Which contraceptive pill is best for me?

There are two main types of contraceptive pills: the combined pill and the mini pill.

Combined oral contraceptive pill

The combined oral contraceptive pill (COCP) contains synthetic (man-made) versions of both oestrogen and progesterone. It primarily works to prevent pregnancy by stopping ovulation (the release of an egg from a woman’s ovaries).

While more popular, COCPs carry greater health risks including an increased chance of blood clots.

Combined pills can be either monophasic or multiphasic. These terms refer to the dose of hormones.

• Monophasic pills contain the same dose of hormones throughout the pack. They often are prescribed to first-time pill users.
• Brand names include: Brevinor, Cilest, Femodene, Mercilon, Microgynon
• Multiphasic pills contain different doses of hormones throughout the pack. This mimics the natural fluctuation of your hormones during the menstrual cycle.
• Brand names include: Binovum, Logynon, Qlaira

Progesterone-only pill

The mini pill only contains a synthetic version of the hormone progesterone. That’s why it’s also known as the progesterone-only pill (POP).

POPs prevent pregnancy by thickening the cervical mucus, which makes it harder for sperm to enter the womb and reach an egg. Sometimes they stop ovulation too, but this isn’t guaranteed.

Progesterone-only pills always contain the same dose of hormones in each pill, meaning that all mini pills are monophasic.

Unlike the combined pill, the mini pill is generally safe to take if:

• you’re over 35 and smoke
• are breastfeeding
• are overweight
• you have a history of blood clots

The following list will outline different health conditions and which pills may be most suitable under these circumstances.

Improving acne

If you struggle with hormonal acne, various types of combined pills can be beneficial. According to several studies, there is little evidence to show that some pills work better than others. However, in general, the combined pill was found effective in improving both inflammatory and non-inflammatory acne.

Some women are prescribed hormonal birth control as a treatment for acne, as it can help balance hormone levels and control breakouts. However, contraceptive pills that are designed for this cause, such as Dianette, are not recommended for the sole purpose of contraception.

Premenstrual syndrome

Symptoms of premenstrual syndrome (PMS) can be improved by taking combined oral contraceptives. This works by keeping your hormones more stable and influencing your natural cycle.

However, this is not the case with all women. In some cases, oral contraceptives can worsen PMS and mood swings.

If you find that you are sensitive to hormones, try taking a lower-dose contraceptive pill such as Eloine, Yaz, or Femodette.

Polycystic ovary syndrome and hirsutism

PCOS (polycystic ovary syndrome) is a condition caused by excess androgens (male sex hormones). It can cause irregular periods and stop ovulation from happening. In some cases, it also causes excess hair growth (something called hirsutism).

The hormones in the combined pill are known to lower the amount of androgens produced by the body. This helps women with PCOS to manage their symptoms. A doctor can advise on a specific pill brand, but COCPs containing drospirenone (like Yaz or Eloine) are a potentially preferred option.

Heavy periods and endometriosis

Any type of contraceptive pill can combat heavy bleeding. Because of their effect on the menstrual cycle, periods will become lighter and less frequent on the mini pill or will be replaced by a withdrawal bleed on the combined pill.

The combined pill may be better suited to women living with endometriosis, a condition that causes extreme pain, very heavy bleeds, and shorter cycles. The COCP stops ovulation and your natural cycle, which stops your regular period (along with its difficult symptoms).

Breakthrough bleeding

Breakthrough bleeding refers to any bleeding that happens in between menstrual cycles. Some women experience more breakthrough bleeding when they are on the pill.

If you are taking the combined pill and want to avoid bleeding between cycles, make sure to take your pill consistently. Skipped pills cause breakthrough bleeds due to the changes in your hormone levels.

You can also opt for a combined pill that contains higher doses of hormones. Examples include Brevinor and Cilest.

Consider avoiding the mini pill if you don’t want to experience breakthrough bleeding. It’s common for women taking the POP to have irregular periods, especially for the first few months.

Managing weight

Some women are concerned that starting a new contraceptive pill might cause weight gain.

However, researchers have found that hormonal contraceptives are very unlikely to do this. Studies have also found that there is no link between hormone dose and the amount of weight gained.

While women do tend to naturally put on weight as they age, there is very little evidence to suggest that contraceptive pills are to blame.

Perimenopause

For women going through perimenopause, there are fewer pill options to choose from. The combined pill is not generally safe to take if you are over 40, or a smoker over 35.

The mini pill, however, is a suitable type of contraception to use in your 40s. As there is no oestrogen, there is much less risk.

As you enter menopause, you become less fertile. You might even prefer to rely on barrier methods of contraception (like condoms) if your main aim is to prevent pregnancy.

However, in some cases, the contraceptive pill can be a way of managing perimenopausal symptoms as your hormone levels naturally start to decrease.

Stopping periods

By taking the combined pill back to back (without breaks) you can stop your periods from happening altogether.

Some women who take the mini pill also experience infrequent periods or no periods at all. This is because, in some cases, the mini pill stops ovulation from happening. Desogestrel mini pills (Cerazette) stop ovulation in 97% of menstrual cycles.

After birth or while breastfeeding

It can be difficult to know what contraception to use after birth or while breastfeeding, or if you need to use contraception at all.

The truth is that you can become pregnant as little as 3 weeks after birth. If you’re having sex, contraception is necessary to prevent another pregnancy.

The mini pill is safe to use within 3 weeks of having a baby. This is because, unlike the combined pill, the mini pill does not contain oestrogen (which can affect milk production while breastfeeding).

Combined oral contraceptives should ideally be avoided until you are no longer breastfeeding.

If you’re overweight

Both the combined pill and mini pill are safe to take if you are overweight. If you are obese (your BMI is 35+), however, the combined pill will not be suitable due to an increased risk of blood clots.

Having a higher body fat percentage increases your chances of blood clots, which can lead to serious medical emergencies like a stroke or a heart attack.

If your doctor says that your BMI is too high, they will likely recommend that you use the mini pill instead.

High blood pressure

If you have high blood pressure, it is recommended that you take the progesterone-only pill as contraception.

The combined pill contains oestrogen, which can cause your blood pressure to increase. The mini pill offers most of the same benefits as the combined pill but without this additional risk.

Use our interactive quiz tool to discover which pill we’d recommend, based on your preferences and medical history.

To help you understand the different contraceptive pill options, we’ve made a comparison table.

This table shows the brand name, as well as how much oestrogen and/or progesterone is contained.

At euroClinix, we sell many different kinds of birth control pills, including combined and progesterone-only. We offer online consultations (included in the price) and fast delivery services.