A full and frank conversation about the pill

The birth control pill is over 99% effective at preventing pregnancy. That is, if it is taken perfectly – at the same time every day, without fail. Of course in reality, everyday life is never perfect. We get ill, our to-do lists fill up, we forget to pick up a repeat prescription…

Then of course there are the claims that the pill can cause weight gain and could increase the risk of some cancers. It’s a lot to consider. So to mark Sexual Health Week which runs 14th – 20th September and World Contraception Day on 26th September, the sexual health experts at YourGP answer some of your most common questions and present the facts about the pill in this full and frank conversation.

What actually is the pill?

There are two main types of pill – the Combined Oral Contraceptive (COC) which contains oestrogen and progestogen. And the Progestogen Only Pill (POP), also known as the “mini-pill”, which does not contain oestrogen.

Both work by thickening cervical mucus to block sperm from reaching the egg and thinning the lining of the uterus so an egg cannot attach to it. Where they differ is the combined pill also stops the ovaries from releasing an egg each month.

What happens if I forget to take the pill?

The combined pill is designed so that you take one pill every day, then stop for seven days. The mini pill has been designed to be taken every day of the month. Regardless of which form of the pill you take, failure to take one will affect your protection.

For the combined pill, if you remember to take the missed pill within 24 hours, you should still be protected. However, being just 3 hours late to take the mini pill can impact your protection levels, so it is advised you use a backup method of contraception such as condoms for the following 2 days.

What happens if I’m ill?

If you vomit or experience diarrhoea within 2 to 3 hours of taking your pill, your body may not yet have absorbed the hormones. Therefore, you should treat it as a missed pill.

Aside from preventing unwanted pregnancies, what other benefits does the pill offer?

As well as preventing pregnancy, the pill can effectively treat heavy periods, lessen period pain, reduce acne, and manage symptoms of endometriosis and polyendocrine metabolic ovarian syndrome (PMOS).

What are the associations between the pill and the risk of cancer?

Studies show there may be a small, temporary increase in the risk of breast and cervical cancers amongst those taking the pill. However, it is important to note that this risk declines after the person stops taking the pill. Studies also show the pill actually lowers your risk of ovarian, endometrial and colon cancers.

Does the pill cause weight gain?

No, studies show that the pill does not cause significant weight gain. However, some women may notice temporary physical changes when they start taking the pill, for example some may find they hold extra fluid or “water weight” for the first few months whilst their body adjusts.

Can the pill affect future fertility?

No, the pill has no lasting or permanent effect on fertility and your natural cycle should typically return within just a few months of stopping taking it.

Is there anyone who shouldn’t take the pill?

The combined pill is generally not recommended for individuals over the age of 35 who smoke, or anyone with a history of blood clots, high blood pressure, stroke, or migraines with aura. You should also avoid it if you have certain heart or liver diseases, or have had breast cancer.

You shouldn’t take the mini pill if you take certain medicines, have unexplained bleeding in between periods or after sex, have had breast cancer or liver disease.

For these reasons, it is always best to speak to a GP before commencing any new form of contraceptive. They will be able to assess your medical history and current lifestyle to help you make an informed decision about which contraceptive is right for you.

Who can I speak to if I have more questions about contraception?

If you’re keen to take control of your sexual health, or you have questions about the pill or any other form of contraception, you can book an appointment at YourGP using our simple online booking system, by emailing reception@your.gp, or by calling us on 0131 556 2525 and we’ll be happy to arrange an appointment at a time that suits you.