Contraceptive pills

The combined oral contraceptive pill has a combination of 2 hormones. These hormones are like those produced by the body — progestogen and oestrogen.

It is safe to take this pill continuously without a 7 day break — take the 21 day hormone pills, then start a new pack straight away. This means missing the non-hormone pills and skipping your period. This is the most effective way to take the combined pill. Choose the time of day that suits you best to take the pill.

How the combined oral contraceptive pill works

It works to prevent sperm reaching the egg and fertilising it. It does this in 3 ways.

• It stops your eggs being released from your ovaries (ovulation).
• It makes it harder for sperm to reach the egg.
• It makes the uterus lining thinner so a fertilised egg can not implant.

Benefits of the combined oral contraceptive pill

If you take the pill correctly, it is over 99% effective. It can help make your periods lighter, more regular, and less painful. It may also reduce premenstrual symptoms. The pill has other health benefits, like reducing the risk of ovarian, colon and uterine cancer. The pill does not affect your ability to get pregnant when you decide to no longer take it and try to get pregnant in the future.

Side effects of the combined oral contraceptive pill

You may experience some, or none, of these side effects for the first few months:

• headaches
• feeling sick (nausea) or throwing up
• breast tenderness
• mood swings
• increased blood pressure
• bleeding and spotting between periods.

Throwing up (vomiting) and having runny poos (diarrhoea) and other medicines can affect how the pill works. Talk to your healthcare provider about this.

Protection against pregnancy

If you start within the first 5 days of your period, you are protected straight away.

If you have short period cycles (23 days or less), start in the first 4 days for immediate protection as you might ovulate early.

If you start after these times, use extra protection such as condoms, for the first 7 days.

If you are starting the pill after pregnancy, it is usually best to wait until 6 weeks after giving birth. You may be able to start 3 weeks after delivery if you are not breastfeeding. It is safe to use the combined pill while breastfeeding.

The progesterone-only pill has one hormone (progestogen). You should take this pill every day with no break between packs.

How the progesterone-only pill works

It works to prevent sperm reaching the egg and fertilising it. It does this in 2 ways.

• It thickens the mucus from your cervix to make it harder for sperm to reach an egg.
• It can stop your ovaries from releasing an egg (ovulation). This is the main action for progesterone-only pills that have the hormone desogestrel.

You have to take the progesterone-only pill around the same time every day. For pills that are progesterone only, within 3 hours. For pills that contain desogestrel, for example Cerazette, the pill must be taken within 12 hours.

Benefits of the progesterone-only pill

If you take the pill correctly, it is over 99% effective. The pill does not affect your ability to get pregnant when you decide to no longer take it, and try to get pregnant in the future. It can be taken by some people who cannot use the combined pill.

Side effects of the progesterone-only pill

You may experience some, or none, of these side effects for the first few months:

• headaches
• breast tenderness
• weight change
• irregular periods — they may happen more or less, or be lighter
• spotting between periods.

Some medicines and certain types of antibiotics can make the pill less effective. Throwing up (vomiting) and having runny poos (diarrhoea) can also affect how it works. Talk to your healthcare provider about this.

Protection against pregnancy

If you start within the first 5 days of your period, you are protected straight away. If you have short period cycles (23 days or less), use extra protection such as condoms, for the first 2 days.

If you start the pill after 5 days, it takes 2 days to work. Use extra protection such as condoms for 2 days.

If you are starting the progesterone-only pill after pregnancy, you can start taking it straight after you give birth. It is safe to use while breastfeeding. 

Talk to your healthcare provider if:

• you are thinking about contraception for the first time
• you are thinking about changing your type of contraception
• your health or medical history has changed.

If you are getting the pill for the first time

If you are getting the pill for the first time, talk to your healthcare provider. To help work out the best pill for you, they will:

• ask you about your medical history
• ask you about your family history
• ask you about any other medicines you are taking
• take your blood pressure
• weigh you.

If oral contraceptive is the best option for you, they will give you a prescription for your pharmacy. You will usually get a 3 month supply. If there are no issues at your 3 month review appointment, follow up appointments or reviews are then usually every 6 to 12 months. You can contact your healthcare provider at any time if you have any concerns.

There may be a charge for your prescription and appointment.

If you already have a prescription

Some brands of the pill are available over the counter at the pharmacy if you meet the eligibility criteria. These include pills that contain:

• desogestrel
• ethinylestradiol
• norethisterone
• levonogestrel.

Eligibility criteria for the pill from a pharmacist

You can get the pill from your pharmacy if you recieved a prescription within the last 3 years and you are 1 of the following:

• from Aotearoa New Zealand and have run out of your contraception pill
• from overseas and have run out of your contraception pill
• collecting the emergency contraceptive pill and have used the contraceptive pill before
• wanting to restart the contraceptive pill and have used it before
• wanting the contraceptive pill after having a baby and have used it before.

If you are breastfeeding you can be given a progesterone-only pill. For other situations, the pharmacy will refer you back to your healthcare provider.

If you are unsure whether you are eligible for over the counter contraceptive, talk to the pharmacist.