Combined oral contraceptive pill - ‘the pill’

The pill.

A daily tablet that contains 2 hormones (oestrogen and progestogen).

Each pill packet contains 28 pills, with up to 3.5 weeks of active (hormone) pills, and up to a week of inactive (non-hormone) pills.

There are many types of the pill, each with different kinds and amounts of hormones. You might have to try a few different pills before you find the one that feels right for you.

Some of the more common uses of the pill include:

• preventing pregnancy
• skipping periods
• regulating periods
• reducing period pain
• reducing heavy period bleeding
• reducing excessive hair growth
• improving acne

The pill works by:

• stopping ovulation (eggs being released from the ovaries)
• thickening cervical mucus so sperm can’t get through to the fallopian tubes (where eggs are fertilised)
• thinning the lining of the uterus so if an egg is fertilised, it is less likely to implant and start a pregnancy

The pill can start working quickly to prevent pregnancy, but the timing depends on when you start taking it in your cycle.

If you start the pill within the first 5 days of your period starting, you are protected straight away. This method also ensures that you aren’t pregnant when you first start taking the pill.

If you start the pill more than 5 days after your last period started, you need to take the active pill for 7 days in a row before you are protected. Use backup contraception (e.g. condoms) or avoid having sex for those first 7 days to prevent pregnancy. If you’ve had unprotected sex between your period and taking the first pill, it is a good idea to do a pregnancy test 3 weeks after you had unprotected sex.

Typical use: 93% effective.

Perfect use: 99.7% effective.

• Take one pill every day.
• Don’t skip active pills.
• Start new packs on schedule after finishing previous packs.
• If you experience gastrointestinal symptoms like vomiting or severe diarrhoea, follow instructions on the pill packet.

Some people set alarms or reminders to help them to remember to take their pill every day.

The pill is less effective if you:

• miss active pills
• have vomiting or severe diarrhoea

The information sheet that comes in the pill packet will give you instructions on what to do if this happens. In these instances, you may need to use another form of contraception (e.g. condoms) to prevent pregnancy, or avoid having sex, until you’re back on track.

Some medicines reduce the effectiveness of the pill, including:

• some antibiotics
• some epilepsy medications

It is best to check with a healthcare professional if any new or current medications or supplements you take will decrease the effectiveness of the pill.

No.

Internal and external condoms are the only types of contraception that protect against STIs.

The pill needs to be taken daily.

Prescriptions can last between 3–12 months. Some healthcare professionals may provide a repeat prescription to reduce how often you need to see them.

It is possible to be discreet while using the pill.

However, it is possible someone might notice pill packets, reminder alarms, or see you taking it.

As with all medications, some people may experience side effects.

Some possible side effects include:

• nausea
• headaches
• sore breasts
• spotting (light bleeding that is not your period)
• mood changes
• decrease in libido (less interest in sex)
• small brown patches or freckles on your face (called melasma)

Side effects vary between different pills and different people. Some people experience no side effects or experience positive changes while on the pill. Side effects can settle after a few months. If the side effects of a certain pill bother you, you may want to try a different pill or a different type of contraception.

Some common health conditions and lifestyle factors that may stop you from using the pill include:

• being over 50 years of age
• current Body Mass Index (BMI) over 35kg/m2
• smoker aged 35 years or older (includes vaping)
• history of blood clots, or strong family history of blood clots
• migraine headaches
• high blood pressure
• history of stroke
• heart disease (current or past)
• breast cancer (current or past), including a strong family history of breast cancer
• severe liver disease or liver cancer
• taking certain types of anti-epileptic or seizure medication

It is important to talk with a healthcare professional about your full medical history when deciding which contraception option is the safest and most suitable for you.

You will need a prescription. You can get one from a doctor (either a GP or relevant specialist, e.g. a gynaecologist), nurse practitioner or pharmacist (in some states and territories). They should ask you questions about your medical history and might do some tests to ensure that the pill is a safe option for you before prescribing.

It is possible to get a prescription at:

• a GP clinic
• a specialist appointment
• a telehealth appointment (online or over the phone)
• sexual health clinics
• family planning clinics
• pharmacies (in some states and territories)

Once you have a prescription, the pill can be bought at most pharmacies, including online pharmacies.

The cost of the pill can vary depending on the brand. Some pills are listed on the Pharmaceutical Benefits Scheme (PBS), which makes them cheaper for those who hold a current Medicare card.

Each repeat of a prescription usually lasts for 3 months but can vary between 1–4 months. Costs for each repeat are:

• PBS-listed pills: up to $25
• PBS-listed pills for concession card holders: up to $7.70
• Non-PBS listed pills: between $30–100

Although some healthcare professionals bulk bill (which means you won’t pay anything to see them), some may charge out-of-pocket costs for the appointment needed to get your prescription.

No, the pill has no impact on long-term fertility.

Your fertility should return to normal soon after you stop taking the pill, but your menstrual cycle might take a little while to settle.

If you are breastfeeding, you will need to wait until your baby is at least 6 weeks old to use the pill. If you are not breastfeeding, you may be able to use the pill once your baby is 3 to 6 weeks old.

It is important to check with a healthcare professional what time is safest and most suitable for you to use this contraception.