The Pill (combined pill or oral contraceptive pill)

The Pill is a daily tablet (also known as the combined pill or oral contraceptive pill). The Pill contains two hormones – oestrogen and progestogen. These are similar to the hormones that are produced by the ovaries.

If used correctly the Pill can be over 99% effective at preventing pregnancy. If you miss a pill, vomit within 2 hours of taking a pill, have severe diarrhoea, or take certain medications it might only be 93% effective.

The Pill works by stopping the ovaries from releasing an egg each month.

You take the Pill by swallowing 1 pill (tablet) around the same time every day. It may be helpful to take the Pill at the same time you do another activity every day (such as cleaning your teeth) or you could enter a reminder into your phone. Once you have taken all the pills in a packet, you start a new packet.

There are many different brands of the Pill. Most brands come in a 28-day pack that includes both hormone and sugar pills. You will usually have your period (bleeding from your vagina) during the sugar pills. You can skip your period by missing the sugar pills and continuing to take the hormone pills. Speak to your doctor, nurse or pharmacist for more information.

When you start the Pill for the first time or after a break it can take up to 12 days to start working to prevent pregnancy. This depends on whether you start with a hormone pill or sugar pill. It also depends on the timing of your menstrual cycle and if you are already using contraception. Speak with your doctor, nurse or pharmacist for more information.

Your doctor or nurse will provide a script which you can take to the pharmacy, who will sell you the Pill. Some pill brands are more expensive than other brands. It is usually recommended to start with a less expensive brand first. Some brands will be cheaper if you have a healthcare card.

The Pill may not work if:

• it is taken more than 24 hours late
• you vomit within 2 hours of taking it
• you have very severe diarrhoea
• you are taking some medications or natural remedies (check with your doctor, nurse or pharmacist).

• It can be used to skip your period if you want to.
• Periods usually become lighter, more regular, and less painful.
• Acne can improve.
• Chance of getting cancer of the uterus (womb) and ovaries decreases.
• It can help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.
• Once stopped your fertility quickly returns to what is normal for you.

Possible side effects for a small number of users can include:

• irregular vaginal bleeding
• nausea
• sore/ tender breasts
• headaches
• bloating
• changes to your skin
• mood changes.

These side effects often settle with time. The Pill has not been shown to cause weight gain.

The Pill causes a very small increase in your chances of a deep vein blood clot/thrombosis, heart attack and stroke. The Pill is associated with a very small increase in the risk of cervical and breast cancer which reduces with time after stopping.

• Find taking or remembering a daily tablet difficult.
• Have certain types of migraine headache.
• Are very overweight.
• Have a close family member who has had a deep vein blood clot/thrombosis.
• Are taking certain types of medication which might stop the Pill from working (check with your doctor, nurse or pharmacist).
• Have had some health conditions like high blood pressure, heart or liver disease (check with your doctor, nurse or pharmacist).
• Are over 35 years and smoke.
• Have breast cancer or have been treated for breast cancer.
• Have severe liver disease.
• Are unable to move around for a long time (for example because of surgery or disability).

• Take the missed pill as soon as you notice (this may mean taking 2 pills on the same day).
• Continue to take your pills as normal.
• Abstain from sex or use condoms for the next 7 days.
• If you have had sex without a condom in the 7 days before missing a pill, you may need emergency contraception or to skip the sugar pills and start a new pill pack in the hormone section. This depends on where you are up to in the pill packet (check with your doctor, nurse or pharmacist).

The Pill will not harm the pregnancy. It is safe to continue the pregnancy (and stop the Pill) or to have an abortion.

If you are breastfeeding the Pill cannot be used until your baby is 6 weeks old. After 6 weeks you can use the Pill but other types of contraception might be more suitable choices.

If you are not breastfeeding the Pill can generally not be used until your baby is 3 weeks old. After 3 weeks you can use the Pill if you do not have any medical risk factors (check with your doctor or nurse or pharmacist).

You can stop the Pill at any time and your fertility will quickly return to what is normal for you.

• Sexual Health Victoria
• A doctor or nurse
• Your local community health service
• An obstetrician or gynaecologist
• 1800 My Options phone line 1800 696 784 or website
• Better Health Channel
• Equinox – for transgender services
• Jean Hailes
• Marie Stopes Australia
• Multicultural Centre for Women’s Health
• The Women’s (The Royal Women’s Hospital)