The combined pill is popularly known as “the pill”. Just as the name implies, it contains a combination of the artificial forms of the two major female reproductive hormones - estrogen and progesterone. The natural forms of these hormones are produced by the ovaries and also partly by the adrenal gland.
Pregnancy occurs as a result of fertilization of the ova (human egg) by the sperm, but this can be prevented through contraception. Contraception acts to prevent this process either by killing the sperm, keeping the sperm away from the ova, or preventing the release of the ova from the ovaries during ovulation.
Every month, every woman’s (except those in the menopausal age and those who have not attained menarche) ovaries releases an egg (ova) with hopes that it would be fertilized. The combined pill acts to prevent this release and also causes,
The combined pills are over 99% effective when used properly but are less effective for most women because only a few use it correctly (the majority of these women are unable to take the pills at a specific time daily). However, other contraceptive methods have been more effective, such as IUS, implants and injections, and IUDs.
Just like every other drug, the pills are produced by different brands but come in 3 major types.
This is the most frequently used type of combined pill. Every pack of these pills contains 21 pills, each containing an equal amount of hormone in it. A pill is taken daily for 21 days, after which a short 7days break is taken. Some common examples are Microgynon, Cilest, Maervelon and Yasmine.
The pack of the phasic pills usually contains 2-3 sets of differently coloured pills. Each set, according to its colour, contains a different amount of hormone it. Just as the monophasic pills, these pills are also taken daily for 21 days and afterwards, a short 7-day break is taken. The phasic pills should be taken as instructed (according to sets) to achieve maximum effectiveness. A common example is Logynon.
Unlike the monophasic and phasic pills, the ED pills contain about 28 pills, 21 of them being active pills and 7 inactive (dummy) pills. These two sets of pills are usually coloured differently and can be easily identified. When taking the ED pills, a pill is taken daily for 28 days (with no 7 days break). Every day pills should be taken in the right order to ensure effectiveness. A common example is Microgynon.
You must keep to the manufacturer’s instructions of your preferred pills. You can always consult your GP, nurse, or pharmacist if you are confused or have questions.
To achieve maximum effectiveness, you need to follow the instructions correctly. Missing your pills, taking them at the wrong times or with certain medications can reduce the effectiveness.
Even while experiencing their menstrual cycle or period, most women can still start their pills. You must seek a medical professional's advice if you have just delivered, had an abortion or a miscarriage.
Sometimes, you may be required to use an extra contraceptive method when taking your first pill- this would be dependent on how far or early you are into your menstrual cycle.
Starting the combined pill on the first day of your menstruation cycle offers you complete protection against pregnancy. In this case, there would be no need for extra contraception.
If you start on the fifth day, the pills will not offer absolute protection until 7 days after starting. Therefore, you would have to make use of extra contraceptive methods.
When starting this pill, you must avoid putting yourself at risk of getting pregnant and also ensure that you haven’t put yourself at risk already since your previous period. Carry out a pregnancy test, at least 3 weeks after your last unprotected sex, if you suspect you are pregnant.
Missing a pill or pills, starting a pack late or taking the pills alongside certain medications can alter its effectiveness. The risk of getting pregnant after you have missed a pill or pills would depend on
There are certain steps to take if you miss a combined pill. To find out about these steps, check here.
Vomiting within 2-3 hours after the intake of your pills can affect its effectiveness. This is because the process of drug absorption may still be ongoing. If this happens, ensure you take another pill immediately and then take your next pill at the selected time.
If your illness persists, you will need to make use of extra contraception until you have recovered (and stopped vomiting).
Severe diarrhoea (with a frequency of about 6- 8 watery stools a day) can also impair the pills' absorption, thereby altering its effectiveness. If you experience this, ensure that you use extra contraceptive devices like condoms until at least 2 days after you have recovered.
As long as you don’t smoke or have medical reasons or conditions preventing you from taking the pills, you can take them, even until you attain menopause. Nevertheless, these pills are still not recommended for every woman. If you would like to know whether you are free to the pills, see your GP, nurse or pharmacist.
These pills are not recommended for or should not be taken by women who
These pills are also not recommended for you if you have or have had
Women who have just had a baby can begin taking pills at least 21 days after delivery if they aren’t breastfeeding but need to consult their doctor for guidance. If you do this, the pills will offer you complete and immediate protection against pregnancy.
If the combined pill is started anytime later than 21 days, it becomes less effective and would require the use of extra contraception, like condoms, for at least 7 days.
You can begin the pills at least 5 days after you have had an abortion or a miscarriage. Doing this, offers maximum and immediate effectiveness of the pills. However, taking pills 6 or more days after the abortion or miscarriage, would require you to use extra contraceptive methods for at least 7 days.
Certain medicines, when administered with the pills alter its effectiveness. A few of these drugs have been listed below. To confirm if your medications are compatible with the combined pills, you can:
Certain antibiotics such as rifampicin and rifabutin (used in the treatment of conditions such as tuberculosis and meningitis) can alter the effectiveness of the pills. However, other antibiotics do not alter its effectiveness.
If you are taking rifampicin or rifabutin, you may need to add an extra contraceptive like condoms, while on this medication. You can also consult your doctor or nurse for medical advice.
Certain medications, called enzyme inducers interact with combine pills and affect its effectiveness. These medicines make the breakdown of these drugs by your liver faster, thereby giving the drugs little time to act. This in turn reduces its effectiveness.
Some enzyme inducers include;
You may be advised by your GP or practice nurse to make use of another contraceptive instead or an extra contraceptive method while taking either of these drugs.
Certain health risks may be associated with the use of combined pills. However, the associated risks are small and can be outweighed by the benefits in most cases.
The hormone estrogen in the pill is capable of causing your blood to clot easily within your blood vessels. If this occurs, it could cause
Although the risk of developing a blood clot is low, you would need to be examined and assessed by your doctor for specific risk factors before the combined pill can be prescribed.
Sometimes, you may be advised to take the combined pills with caution if you have any of the following risk factors. Although, if you possess two or more of these risk factors, you may be advised against taking the combined pills.
You will be advised against it if you
Research is presently ongoing to determine the link or connection between the combined pill and breast cancer. Some studies reveal that women who use contraception are slightly at a higher risk of developing breast cancer than those who don’t. However, women who stop using contraceptive pills for at least 10 years have just the same level of risk as women who have never used contraceptives.
Certain researches have revealed that there may be a link between the intake of combined pills and the chances of developing cervical cancer and a rare type of liver cancer. However, these pills may reduce your risk of developing ovarian, endometrial and colon cancer.
The advice you are given and also the decisions you make.
This is because doctors and nurses work under stringent guidelines when handling, treating, advising or attending to people under 16. The most they can do is try to encourage or convince you to tell your parents or caregivers, but you would not be forced to tell.