LSU CASH’s Workshop Coordinator and volunteer writer, Megan McKone gives a rundown of one of the most common forms of contraception: the pill.
The pill is a hormonal method of contraception, when it is used correctly the pill is 99% effective, this means that for every 100 people taking the pill in any one year, 1 person will become pregnant. There are two main types of pill – the combined pill and the progesterone only pill. The pill is often associated with side effects such as mood swings and changes in acne, however after a few months these side effects generally lessen. One of the biggest misconceptions is that the pill will make you gain weight, there is currently no evidence for this, however the pill could cause bloating. The pill is free to take in the UK and can be prescribed by a doctor. The aim of the pill is to prevent pregnancy, there is also an emergency contraceptive pill – often called the morning after pill. The insertion of an IUD is also another method of emergency contraception and is more effective than the emergency pill.
Combined Pill
The combined pill contains oestrogen and progesterone. During the menstrual cycle, usually oestrogen would stimulate the release of the egg but in high concentrations, such as in the combined pill, oestrogen inhibits another hormone called FSH. FSH is what causes the egg to mature, so oestrogen in the combined pill prevents the egg from maturing. Progesterone in a contraception-free menstrual cycle causes the uterus lining to thicken. When it is used in the combined pill, progesterone thins the lining of the uterus making it difficult for a fertilised egg to implant and it thickens the mucus of the cervix which makes it harder for the sperm to get through and fertilise the egg. The combined pill is 99% effective, when it is taken properly according to its instructions. The pill is most often taken every day – at the same time – for 21 days and the 7 final days of the cycle are pill free days. During these 7 days is when you will bleed like you would during your period. For those taking the pill for a long time, this bleeding may become lighter and lighter and eventually stop. Some people take the pill every day and have placebo pills during their 7 days pill-free or some take the full pill every day, but it is important to discuss this with a doctor first. The combined pill may alleviate some symptoms of endometriosis.
What do I do if I miss a combined pill or take a combined pill late?
Having one late pill will generally not cause any issues, take the one missing pill when you remember even if you need to take two pills that day. Do not take more pills than this. A pill is considered late if it is taken less than 24 hours after the time it should have been taken, a pill is considered missed if it taken more than 24 hours after the time it should have been taken. If two or more pills are missed, then it is important to use backup contraception such as condoms to prevent pregnancy for 7 days if you resume taking the pill correctly.
What if I am sick?
If you vomit within 2 hours of taking the pill you should take another one as soon as possible for if you feel you may be sick again or have diarrhoea, then do not take another pill but consider it a missed pill. Remember if you miss more than 2 pills though that additional contraception will be necessary to prevent pregnancy.
Can some medications interfere with the pill?
Yes, it is important to consult a doctor about the medications you are taking, and they will advise you on either the best type of pill for you or on another method of contraception that may be more suitable for you. If you are ever unsure speak to your doctor.
What are some common side effects of the combined pill?
There are a variety of different pills you can take, and each person will experience different side effects, for example if you and a friend are both taking Rigevidon, one of the most common combined pills, one of you may experience acne or bloating while the other may experience improved acne or irritability. Taking the pill can interfere with sex drive, can cause headaches, breast tenderness, nausea, or mood swings for example. The side effects could be minimal for you but could be much more prevalent in others. If the side effects are overpowering, then consult your doctor and they will trial you on a new pill. The pill could have positive side effects, in some it improves acne, it could reduce period pain, improve the regularity, or reduce the amount of bleeding.
Progesterone Only Pill (aka Mini pill)
The progesterone only pill primarily causes the cervical mucus to thicken to prevent the sperm reaching the egg. When taken correctly it is more than 99% effective but when the pill is not taken correctly about 1 in 10 will become pregnant within one year.
What do I do if I miss a pill or take a pill late?
Most mini pills need to be taken within a three-hour window if the pill is late for it to be effective. Mini pills taken after these three hours is considered missed and backup contraception such as condoms need to be used for the following 48 hours if having sex.
What if I am sick?
If you vomit within 2 hours of taking the pill you should take another one as soon as possible for if you feel you may be sick again or have diarrhoea, then do not take another pill but consider it a missed pill. Remember if you miss more than 2 pills though that additional contraception will be necessary to prevent pregnancy.
Can some medications interfere with the pill?
Yes, it is important to consult a doctor about the medications you are taking, and they will advise you on either the best type of pill for you or on another method of contraception that may be more suitable for you. If you are ever unsure speak to your doctor.
What are some common side effects of the progesterone only pill?
The hormones that are involved in the pill affect the reproductive system but also the brain. Elevated hormone levels could increase the risk of depression and can alter moods. The most common side effects of the progesterone only pill is spotting and bleeding, some may experience nausea, dizziness, headaches, acne may improve or worsen, and you could experience changes in sex drive. Some may develop ovarian cysts and sore breasts, but these are less common.
The Emergency Pill
There are two different emergency contraceptive pills in the UK, these are Levonelle and ellaOne. The emergency pill is free from sexual health clinics, some pharmacies, most GPs, and some hospitals. The emergency pill can also be bought from most pharmacies. Taking either pill could cause some side effects such as stomach cramps, headache, or nausea. If you were to be sick within two hours of taking Levonelle or within three hours of taking ellaOne another dose is required to prevent pregnancy. The following period after taking an emergency pill may be longer, heavier and/or more painful. Some HIV medications may affect the effectiveness of the pill, so it is important to consult a doctor or pharmacist.
Levonelle
Levonelle is most effective if taken within a 12-hour window of the unprotected sex but it may still be taken within 72 hours. Over 16s do not require a prescription. The Levonelle pill costs around £25. Levonelle contains a synthetic version of progesterone called levonorgestrel. Levonorgestrel is thought to delay the release of an egg.
EllaOne
EllaOne is most effective when taken as soon as possible after unprotected sex but it can still be taken within 120 hours (5 days) of unprotected sex. A prescription is not required for any age, ellaOne is more expensive, and roughly costs £35. EllaOne also delays or stops the release of an egg but this is done through ulipristal acetate.
Emergency contraception does not cause abortion.
The pill is one of the most common methods of contraception, but it is okay if it is not for you, the right method of contraception for you is out there. Next week, I will be discussing different methods of contraception such as the IUD, the vaginal ring, and contraceptive injections. For more information, please visit the NHS website. Another good source of information can also be found via the YouTube channel Hannah Witton, whose channel is based around sex education, she also has a book and Instagram account called the hormone diaries which discusses different methods of contraception and real people’s experiences with them.
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Featured header image designed by Christos Alamaniotis.
