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The Combined Oral Contraceptive pill

The combined oral contraceptive pill (often called “the pill”) is a popular and effective method of contraception. It contains two hormones – oestrogen and progestogen – which are similar to those produced naturally by the body.

Combined Pill | Contraception Choices

Different ways to take the combined pill (PDF)

How does the combined pill work?

The pill prevents pregnancy by:

  • stopping ovulation (release of an egg)
  • thickening cervical mucus to make it harder for sperm to reach an egg
  • thinning the lining of the womb

How effective is it?

  • Over 99% effective when taken correctly
  • Around 91% effective with typical use (when pills are missed)

How do I take the pill?

There are different types of combined pill, but most are taken:

  • Once a day for 21 days, followed by a 7-day break, or
  • Every day continuously, depending on the type prescribed

Your GP or nurse will explain how to take your specific pill.

When does it start working?

  • If you start the pill on days 1–5 of your period → you are protected immediately
  • If you start at any other time → use additional contraception (e.g. condoms) for 7 days

Advantages of the combined pill

  • Highly effective when taken correctly
  • Can make periods lighter, less painful, and more regular
  • May improve acne
  • Can help with symptoms of PMS
  • May reduce the risk of ovarian, womb, and bowel cancer

Possible side effects

Some people may experience:

  • Nausea
  • Breast tenderness
  • Headaches
  • Mood changes
  • Breakthrough bleeding (spotting), especially in the first few months

These often improve over time.

Risks and safety

The combined pill is safe for most people, but it is not suitable for everyone.

You may not be able to take it if you:

  • Smoke and are aged 35 or over
  • Have a history of blood clots (DVT/PE)
  • Have certain types of migraine (with aura)
  • Have high blood pressure
  • Have a history of breast cancer

There is a small increased risk of blood clots when taking the combined pill. Your clinician will assess your individual risk.

Missed pills

If you miss a pill, follow the instructions in your pill packet or contact the practice for advice. You may need to:

  • Take the missed pill as soon as possible
  • Use additional contraception

Other important information

  • The pill does not protect against sexually transmitted infections (STIs)
  • Some medications can make the pill less effective — always check with a pharmacist or GP
  • Vomiting or severe diarrhoea can affect how well the pill works

Our services

We offer:

  • Pill checks and reviews
  • New prescriptions
  • Advice on side effects or changing pills

All consultations are confidential.

When to seek advice urgently

Seek medical help if you develop:

  • Severe chest pain or breathlessness
  • Severe headache or vision problems
  • Pain or swelling in your leg

These may be signs of a blood clot (rare but serious).

Book an appointment

Page published: 20 April 2026
Last updated: 14 May 2026