If you've never used the pill before, you probably have a lot of questions. How exactly does it work? Are there any side effects to be mindful of? What are the different types and, more importantly, how effective are they?
Diving into birth control with zero understanding of what the contraceptive pill is isn’t the smartest approach, but if you're feeling a bit confused, we can help. Let’s answer all your questions and master the basics of this type of oral contraception.
What is the oral contraceptive pill?
The oral contraceptive pill (a.k.a. the pill) is a method of birth control used to prevent pregnancy. For many of us, it’s also a helpful way to manage uncomfortable menstrual symptoms like bloating, cramps, and heavy, irregular bleeds.
The most common type of pill uses 2 types of hormones (oestrogen and progestogen) to prevent unwanted pregnancy, similar to the hormones our bodies naturally produce. There are also types of oral contraceptive pills that use just 1 type of hormone. Your GP can prescribe the pill to you and help you choose the right brand for you. In most cases, the Pill comes in a 28-day pack with a combination of 21 active pills and 7 sugar pills.
How does the pill work?
The pill is a hormone-based form of birth control. But what do hormones have to do with our ability to fall pregnant?
Basically, each tablet contains hormones that alter the way your body behaves. These hormones prevent your ovaries from releasing an egg every month. Plus, the pill also thickens the fluid around the cervix (the opening that leads to your uterus), which ensures sperm can’t fertilise your eggs.
As ovulation isn’t happening and thickened mucus is blocking sperm from entering your cervix, it’s close to impossible for you to fall pregnant while taking the pill correctly. But remember it can take up to 7 days of continuous use before the pill’s birth control becomes effective. So, make sure to double-up your contraception (such as with a condom) to safeguard against unwanted pregnancy when starting on the pill.
Are there different types of pill?
To make things a bit more complicated, there are many different brands and types of oral contraceptive pills. These types differ based on the hormones used, the quantity of these hormones plus the duration of each cycle.
The most common type of birth control pills is the combination pill, which uses a combination of both oestrogen and progestin to prevent pregnancy. But the options don’t stop there.
There are different types of combination pills, including:
Monophasic pills
These prescriptions follow 1-month cycles and each tablet contains the same dose of hormones. Plus, the final 7 days of each cycle are sugar pills which means you’ll have a period once every month.
Multiphasic pills
These prescriptions follow 1-month cycles and each tablet contains different hormone levels during your cycle. Plus, the final 7 days of each cycle are sugar pills which means you’ll have a period once every month.
Extended-cycle pills
These prescriptions follow 13-week cycles. This means you’ll take active pills continuously for 12 weeks, with the final 7 days using sugar pills. This means you’ll have a period 3-4 times per year.
You might have heard your friends throwing around names like ‘Yasmin’ or ‘Diane’ when talking about their pill. This just refers to the brand names used to categorise different variations of the pill.
Aside from combination pills, you can also access progestin-only pills (a.k.a. the mini pill). This type of pill is typically prescribed for women who aren’t able to take oestrogen hormones for health reasons. This type of pill is taken continuously, meaning you won’t have a period when taking progestin-only pills.
How effective is the pill in preventing pregnancy?
For most of us, taking the pill is a decision driven by one main goal: to prevent unwanted pregnancy. While no form of contraceptive is ever 100% effective, it’s important to understand the factors that can impact the effectiveness of the pill.
When we take the pill correctly, this form of birth control is 99% effective. In fact, nearly 1 in 10 women who take the pill may still fall pregnant, meaning there are no absolute guarantees.
There are a bunch of things that can stop the pill from working properly, including:
- Taking a pill over 24 hours late
- Vomiting within 2 hours of taking the pill
- Experience severe diarrhoea
- Taking certain medications and supplements
If you’re concerned about whether you are taking the pill correctly or want to check if your existing medications may be impacting the effectiveness of the pill, make sure to speak with your GP.
Will I get a period on the pill?
So, we know that certain types of pills contain sugar pills which give us a period on a regular basis. But, is this the same as a natural period?
In short, no. The bleeds that we experience while on the pill aren’t the same as menstrual bleeding. In fact, this ‘period’ is actually a symptom of short-term hormone deprivation, often referred to as withdrawal bleeding.
When we stop taking active pills, we experience a drop in hormones that cause the release of blood and mucus from our uterus’ lining. As a result, these bleeds are much lighter and shorter than natural periods, which can make this form of birth control an attractive option for those who experience heavy, irregular or painful periods.
So, is it safe to skip our sugar pills? Absolutely. These placebo pills don’t have any medical benefit and it’s perfectly safe to take your active pills continuously. These sugar pills were created to replicate our natural cycles, but skipping withdrawal bleeding won’t have any real negative impact on your body.
But it’s important to understand that taking the pill continuously can heighten the chances of breakthrough bleeding. This spotting or short unexpected bleeds can be an inconvenience for some of us. In most cases, this will stop after your first few months on the pill. But if heavy bleeding for more than 4 days continues while continually taking the pill, make sure to speak with your GP.
What side effects can I expect from the pill?
As with any regular medication, there are side effects to the pill. But it’s important to remember that everyone’s experience on the pill will be different, so make sure to chat with your GP to understand how the pill’s hormones may affect your body.
Some of the common side effects of the pill include:
- Headaches
- Nausea
- Sore breasts
- Breakthrough bleeding/spotting
In most cases, these side effects won’t last longer than a couple of months.
Some studies suggest that taking the birth control pill increases your risk of breast cancer, but the risk is very small, increasing from about 1 time higher to 1.6 times higher.
If you’re experiencing severe side effects that cause you to feel unwell and uncomfortable, have a chat with your GP to assess if a different type of contraception is better suited to you.
What happens if I forget to take the pill?
Life happens. And sometimes forgetting to take our daily pill can happen too. So, what should you do if you miss a dose? And what happens if you accidentally start a new pack late?
As a general rule, if you miss 1 active pill make sure to take this missed pill ASAP and continue following your normal schedule (even if that means taking 2 pills in 1 day). However, if you miss 2 or more active pills, take both ASAP, continue your normal schedule and consider using additional contraception (such as a condom) for the next 7 days.
But, what about missing the sugar pills? In this case, simply discard these missed doses and continue on your normal schedule. And remember that you shouldn’t go more than 7 consecutive days between taking active pills.
If you’re ever in doubt or concerned about missing a dose, make sure to chat with your GP ASAP to assess the best course of action for your unique situation.
Does the pill protect me against STIs?
Although the pill can do a lotta good stuff, it doesn’t protect you against everything.
The pill doesn’t protect against sexually transmitted illnesses (STIs), which means you’ll need to use an additional method of barrier contraception such as a condom.
Although it’s the most popular form of contraception in Australia, the contraceptive pill won’t suit everyone. With so many types and brands on the market, doing your research and speaking with your GP is essential to finding the right match for you. And if things don’t work out? There are plenty of other non-hormonal and hormonal contraceptives you can consider instead.
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