Daily Combined Hormonal Contraceptive Pill

Daily combined hormonal contraceptive pills release a small amount of progestogen and oestrogen.
Daily Combined Hormonal Contraceptive Pill
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Street names The pill
Medical names Combined Oral Contraceptives, COC
Effectiveness 91% ?
It lasts 1 day (needs to be taken daily to have ongoing effect)
Fertility Ovulation returns quickly once stopped
Who can use it? People with a vagina and uterus of any age from menarche to menopause
Hormones Contains oestrogen and progestogen hormones
Visibility Discreet but you need to store the packets
STIs No protection ?
Side effects Headaches, nausea, breast tenderness, bloating, uterine bleeding. Allow 6 months to adjust to the hormones
Cost Between $7 and $40 for a 3—4 month supply, depending on the brand and if you have a Healthcare card or private script
Where to get it Visit a reproductive and sexual health clinic or your local doctor. You may need to visit a pharmacy to pick up a prescription

How does it work?

The hormones prevent ovulation so there are no eggs (ova) released from the ovaries. It also changes the mucus of the cervix, making it harder for any sperm to enter the uterus. This prevents pregnancy.

Each individual pill contains a small mixture of progestogen and oestrogen hormones, and the amount and type of each hormone differs depending on the brand and design. There are over 30 brands of daily combined contraceptive pills available in Australia. Most packets have 28 pills, but some only have 21 pills.

You will still need to consider the risk of Sexually Transmitted Infections (STIs) every time you have sex.

What’s it like to use?

Most people find the pill easy to swallow as it is smaller than other tablets and multivitamins.

After 21 days of taking hormonal pills, you will either take a 7 day break without pills or you will take 7 of non-hormonal (sugar) pills. During that time you will experience a uterine bleed, which is similar to a menstrual bleed but is usually lighter.

Some brands of pills are monophasic, meaning that each pill has the same amount of progestogen and oestrogen hormone. Other brands are triphasic, meaning that the amount of hormones may differ each week.

Tricycling is possible if your pill brand is monophasic. Tricycling involves using 3 packets of hormonal pills in a row without a break. It means you experience uterine bleeds less often. Before you experiment with tricycling, discuss it during an appointment with a reproductive and sexual health clinician or your local doctor.

What if I forget about it?

To be effective you need to remember to take the pill regularly every day.

  • If you took the last pill within the past 48 hours (if it is up to 24 hours late): take the missed pill immediately. Your contraception will continue working.
  • If you took the last pill more than 48 hours ago (if it is more than 24 hours late): take two pills, and then continue taking the pills as normal. You will need to use an alternative contraception method for 7 days. If you have had unprotected penis in vagina (PIV) sex, you may need to consider emergency contraception.

Who can use it?

People with a vagina and uterus of any age, from menarche to menopause.

The pill needs to be taken daily. If you are someone who is likely to forget, or if you do not have regular routine, consider a different contraceptive method.

It is suitable for people who have never experienced pregnancy and for use as contraception after pregnancy.

The pill should not be used if you have a history of migraines with aura, which is a specific type of headache that should be excluded by a clinician. Some people have personal risk factors for thrombosis or a family history of thrombosis and this may be evaluated by a clinician.

Contraceptives that contain oestrogen may be less suitable if you have a Body Mass Index (BMI) above 30. Consider progestogen only or non-hormonal contraceptive options.

If you experience polycystic ovarian syndrome (PCOS), the Combined Contraceptive Pill is generally considered to be the best contraceptive option. However, it is best to discuss your exact situation with a doctor.

If you are over 40 years old, contraceptives that contain oestrogen may be less suitable, especially if you have other medical conditions. The combined contraceptive pill should generally not be used by people beyond the age of 50 years old.

It is suitable for people who may have a family history of breast cancer. It is generally not suitable for people who have experienced breast cancer in the past.

Side effects

It may take some time for your body to adjust to the hormones. Some people try a few different versions of the daily combined contraceptive pill before they find the dosage and type of hormone that is most suitable.

Side effects can include increased headaches, nausea, breast tenderness, bloating, and uterine spotting. You may find that you experience less hormonal mood changes and that your acne decreases. While body weight can change alongside hormonal changes, there is no reliable medical evidence linking contraceptive pills with weight gain.

A serious, but rare, risk of taking the daily combined contraceptive pill is thrombosis. Thrombosis occurs when blood clots form in major blood vessels. Warning signs of a thrombosis are severe sudden chest pain, shortness of breath, severe pain or swelling in one leg, sudden blurred vision or loss of sight, or sudden severe headache. If you have any of these symptoms contact your doctor or go to your nearest emergency department immediately.

Learn more about your reproductive organs and sexual health and hormonal contraceptives.

If at any point you feel that this contraceptive method is making you feel uncomfortable or unwell, get advice from a doctor or medical professional. If it is an emergency, call an ambulance on 000.

How and where to get it

A reproductive and sexual health clinician or your local doctor can undertake a health assessment and can supply the contraceptive pill.

If the reproductive and sexual health clinic or your local doctor does not have the pills in stock you will need to buy them at a pharmacy.

The pill will cost between $7 and $40 for a 3 to 4 month supply. The price varies depending on the brand of pill and if you have a Health Care Card. There may also be consultation fees. You can ask for a quote when you book an appointment.

What if you change your mind

You can stop using the pill at any time. Ovulation may begin within 48 hours. If you decide to stop taking it, visit a reproductive and sexual health clinic or your local doctor to discuss your contraceptive options.