HEALTH RISKS
Serious health problems caused by the Pill are rare - the most dangerous is blood clotting. Warning signs are severe sudden chest pain, severe pain or swelling in one leg, sudden blurred vision or loss of sight, or sudden severe headache. If you have any of these symptoms contact your doctor immediately.HEALTH BENEFITS
The Pill does have some health benefits. You have less chance of getting a serious pelvic infection, cancer of the ovary, cancer of the endometrium (lining of the womb), anaemia, non-cancerous breast lumps, and cysts on the ovary.When you are taking the Pill, periods are less painful, bleeding is lighter and more regular and there is often less premenstrual tension. Acne may also improve on the Pill, especially if you tend to get it mainly around period time.
IF YOU PLAN TO HAVE SURGERY
If you know you are going to have surgery, tell your doctor you are on the Pill. You will probably be asked to stop taking it and to use other contraception, eg condoms, for four to six weeks before you go to hospital for major surgery, unless the surgeon is going to give you an anti-clotting drug.You should also stop the Pill and use other contraception if you are bedridden or have a leg in plaster.
MEDICAL CHECKUPS
It is good to have your blood pressure and weight checked when you renew your prescription each year. All women should also have a Pap test every two years.PERIODS AND THE PILL
Your periods will probably be darker in colour and you will usually bleed less while you are on the Pill. Periods usually start a few days after you stop taking the hormone pills in your packet. Sometimes periods on the Pill can be so light they almost disappear completely.IF YOU MISS A PERIOD
You may sometimes miss a period while you are taking the Pill, this does not mean you are pregnant, but if this is the first time this has happened to you, it is sensible to do a pregnancy test. If the test is negative and you have taken the Pill as directed just keep taking it as usual. If you have any other unusual symptoms see your doctor, nurse or healthcare provider.GETTING PREGNANT AFTER TAKING THE PILL
Most women who want to have a baby get pregnant within six months of stopping the Pill. Women whose periods have not started again three or four months after stopping the Pill should talk with their doctor, nurse or other health provider.Download more info The Pill (Adobe PDF File)
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For further information
- Contact the Healthline on 1300 658 886.
