What you need to know about the combined pill

The combined pill is a tablet you take once a day. It contains synthetic versions of the hormones oestrogen and progesterone.

Also known as

  • the pill

  • the combination pill

The pill is completely under your control. You can start and stop it when you need to, but you have to remember to take it correctly. It’s great for people who want to have more control over their bleeding pattern.

Dr Paula Baraitser. Medical Director, SH:24

Likelihood of getting pregnant over 1 year

The pill is highly effective at preventing pregnancy. Used perfectly, the pill is over 99% effective. But none of us are perfect and it's more usual that people will miss pills or not follow the instructions exactly. So with more typical use, it's 91% effective.

This means typically 9 in 100 people using the pill will get pregnant in one year.

The pill is a good option if…

  • you’re good at remembering to take it every day. If this might be a problem, consider a coil, implant, patch, injection or vaginal ring instead, as you don’t need to think about them as often

  • you suffer from heavy or painful periods or have anaemia. The pill will make your periods lighter and gives you the option not to bleed at all

  • you suffer from spots or acne – the pill may improve this

  • you have PCOS – polycystic ovary syndrome – that causes unwanted hair growth or acne

  • you have endometriosis or PMS (premenstrual syndrome)

  • you’re aged up to 50, as long as you’re fit, in good health and don’t have any of the health issues listed below

Do not take the combined pill if you...

  • have a higher risk of thrombosis (blood clots), including people who have had a thrombosis in the past or have a family history of thrombosis

  • smoke and are aged over 35. This causes a higher risk of heart disease

It's also not recommended if you have:

  • irregular bleeding, unless you’ve investigated the treatable causes of it

  • BMI (body mass index) of over 35, this increases your risk of thrombosis

  • high blood pressure, which means over 140/90 mmHg - the pill can make high blood pressure worse in a small percentage of people

  • thrombosis (blood clots) or strokes – or your close relatives had these under the age of 45

  • limited mobility, because this causes a higher risk of thrombosis

Is the pill right for you?

To decide if the pill is right for you, you’ll need to balance the advantages and disadvantages for you, your health and your lifestyle.

If your circumstances, relationships and sex life change, then you might change your mind about the pill too. 

It’s a good idea to keep a record of how it makes you feel, read about all the different options and talk to other people about their experiences.

You can choose not to bleed at all, bleed every month, or every 3 months. You just need to make sure you’re taking it correctly.

All brands of the pill tend to reduce acne.

It reduces the risk of cancer of the ovaries, lining of the womb and bowel but slightly increases the risk of breast cancer.

There are a few different types of combined pill. All of them are effective but they have different potential side effects and health risks.

What makes each one unique is the type of progestogen it uses and the amount of oestrogen it contains.

Everything you wanted to know about sexual health and wellbeing - your questions answered by our expert team.