Combined Pill

What is the combined pill?

Usually, the combined oral contraceptive pill is just called “the pill”. The pill contains synthetic (otherwise known as artificial) versions of the female hormones (which are progesterone and oestrogen) that women naturally produce in their ovaries.

These artificial hormones that are in the pill stop your ovaries from releasing an egg (from ovulating). The combined pill is mostly taken to prevent any pregnancies, because it is as a form of contraceptive. This type of combined pill can also be taken to treat endometriosis, heavy periods/painful periods and premenstrual syndrome (PMS).


What can I expect? Your IPSA combined-pill consultation

During your full-length IPSA combined-pill consultation, your female IPSA physician, who is an experienced family planning practitioner, will see you (this can be on the same day you book your consultation), examine you, and work holistically with you, making the setting conducive, so you are relaxed and involved in the decision-making process regarding your contraceptive choice. After talking through all of the different types of available contraception with you, if the decision is that the combined pill is the most suitable choice, then your IPSA physician will counsel you on any side effects of the combined pill, about how to take it, and about what to do if you happen to miss taking one of your combined pills on time.


Where can I get the combined pill?

You can be prescribed the combined pill at the IPSA clinic during your consultation, and booked in for follow-up combined pill reviews (at appropriate time intervals).


The combined pill and family planning

  • The pill is more than 99% effective (when taken correctly) at preventing pregnancy.
  • The pill should be taken every day for 21 days; you then need to stop for seven days. And, during this week, you will have a bleed that is similar to a period. The pill is taken again after the seven-day break.
  • The pill needs to be taken at the same time each day, because you might become pregnant if you don’t do this, or if you vomit, have severe diarrhoea or miss taking a pill.
  • The combined pill can help with heavy or painful periods.
  • Breast tenderness, headaches and mood swings are the minor side effects of the pill.
  • There is a lack of evidence for the pill making women gain weight.
  • Serious side effects are not common when taking the pill (such as blood clots/cervical cancer).
  • The combined pill is not appropriate for some women with particular medical conditions or for women over 35 who smoke.
  • The combined pill does not protect you against an STI (sexually transmitted infection). Using a condom in addition to the pill will help in protecting you against STIs.


Starting the combined pill

The majority of women are able to start taking the pill at any time during their menstrual cycle. If you have recently had an abortion, had a baby, or had a miscarriage, then your IPSA practitioner will offer you special guidance. Depending on what day of your menstrual cycle you are on, you might have to use additional contraception during your first few days taking the pill.


Who can use the combined pill?

You can continue to take the combined pill until the menopause, as long as there are no medical reasons for you not being able to take the pill and you do not smoke. The combined pill is not suitable for everyone. This is the case especially if you:

  • Are pregnant
  • Smoke and are over 35
  • Are very overweight
  • Are over 35, and have only stopped smoking within the last year
  • Are taking certain types of medicines (ask your IPSA physician for more information on this)

You should not take the combined pill if you have had or if you have:

  • A blood clot (thrombosis)
  • High blood pressure, heart disease or a heart abnormality
  • Severe migraines, especially with the warning symptom of an aura
  • Breast cancer
  • Liver or gallbladder disease
  • Diabetes: if you have had diabetes for at least 20 years or if you have any complications


Advantages: The combined pill

  • The combined pill means that sex is never interrupted
  • The combined pill usually makes your periods less painful, more regular, and also lighter
  • Your risk of cancer of the womb, of the ovaries and of the colon is reduced
  • Premenstrual syndrome symptoms can be reduced
  • Sometimes it can alleviate acne
  • The combined pill might protect you against pelvic inflammatory disease
  • The risk of non-cancerous (benign) breast disease, of getting fibroids or ovarian cysts is reduced


Disadvantages: The combined pill

  • Initially, temporary side effects such as breast tenderness, headaches, mood swings and nausea may be felt; changing to a different pill might well help with this if these side effects do not fade after a few months
  • Your blood pressure may rise
  • The combined pill does not protect against STIs
  • During the first couple of months using the combined pill, issues regarding spotting and breakthrough bleeding are common
  • There is some evidence of a link to an increased risk of some serious health issues such as breast cancer and blood clots (thrombosis)


If you are thinking about taking the combined pill, then book your IPSA combined pill consultation today.



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