“Contraception and Me” speaks to real people about their contraception experiences and gives you their honest answers. Each month, we’ll look at a different kind of contraception. This month, we’re looking at the contraceptive pill.
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The combined pill uses oestrogen and progesterone, hormones naturally produced by the ovaries, to stop your ovaries from releasing an egg. It also makes it harder for sperm to get into the fallopian tubes, and for a fertilised egg to implant in the womb lining. You take pills for 21 days of a 28 day cycle, and then have a 7 day break in order to have a bleed similar to a period.
The progesterone only pill (POP) contains only progesterone which works in a not dissimilar way to the combined pill, thickening the cervical mucus to prevent sperm from reaching an egg. Depending on the brand, it may also prevent ovulation. You take one pill every day at around the same time.
Both are over 99% effective at preventing pregnancy. Both can be affected by sickness, diarrhoea, or other medications. Both can have an effect on your periods and can be used to make them lighter or less painful. Neither protects against sexually transmitted infections.
Both can have side effects, including mood swings and breast tenderness. The combined pill is not suitable for some people such as smokers over 35, people who are very overweight, have severe migraines, or high blood pressure. Your doctor should ask about these things.
We asked several people to give their honest answers about both pills.
10 respondents, 7 who’ve taken both types of pill, and 3 who have only taken the combined pill.
What made you choose this type of contraception?
HW: I was 14, was to control PMT and skin.
CD: I started with combined for heavy and very painful periods. A few years later I went for POP as a friend said it had completely stopped her periods.
EH: It was originally to help with my terrible acne and very, very painful periods as a teenager.
MR: To be honest, I was told it was the best option for me and went with it.
SG: I was having very heavy periods that were leaving me in a bit of a state each month. Doctor suggested trying pill as can be quickest to work for ‘those things’.
BC: To prevent pregnancy.
ET: It was recommended to me to help my polycystic ovary syndrome (PCOS) symptoms, alleviate cramps & regulate my period.
SM: I started at 15 to regulate heavy periods, I didn’t know anything about different options. I was a little awkward as I was still a kid.
CC: Birth control.
LM: I wanted it to regulate periods. Had a bit of a battle with GP, but got there in the end. Didn’t get period pains too much, just felt cold and a bit nauseous. But cycles were seriously out of whack 23-38 days and I was bleeding for at least eleven days per cycle, seven of those so heavily I had to double up on tampons and towels and change every 90 mins or leak.
Did you experience any side effects?
HW: Not at first.
CD: I gained a dress size and quickly started having mood swings on combined. For POP it was just a bit of breast tenderness and spotting.
EH: Very luckily, no.
MR: Yeah! The first one I took gave me constant nausea even though I was taking it religiously at the same time every day. Both have a terrible impact on my mental health but it’s sadly the price we pay. I have gained weight from both.
SG: Came off combined because of headaches and blurred vision. Literally woke up one morning not able to see anything properly. Nothing on POP so far (over a year now).
ET: Not really.
SM: Some weight gain, I think it did affect my mood though it’s hard to be certain it wasn’t caused by something else.
CC: My mood swings had gotten considerably worse, especially in recent months, I was having trouble eating as I felt nauseated and my vision would go blurry regularly, I saw my doctor for tests (I thought I might be diabetic), she surmised they were due to the combined pill.
Was it effective?
HW: Helped with PMT, not so much with my skin.
CD: Combined pill helped at first, but after a year the painful periods were back. POP has been a blessing, no periods!
EH: It improved my acne and did improve my period pain. I have switched over the years and now I don’t ‘bleed’ and it has improved my well-being massively.
MR: 100%.
SG: Well, I’ve not had a period for quite a while and it is delightful. I’m also not pregnant, but I’m not going to count my chickens too loudly!
ET: Yes in regulating my period, not in alleviating cramps or any other PCOS symptoms.
SM: Periods were less heavy and painful and were more regular which was an improvement!
LM: I missed a few and got pregnant, whoops. On both types.
How was it coming off this?
CD: As soon as I stopped taking the combined pill my periods became less painful again, I didn’t think that was supposed to happen.
EH: I had an accidental break when I didn’t sort my prescription in time and got breast pain and nausea, which was nothing short of terrifying until I realised it was common!
ET: Painful. My periods became much worse when I came off it.
SM: My periods seemed a bit worse during the time when I came off the pill and switched to another method.
LM: I decided to have another kid, stopped taking the pill, figured I wouldn’t get pregnant until my body had adjusted but whoops got pregnant again.
Did you combine this method with anything else?
MR: Condoms. Always.
BC: I use condoms as well.
SM: I used condoms when needed to protect against STIs and as an additional barrier against pregnancy.
If you’ve taken both types of pill, how did they compare? Which did you prefer?
CD: At first they were both about the same, but it was very quick for combined to become problematic. POP is possibly the best medicine I’ve ever taken.
SG: Only one of them made my vision funny, so…
CC: I had been put on the combination pill for years but I really shouldn’t have been. The doctor prescribed me POP and things have been a lot better since.
Anything else you would like to add?
HW: I started getting regular migraines in the run up to my period. I tried varied brands of pill, to no effect. Changed to POP as that has no oestrogen. Unfortunately, that didn’t help so I stopped taking anything. I’ve not been on the pill for about six years now.
CD: POP doesn’t stop everyone’s periods, and I’ve heard 1 in 5 get worse, but I feel like it’s worth a try if your periods are horrendous like mine were.
EH: Don’t be afraid to talk to your GP about what you need it for and challenge if your pill doesn’t work for you. I have the odd niggle with mine (if I miss just one night it can cause havoc) but all in all no other issues and something you are taking every single day potentially for years shouldn’t bother you at all.
MR: For me, the major problem is how it affects my already terrible cocktail of mental illnesses – unfortunately, this affects so many people and it really is a choice we have to make if we’re not in a place to/don’t want to have children.
SG: If you are taking the pill and start to experience problems… go back to your GP! There are so many options, you will find something!
BC: After seeing three doctors, I was informed I should never have been on the combined as I get migraines on a semi-regular basis and estrogen has been shown to increase the risk of strokes in migraine sufferers. The other two didn’t mention this. That was pretty terrifying.
ET: Some people are very judgemental about it. I once booked an appointment at my university doctor and the receptionist told me she thought ‘all girls should have a chastity belt put on them when they start university’. Also I have had to deal with doctors not wanting to give me the pill as both my partner and I have vaginas so they don’t see the need for it.
SM: As a trans man it’s important to me to not be putting any additional oestrogen into my body so the combined pill is not something I would use again. I found it difficult to remember to take the pill consistently, either missing days completely or being late on taking it.
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For more information about the contraceptive pill, speak to your nurse or GP, or check out the NHS Contraceptive Guide.
