Combined Hormonal Oral Contraceptive (the Pill)

The pill, also known as the combined pill or oral contraceptive, contains oestrogen & progestogen, which are hormones similar to the ones made in the ovaries. 

Many brands of the pill are available in Australia. All have different types and doses of progestogen and oestrogen in them. 

Most packets of the pill contain either: 

  • 21 hormone pills and seven non-hormone pills (pills which do not contain either hormone, also known as sugar pills)
  • 24 hormone pills and four non-hormone pills

Note: The combined oral contraceptive pill (the pill) is not the same as the ‘mini pill’. You can learn about the mini pill here.

How does the pill work?

  • The two hormones work together to prevent pregnancy by stopping the release of an egg each month (ovulation)
  • The hormones cause a thickening of the mucus in the cervix, which stops sperm from entering the uterus (womb)
  • When you take the non-hormonal pills, you will get a withdrawal bleed, which is like a menstrual period

How well does it work?

  • The pill is a tablet that needs to be taken at the same time each day
  • If used correctly, it is over 99.5% effective at preventing pregnancy
  • It can be less effective if it is missed or not taken at the correct time
  • It can be less effective if you have diarrhea or vomit within two hours of taking it
  • Certain medications, including epileptic and herbal remedies, can reduce the effectiveness of the pill

Who can take the pill?

You can safely take the pill up to the age of 50 as long as there are no medical reasons not to. 

Medical reasons where the pill is not recommended include: 

  • a history of deep vein thrombosis (DVT – blood clot in the vein), stroke, heart attack or other types of heart disease
  • a condition prone to blood clots
  • breast or liver cancer
  • severe liver problems
  • certain types of migraines
  • systemic lupis erythematosus (SLE)
  • unusual vaginal bleeding
  • being over 35 years old and a smoker

You also may not be able to take the pill if you: 

  • have high blood pressure or diabetes and/or
  • are overweight

Is the pill right for me?

The pill may not be the right choice if: 

  • you have difficulty remembering to take the pill at the same time every day
  • you have spotting or breakthrough bleeding
  • you cannot have the hormone oestrogen

There is a small risk of blood clots (deep vein thrombosis), stroke and heart attack. This risk increases if you smoke, or have high blood pressure or diabetes.

Advantages

  • Works well when taken correctly at the same time every day
  • Can reduce period pain and heavy menstrual bleeding
  • Can be used to prevent a period
  • Fertility returns to normal straight away when you stop taking them
  • It can help manage the symptoms of endometriosis
  • Regulates monthly bleeding, which is good for those with irregular periods 
  • May improve premenstrual syndrome (PMS)
  • Can improve acne
  • Can reduce the risk of some cancers including ovarian, uterine and bowel cancers

Possible side effects

  • Headaches
  • Nausea or bloating
  • Breast tenderness
  • Acne
  • Mood changes
  • Reduced interest in sex
  • Skin changes – brown marks

Most side effects settle within three months. If they continue and are impacting on your lifestyle, make an appointment with one of our doctors to discuss your options.

Where can I get the pill?

Starting the pill for the first time requires an assessment by a doctor and you will need a prescription (script). 

The pill is available from most pharmacies with a prescription. The cost of the pill is largely dependent on whether you have a Concession and/or Medicare card. 

Your doctor will be able to identify which brand of the pill is most suitable for you.

How do I take the pill?

The pill needs to be taken at the same time every day. 

It is recommended to start the pill in the first five days of a normal period. In this case, the pill will be effective immediately. 

You can start later in your monthly cycle but you will need to wait seven days for the pill to become effective. 

When you are on the pill you will have a period whilst you are taking the non–hormonal pills (sugar pills). This is referred to as withdrawal bleeding. 

You can choose to skip your period (withdrawal bleeding) by not taking the non-hormonal tablets (sugar pills) and continue with the first hormonal pill of a new packet the following day. 

It’s a good idea to set a reminder, such as on your phone or calendar, to help you remember to take your pill.

What could stop the pill from working?

The pill might not work if: 

  • you are more than 24 hours late taking it or you missed more than one pill
  • you vomit within two hours of taking it
  • you have had severe diarrohea
  • you are taking certain medications and natural remedies

What else do I need to know?

  • If you run out of pills and are unable to see a doctor, speak to a pharmacist. Some pharmacists may be able to help if you show them your old pill packet
  • If you are breastfeeding, you can’t use the pill until your baby is six weeks old
  • If you think you are pregnant, you should stop taking the pill immediately
  • If you do get pregnant while on the pill, there is no evidence to suggest it will affect the pregnancy
  • Some studies show an increased risk of breast cancer in women taking the pill
  • The pill does not protect you from sexually transmitted infections (STIs)

If you want to know more about how contraception might work best for you, you can speak with one of our friendly doctors. Click here to find your closest clinic and make an appointment.

Useful documents

You might find these downloads helpful:

Combined Hormonal Oral Contraceptive (the Pill)
What to do if you miss a Pill
Contraceptive choices overview

This content is provided for general information and education purposes only and does not take into account individual circumstances. It is not to be relied on in substitution for specific advice from a medical professional and Family Planning Tasmania does not accept responsibility for such use. Family Planning Tasmania has taken every effort to ensure that the information is up to date and accurate, however information and knowledge is subject to change. Family Planning Tasmania advises that you always consult a medical professional for individual advice.

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