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Which contraceptive pill is best?

Virtually Healthcare is an innovative GP practice providing comprehensive contraceptive care. The service is easily accessible online, on the phone, or in person, with all appointments free of charge on the NHS.

What is the contraceptive pill?

The combined oral contraceptive or COC is an effective hormonal method of contraception often known as ‘the pill’. The pill contains synthetic versions of the natural female hormones oestrogen and progesterone.

There’s a wide range of combined oral contraceptive pills available. The experienced family-planning GPs at Virtually Healthcare can help you find the best formulation for your needs.

How does the contraceptive pill work?

The combined oral contraceptive prevents pregnancy by stopping the ovaries from releasing an egg. It also thickens the mucous in the cervix so that it’s more difficult for the sperm to reach the egg and thins the womb lining, so a fertilised egg is less likely to implant in your womb.

When taken reliably according to instructions, the pill prevents more than 99% of pregnancies. Your doctor will advise you on how and when to take the pill, how soon it is effective and when you may need additional contraception.

What type of contraceptive pill is best?

The best contraceptive pill for you will depend on your health, your lifestyle and your preferences. Your family-planning doctor will take you through the options and help you find the right pill for your needs. Considerations include:

  • Acne treatment: Certain combined contraceptive pills can reduce the effects of natural male hormones and prevent spots and acne. These pills, such as Dianette or Yasmin, may have an increased risk of thrombosis and should not be used for prolonged periods. Your doctor will carefully explain the pros and cons of treatment.
  • Risk factors: If you smoke, are overweight or over 40, or suffer from migraines or hypertension, the combined oral contraceptive may not suit you. Talk to your family planning GP about your options. If you’d want an oral hormonal contraceptive, the mini or progesterone-only pill might be a safer option.
  • Side effect problems:  Some people experience troublesome side effects on the pill. If you suffer from nausea, headaches or tender breasts, a lower dose pill could suit you more. Discuss the options with your doctor; they may recommend a pill with lower levels of oestrogen, such as Loestrin 20. Phasic pills have different amounts of hormones at different times in your cycle; an example is Logynon. Phasic pills have lower oestrogen and could potentially reduce side effects and unscheduled bleeding, although there is little strong evidence for this.
  • Memory matters: If the pill-free break causes confusion and makes you forget to restart your pills after seven days, you may prefer a continuous or ‘every day pill. These types of COC include seven ‘dummy’ pills in the packet, so you take one pill every day. Every day pills need to be taken in the correct order, as marked on the packet. An example of an every day pill is Microgynon ED.

Contraceptive care at Virtually Healthcare

The specialist family planning GPs at Virtually Healthcare provide full and free contraceptive services. They will discuss your health, preferences, and pregnancy plans before suggesting contraceptive options to suit your lifestyle. These could include the contraceptive pill and other hormonal methods, including the mini-pill, contraceptive implants, injections or patches. They can also recommend barrier methods such as condoms and caps or insert coils or intrauterine systems like the Mirena device.

The Virtually Healthcare difference

Virtually Healthcare is a cutting-edge GP practice, providing expert healthcare in the comfort and privacy of your home. The Virtually Healthcare service is designed to fit in with modern lives. You can access consultations easily with virtual appointments available seven days a week.

The team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as highly-skilled GPs, the team includes experienced family planning and sexual health specialists, physiotherapists and practice nurses to offer a comprehensive primary care service.

During the pandemic, many patients are finding it more difficult to access healthcare. Virtually Healthcare provides rapid access video or telephone appointments, with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.

At Virtually Healthcare, we focus on you. Our clinicians take a holistic approach to care. Whether you want an easy, convenient way to get contraception or a discreet testing service for STIs, our dedicated team can provide expert advice and treatment.

What are the pros and cons of the pill?

Every contraceptive method has advantages and disadvantages. Your doctor will take you through the risks and benefits so that you can make an informed choice. For the combined oral contraceptive, these include:

The advantages

  • The COC is highly effective, providing 99% protection from pregnancy if taken correctly.
  • The pill works continuously so that sex can be spontaneous and uninterrupted.
  • The contraceptive pill can make your periods lighter, less painful and more regular.
  • Your fertility should swiftly return to normal when you stop the pill.
  • The pill can reduce problems with premenstrual syndrome.
  • Contraceptive pills can help reduce acne and break-outs.
  • The pill can protect against some cancers, including ovarian, endometrial and colon cancers.
  • The COC can help reduce your risk of pelvic inflammatory disease, fibroids, ovarian cysts and benign breast disease.

The disadvantages

  • The contraceptive pill doesn’t protect against STIs. You will need to use a barrier method for STI protection.
  • If you forget the pill or have sickness or diarrhoea, the pill may be ineffective, and you will have to use additional protection during sex.
  • You may get side effects including headaches, nausea, breast tenderness and mood swings.
  • The pill may increase the risk of problems, including blood clots and breast cancer.
  • Some medications can affect the effectiveness of the pill. Talk to your GP or pharmacist if you use regular medication. It’s also important to check if you use herbal or over-the-counter medications; treatments such as St John’s Wort can affect the implants efficacy.
Hot topics in contraceptive care

I’m going on holiday, can I skip my pill-free break?

It’s perfectly safe to take two packets of pills consecutively with no break. The bleed you have when you’re on the pill is known as a ‘ withdrawal’ bleed. It happens because you stop taking the hormones in the pill. There is no disadvantage to missing a withdrawal bleed, and you will be protected from pregnancy throughout.

How soon is the pill effective?

You can start the pill at any time during your menstrual cycle, but the time you start will affect the time before you are protected against pregnancy.

If you take the first pill on one of the first five days following the start of your period, the COC will prevent pregnancy immediately. If you start the pill later in your cycle, you should use additional protection for seven days.

Who can’t use the pill?

If you’re healthy, a non-smoker, and have no medical reasons to prevent COC use, you can use the contraceptive pill until you reach 50 years. It may not be safe or healthy to use the contraceptive pill if:

  • You may be pregnant.
  • You’re over 35 and smoke or have given up smoking in the last year.
  • You use drugs that can interact with the pill, such as epilepsy or anti-HIV medication.
  • You have a history of cardiovascular disease, hypertension or stroke.
  • You suffer from migraines with aura.

You have active liver or gallbladder disease.

You have breast cancer or have the BRCA gene.

You have a history of thrombosis or blood clots.

You have diabetes with complications.

You are a wheelchair user or have long periods of immobility.

Types of consultations we offer

We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.