How to choose the right contraceptive pill for you
Choosing which contraceptive pill to take can be a difficult decision for a woman. Knowing which one is right for you can be confusing.
LloydsPharmacy Online Doctor conducted a survey of 500 and found that almost half of British women (48%) have had to change contraceptive pill to find the one that works best for them.
Luckily, Dr Bhavini Shah from LloydsPharmacy Online Doctor is here to explain what the different types of pill are, what differentiates them, and why some people may prefer one over another.
What types of contraceptive pills are there?
The main two types of contraceptive pill are the combined pill and the mini pill (also called the progesterone only pill).
Combined pill
Combined pills contain both oestrogen and progesterone. Different types of combined pill contain different levels of each hormone and they can be selected depending on the frequency you would like to have periods or which balance of hormones work best for you.
In the most common combined pill, you would take your pill every day for 21 days and then take a break for seven days, however exact numbers of days depend on which combined pill you take as well as advice from your doctor. Other forms of combined pill offer inactive pills which are taken on these break days.
Extended cycles are also an option, where there are more active pills, allowing your period to occur just four times per year, rather than twelve. You may also choose continuous dosing, where only active pills are taken, and your period may be withheld indefinitely.
The combined pill can also be monophasic or multiphasic. Monophasic pills have a consistent balance of hormones in them throughout the packet, whereas multiphasic pills have different concentrations of hormones for different times throughout the month.
The mini pill
Also known as the progesterone-only pill, the mini pill does not come in such a variety as the combined pill, and contains no oestrogen. The mini pill also does not involve inactive pills.
The mini pill is usually the second choice for contraceptive pills as it is marginally less effective (although it’s more than 99% effective if taken correctly) and can often come with more side effects. However, it can be more suitable than the combined pill for some people.
Which pill can help with what?
Acne and skin
If you suffer from acne, the combined pill may be able to help you. Many people who get spots suffer from hormonal acne – where changing hormones produces a buildup of sebum, blocking hair follicles and creating a spot.
An important thing to note is that only the combined contraceptive pill has the effect of balancing the hormones that cause a flare up. In fact, the mini pill may result in a higher fluctuation in hormones and could worsen acne.
Our survey found that one in six women would consider using the contraceptive pill to reduce acne or improve their skin.
Co-cyprindiol, Yasmin and Lucette are three combined pills often prescribed by doctors to treat acne. It usually takes two to six months to notice an improvement in your skin after starting the combined pill so it may take some patience.
Cramps
The combined pill has been shown to alleviate cramping and period pain. By preventing ovulation, the uterus lining does not thicken and reduces the chance of you experiencing cramps.
We surveyed 500 women and found that only 7% have never experienced menstrual cramps or period pain before, with 29% reporting that they experience them intensely every month. We also found that two in five women (40%) have considered taking the contraceptive pill to prevent cramps and period pain.
PMS
Premenstrual syndrome (PMS) is characterised by experiencing distressing symptoms in the lead up to your period. Symptoms usually include mood swings, anxiety, irritability, nausea, headaches, bloating and breast tenderness. It’s thought around 40% of British women experience PMS.
Though the cause of PMS is not known precisely, it is thought to be due to sensitivity to the fluctuation of hormones just before your period. When using the combined pill, hormone levels are more balanced, steadying oestrogen and progesterone levels.
Unwanted body hair
An uncommon use of the contraceptive pill is to reduce unwanted body hair, a condition which affects 5-15% of pre-menopausal adult women.
The combined pill works here as it reduces hormonal androgen levels by increasing oestrogen and progesterone, preventing the excessive hair growth.
PCOS
Polycystic ovary syndrome (PCOS) affects 10% of women and can cause irregular periods, excessive production of androgens (‘male’ hormones), and polycystic ovaries.
While there is no cure for PCOS, the pill can help alleviate symptoms. The combined pill can help regulate periods for people with PCOS and can also reduce the risk of developing endometrial cancer, even after you’ve stopped taking it.
Endometriosis
Endometriosis is a condition where similar tissue to the womb lining begins to grow in the ovaries and fallopian tubes. Although there is currently no cure for endometriosis, both the combined pill and the mini pill are both effective ways of relieving the symptoms of endometriosis.
Which pill should I be taking?
Deciding what pill to take depends entirely on your current medical status and what you’re looking to get out of the pill.
The combined pill will be best suited for most people. However, it is not suitable for everyone. These people may still be able to take the mini pill, such as smokers over 35 or those with high blood pressure, diabetes complications, or a history of breast cancer, stroke, heart-disease, high blood pressure or migraines with aura.
Things to consider
How regularly can you take your pill?
If you do not have a regular schedule, perhaps through shift work, you may be better suited to the combined pill.
“The combined pill has a 24-hour grace period where you can still take your pill and be protected from pregnancy. You must take the mini pill at the same time each day. If you take it more than three hours late (or 12 hours late if you take a desogestrel pill, such as Cerazette) it may not be effective.
What is your current health situation?
The mini pill can be used by women who can’t use contraception that contains oestrogen. For example, because they have high blood pressure, have had previous blood clots, are overweight or smoke after the age of 35. This group should discuss contraception options with their doctor.
Author: Dr Bhavini Shah from LloydsPharmacy Online Doctor.
