Contraceptive pills - Brighton Sexual Health and Contraception Service

Four different contraceptive pill blister packs on a pink and yellow background

What are contraceptive pills?

Contraceptive pills contain hormones that help prevent pregnancy and are taken every day. The two main types are the combined pill and the progestogen-only pill.

Combined pill (COCP)

COCP stands for combined oral contraceptive pill. It is usually known as the combined pill or simply “the pill”.

It’s called the combined pill because it combines two hormones: oestrogen and progestogen. It mainly works by stopping the ovaries releasing an egg each month (ovulation). It also thickens the mucus at the entrance to the womb, making it harder for sperm to reach an egg.

There are many different brands of combined pill, containing slightly different hormones and doses.

Progestogen-only pill (POP or mini pill)

POP stands for progestogen-only pill and is sometimes called the “mini pill”. It contains one hormone, progestogen.

Most POPs work by thickening the mucus at the entrance to the womb, making it harder for sperm to reach an egg. Some also stop ovulation, depending on the type of POP.

There are different types of POP, including desogestrel, drospirenone and traditional POPs containing norethisterone or levonorgestrel. They have different instructions about when to take them and what counts as a late or missed pill.

How effective is the contraceptive pill?

Both the combined pill and the progestogen-only pill are highly effective methods of contraception when they are taken correctly.

Perfect use

If the pill is taken exactly as instructed every day, fewer than 1 in 100 people using it will become pregnant during a year.

Typical use

In real life, pills are sometimes forgotten or taken late.

With typical use, around 9 in every 100 people using the pill will become pregnant over one year.

How to make the pill as effective as possible

The pill is most effective when it is taken correctly every day. Missing pills or taking them late can reduce how well it works.

You can help make your pill as effective as possible by:

taking it at the same time every day
setting a daily reminder or phone alarm
starting each new packet on time
following missed pill advice if you forget a pill
checking with a healthcare professional before taking new medicines
using condoms if you are advised to after missing pills
attending regular pill reviews.

If remembering to take a pill every day feels difficult, you may prefer a long-acting reversible contraceptive (LARC) such as the contraceptive implant, hormonal coil or copper coil. These methods are over 99% effective and work continuously without needing to remember a daily pill.

Is the contraceptive pill right for me?

During your appointment, a healthcare professional will ask about your health and discuss the different options with you to help you choose the method that best meets your needs.

Both types of pill are highly effective when used correctly, but one may be more suitable than the other depending on your health, age, lifestyle and personal preferences.

There isn’t a “best” pill that suits everyone. If one type isn’t suitable, we can discuss other hormonal and non-hormonal methods of contraception with you.

Choosing the combined pill (COCP)

The combined pill may be suitable if you want a contraceptive method that you control yourself and can remember to take every day.

It may also be a good option if you:

prefer regular, predictable monthly bleeding
have heavy, painful or irregular periods
experience symptoms of premenstrual syndrome (PMS)
have acne that may improve with certain combined pills.

Because the combined pill contains oestrogen, it is not suitable for everyone. You may be advised not to use it if you:

have migraine with aura
have previously had a blood clot in your leg or lungs
have certain heart or circulation conditions
have uncontrolled high blood pressure
have certain liver conditions
smoke and are aged 35 or over
have certain types of breast cancer
are within the first few weeks after giving birth.

Before prescribing the combined pill, a healthcare professional will ask about your medical history, check your blood pressure and discuss any medicines you take to make sure it is safe and suitable for you.

Choosing the progestogen-only pill (POP)

The progestogen-only pill is suitable for most people and can often be used by those who cannot take the combined pill.

It may be recommended if you:

are breastfeeding
smoke and are aged 35 or over
have migraine with aura
have a higher risk of blood clots
cannot take medicines containing oestrogen
prefer a pill that does not contain oestrogen.

Before prescribing a progestogen-only pill, a healthcare professional will ask about your medical history and any medicines you take to make sure it is safe and suitable for you. The exact advice may depend on the type of POP you are prescribed.

How can I get free contraceptive pills in Brighton and Hove?

The contraceptive pill is available free of charge from any of our clinics, many GP surgeries and some community pharmacies. During your appointment, we’ll ask about your health, answer any questions you have and help you choose the method that’s right for you.

Whether you’ve already decided which pill you’d like or want help choosing between the different options, we can talk you through the choices and answer any questions you have.

See how to book a contraception appointment for booking details and phone line opening times.

Some community pharmacies can provide both the combined pill (COCP) and the progestogen-only pill (POP) free of charge through the NHS Pharmacy Contraception Service, without the need for a prescription. Find a pharmacy that offers the contraceptive pill without a prescription.

Getting repeat supplies

Once you have started taking the pill and it remains suitable for you, you can usually get a repeat prescription from Brighton SHAC, your GP surgery or participating community pharmacies without needing a full contraception consultation each time. From time to time, you will be asked to have a pill review to make sure your pill is still safe and suitable for you.

Taking the contraceptive pill after having a baby

Your fertility can return surprisingly quickly after pregnancy, even if your periods have not started again.

The type of pill you can use after having a baby depends on:

whether you are breastfeeding
how many weeks ago you gave birth
your medical history
whether you have any additional risk factors for blood clots.

Many people can start the progestogen-only pill immediately after giving birth, while the combined pill usually needs to be started later because of the increased risk of blood clots in the weeks after pregnancy.

If you are breastfeeding, the progestogen-only pill is usually suitable. The combined pill may be started later and may affect milk supply in some people.

For detailed guidance about contraception after pregnancy, including breastfeeding and when different methods can be started, see our contraception after pregnancy page.

Frequently asked questions (FAQs) about contraceptive pills

No. Neither the combined pill nor the progestogen-only pill protects against sexually transmitted infections (STIs).

If there is a risk of STIs, using external (male) condoms or internal (female) condoms as well as your contraceptive pill provides the best protection. Regular STI testing is also recommended if you have a new sexual partner or more than one partner.

Vomiting or severe diarrhoea can stop your body absorbing the hormones in your pill properly, which may reduce its effectiveness.

If you vomit within a few hours of taking your pill or have severe diarrhoea lasting more than 24 hours, follow the missed pill advice for your type of pill.

Use condoms if advised and seek medical advice if you have had condomless sex, as you may need emergency contraception.

If you take the combined pill (COCP), you can often delay or reduce bleeding by taking active pills continuously instead of having a pill-free break or taking inactive pills. This is safe for many people and may be recommended if you have heavy or painful periods.

If you take the progestogen-only pill (POP), you cannot plan or delay bleeding in the same way. Bleeding may become lighter, irregular or stop altogether, depending on the type of POP you use.

If you’re unsure whether continuous pill-taking is suitable for you, speak to a healthcare professional.

Some medicines and herbal remedies can reduce how well the contraceptive pill works.

Always tell your doctor, nurse or pharmacist that you are taking hormonal contraception before starting any new medicine.

Examples include:

some medicines used to treat epilepsy
rifampicin and rifabutin (used to treat tuberculosis and some other infections)
some medicines used to treat HIV
some medicines used to treat hepatitis C
St John’s Wort

Never stop taking prescribed medication without medical advice. If a medicine affects your contraception, your healthcare professional will explain whether you need to use additional contraception or consider another contraceptive method.

Mounjaro® (tirzepatide) may make combined and progestogen-only pills less effective. Use condoms for 4 weeks after starting Mounjaro and for 4 weeks after each increase in dose, or consider contraception that is not taken by mouth.

Other GLP-1 medicines, including Wegovy® and Ozempic® (semaglutide), and Saxenda® and Victoza® (liraglutide), are not known to have the same direct effect on the pill. However, vomiting or severe diarrhoea caused by any weight-loss medicine may stop your pill being absorbed properly.

Contraceptive pills can affect people differently, and side effects can vary depending on the type of pill you take.

Changes to your bleeding pattern are common. Some people also report headaches, feeling sick or dizzy, sore breasts, and acne. Some people report mood changes, low mood, or changes in sex drive when taking the pill, while others notice no change or find their mood improves, particularly if premenstrual symptoms are reduced.

There is no clear evidence that either the combined pill (COCP) or progestogen-only pill (POP) causes long-term weight gain, although some people may notice short-term changes in their weight or appetite.

If side effects are persistent or causing you problems, speak to a healthcare professional. Changing the type or brand of pill may help, or another method of contraception may be more suitable.

For most people, contraceptive pills are safe, but as with all medicines, there are some risks to be aware of.

The combined oral contraceptive pill (COCP) is associated with a small increased risk of blood clots and heart attack, particularly in people with certain medical conditions or risk factors. It is also linked to a small increased risk of breast and cervical cancer while taking it, which returns to normal within 10 years of stopping. The combined pill is also associated with a reduced risk of ovarian, womb (endometrial) and bowel cancer.

The progestogen-only pill (POP) does not contain oestrogen and has fewer serious health risks. There is a small increased risk of breast cancer while taking the POP, which also returns to normal within 10 years of stopping.

Some people cannot safely use the COCP and may be advised to use the POP or another method instead. A healthcare professional will assess your medical history to help you choose a safe and suitable option.

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