The Pill

There are two types of contraceptive pill. The Combined Pill contains two hormones similar to those produced naturally by the body; progestogen and oestrogen. The Progestogen Only Pill, also known as the “mini pill” contains only progestogen.

Overview

There are two types of ‘pill’ – the combined pill and progesterone only pill, that prevent pregnancy.

Combined

Progesterone Only

Combined Pill

How it Works

The combined pill works to prevent the sperm reaching the egg and fertilising it. It prevents pregnancy by interrupting this process in three ways:

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

Pros

  • It is over 99% effective if taken correctly.
  • It doesn’t interrupt sex.
  • There is no evidence that it causes additional weight gain.
  • There are no long term effects to your fertility.
  • It can help make your periods lighter, more regular, and reduce period pains.
  • It may also help to reduce premenstrual symptoms (PMS).
  • Certain brands can improve acne.
  • The pill can also have additional health benefits, such as reducing the risk of cancer of the ovaries, womb and colon.

Cons

  • Temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings.
  • It can increase your blood pressure.
  • It does not protect you from STIs.
  • Breakthrough bleeding and spotting (this means bleeding outside of the seven day break) is common when you first start taking it.
  • Vomiting, diarrhoea and other medications can affect how the combined pill works.
  • You will need to see a nurse or doctor for check ups and prescriptions.

Progesterone-Only Pill

How it Works

The POP pill works by preventing the sperm reaching an egg and fertilising it. It interrupts the process in two ways:

 

  • Thickening the mucus from your cervix, making it difficult for sperm to move through and reach an egg.
  • It sometimes stops your ovaries releasing an egg (ovulation). This is the main action of POPs containing the hormone desogestrel.

Pros

  • It is over 99% effective if taken correctly.
  • It doesn’t interrupt sex.
  • There is no evidence that it causes additional weight gain.
  • There are no long term effects to your fertility.
  • It can be taken by some people who cannot use contraception that contains oestrogen, such as the combined pill.

Cons

  • Your periods may become irregular. They may happen more often, less often, be lighter or reduced altogether. You may also get spotting in between periods.
  • It doesn’t protect against STIs, so you will need to use a barrier method such as condoms.
  • You have to take the progesterone only pill around the same time every day (within three hours for some progesterone only pills, and 12 hours for those containing desogestrel).
  • Some medicines and certain types of antibiotic can make the progesterone only pill less effective.
  • You may get some side effects when you first start taking the progesterone only pill, such as spots, headaches, weight change and breast tenderness. These should stop within a few months.
  • Vomiting and diarrhoea and can affect how the progesterone only pill works.
  • You will need to see a nurse or doctor for check ups and prescriptions.

FAQs

The pill needs to be given by a nurse, midwife or doctor who has been specially trained. Visit your local doctor or nurse or speak with your midwife to find out more. There may be a charge for your appointment and the prescription, so make sure to ask when you get in touch. Cerazette is currently not funded in New Zealand.

There is a guideline (2019) that confirms it is safe to take the combined pill continuously without a seven day break – take the 21 hormone pills, then start a new packet straight away. This means missing the non-hormone pills and skipping your period. This is the most effective way to take the combined pill.

The progesterone only pill should be taken every day with no break in between packs. 

For all pills:

  • Choose the time of day that suits you best.
  • Take it at the same time every day until you finish the packet (this is helpful for remembering and getting into the habit of taking it).
  • Always follow the instructions that come with the packet, paying careful attention to which medicines and antibiotics might affect it.

Combined Pill: If you start within the first five days of your period, you’re protected right away. If your periods are short (23 days or less), start in the first four days for immediate protection (since you might ovulate early). If you start at other times, use extra protection like condoms for the first seven pill days. 

Progesterone-Only Pill: If you start within the first five days of your period, you’re protected right away. If you have short periods (23 days or less) and start after the fifth day, use extra protection like condoms for the first two days. If you start at other times, it takes two days to work, so use condoms for two days.

An appointment will typically include:

  • A few questions about your medical and family history, to work out what would suit you best.
  • The doctor, midwife or nurse will take your blood pressure and they will weigh you.
  • You’ll discuss other medicines you are taking in case they make the pill less effective.
  • When you first start the pill you will usually be given a three month supply. Follow up appointments and reviews are then usually every 6-12 months providing there are no issues. You can return to your nurse or doctor at any time if you are worried about anything.

The short answer is yes—there’s no reason to take a break from the pill unless you’ve decided you want to get pregnant.

There’s been lots of research on contraception pills over the years and the consensus is that long-term use doesn’t affect your ability to get pregnant once you stop taking the pill. It’s always a good idea to stay current on your annual health exams, whether you use the pill or another method. Our health changes over time, and some changes like rising blood pressure or worse migraines may make it risky to use methods with estrogen.

The contraceptive pill increases the risk of blood clots, but for most people this risk is tiny. It is important to have a thorough assessment with your health provider to make sure the pill is the right choice and safe for you.

The risks of blood clots (Deep Vein Thrombosis DVT) are low for most people, but they can happen for women/wāhine+ when they are not using oral contraceptives. For every 10,000 women aged 15-44 who are not taking the pill, approximately 1-2 will develop a blood clot in one year.

Taking a combined oral contraceptive pill increases this very small risk of developing a clot between 3x and 8x depending on the type of pill. (There is a 10x increase of developing a clot during pregnancy). If a close family member gets a blood clot, tell your health provider as this may increase your chance of a blood clot.

If you are using a progestogen-only pill, you are at little or no increased risk of blood clots.

Non-Hormonal IUD – Copper

A non-hormonal (Copper) IUD is a small, T-shaped plastic device which contains copper. It is put into the uterus (womb). A Copper IUD does not contain hormones. The copper IUD can also be used as an Emergency Contraception.

LASTS FROM 5 TO 10 YEARS | PLACED IN THE UTERUS | EFFECTIVE IMMEDIATELY | EMERGENCY CONTRACEPTION – UP TO 5 DAYS AFTER SEX

Hormonal IUD - Mirena | Jaydess

A Hormonal IUD is a small, T-shaped plastic device, which contains the hormone progestogen to control your fertility. The device is put into the uterus (womb).

HORMONES | LASTS FROM 3 TO 5 YEARS | PLACED IN THE UTERUS | EFFECTIVE IN 7 DAYS

Implant – Jadelle

Two small, flexible plastic rods that are placed just under the skin in the upper arm. The implant releases the hormone progestogen to control fertility.

HORMONES | LASTS UP TO 5 YEARS | PLACED IN THE ARM | EFFECTIVE IN 7 DAYS