What is the combined oral contraceptive pill?

The combined oral contraceptive pill is a type of contraception (birth control). It is often just called 'the pill'. Some doctors refer to it as the ‘OCP’.

You take the pill as a daily tablet. It contains 2 hormones — oestrogen and progestogen.

Types of combined oral contraceptive pills

There are many different types of combined OCP.

If you are thinking about going on the pill, talk to your doctor about the best option for you. You need a doctor’s prescription to take the pill.

Some types of the pill are available on the Pharmaceutical Benefits Scheme, which means they are cheaper to buy.

How does the pill work?

The main way the pill works is by stopping ovulation (eggs being released from the ovaries).

The pill also thickens the mucus at the entrance of your uterus (womb), which prevents sperm from entering.

How do I take the pill?

The pill usually comes in a packet of 28. You should take one pill around the same time every day.

Pill packets may contain:

• 21 hormone tablets and 7 non-hormone pills (28 pills altogether)
• 24 hormone pills and 4 non-hormone pills (28 pills altogether)

Check the instructions that come with your pill carefully. They will tell you what to do if you:

• are late taking your pill
• miss a dose

Missing a pill may mean your pill won’t protect you from getting pregnant.

If you are not sure what to do if you miss a pill, you can:

• ask your doctor
• call your local family planning clinic

How well does the pill work at preventing pregnancy?

The pill works well at preventing pregnancy when used properly. But with typical use, 7 in 100 people will become pregnant when using the pill.

The pill may not work properly if:

• you don’t take it regularly or miss a dose
• you've had vomiting or diarrhoea (the pill may not be absorbed properly)

Also, some medicines and supplements may prevent the pill from working. If you take any other medicines, ask your doctor or pharmacist about how they might affect the pill.

If you are not sure what to do if you have been unwell, you can:

• ask your doctor
• call your local family planning clinic

There are other forms of contraception that have been shown to be very effective, such as the contraceptive implant or intrauterine contraceptive device (IUD). Talk to your doctor about the different types of contraception.

What are the advantages and disadvantages of the pill?

Advantages of the pill:

• It is effective when taken properly.
• It can help control heavy periods and reduce period pain.
• It can improve acne, endometriosis symptoms, polycystic ovarian syndrome (PCOS), pre-menstrual syndrome (PMS) and some symptoms of perimenopause.

You can also talk to your doctor about how to take the pill to avoid having periods.

Disadvantages of the pill:

• You need to remember to take it every day.
• It may not work properly if you have vomiting or diarrhoea.
• You may have spotting or breakthrough vaginal bleeding.
• It can cause side effects, especially when you first start taking it.
• When you stop taking the pill, there may be a short delay in the return of your normal cycle and fertility.
• The pill can increase your risk of blood clots, stroke and heart attack.
• It won't protect you from sexually transmitted infections (STIs).

What are the possible side effects of the pill?

Side effects of combined hormonal contraception may include:

• headache
• nausea
• tender breasts
• bloating
• mood changes
• less interest in sex
• weight gain
• brown patches on the face

Who should not take the pill?

Talk with your doctor or family planning clinic about whether the pill may be suitable for you.

The pill may not be recommended if you:

• have, or have ever had, blood clots such as a deep vein thrombosis
• have a condition that increases your risk of blood clots
• are older than 35 years and smoke
• have had a baby in the last 6 weeks and are breastfeeding
• have ever had a heart attack or stroke
• have certain types of heart disease
• have high blood pressure

The pill may also not be recommended if you have other conditions, including:

• severe liver problems
• breast cancer
• some types of migraine

Resources and support

Family Planning Australia has fact sheets on contraception.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.