2026-10-02 • 16 min read

The Contraceptive Pill: Everything You Need to Know About Hormonal Contraception

We've already talked about the morning-after pill – so now it's the contraceptive pill's turn in the spotlight. What is it? How is it used? What are its benefits and drawbacks? Read on and find out everything about the contraceptive pill!

Let's start at the beginning: contraceptive pills are medicines that contain hormones. They are safe, widely available and effective at preventing pregnancy – provided they are always taken on time.

What are contraceptive pills?

The contraceptive pill is a tablet taken daily that contains hormones which alter the way the body works and thereby prevent pregnancy. Hormones are chemical messengers that direct the work of the organs – and the hormones in the pill act on the ovaries and the womb.

How exactly does it work?

Most contraceptive pills are "combined pills", containing a mixture of oestrogen and progesterone to prevent ovulation (the release of an egg). Without ovulation, pregnancy cannot occur, because there is no egg available to be fertilised.

However, the pill does not protect against sexually transmitted infections. Keep that in mind if you decide to go on the pill! And above all: do make sure you get advice from a gynaecologist so you can find the preparation that suits your body and your needs. That way you can avoid side effects as far as possible.

When are contraceptive pills indicated?

Contraceptive pills are a hormonal method of contraception taken daily to prevent pregnancy. They are particularly suitable for sexually active women who want to avoid an unplanned pregnancy without relying on unreliable methods such as the withdrawal method. It's important to remember, though: the contraceptive pill protects only against pregnancy, not against sexually transmitted infections.

If you'd like to learn about other methods of contraception, read our article on what the options are and which is the most effective HERE.

In addition, the pill may be prescribed by a doctor to treat or ease a number of other complaints and problems relating to menstruation, including:

Dysmenorrhoea (severe period pain)
Premenstrual syndrome
Endometriosis
Benign breast changes
Precocious puberty
Acne

How does the doctor choose the right pill?

The doctor will first look at your general health, your medical history and any other treatments you may currently be having before deciding which type of pill is best suited to you. Your current circumstances, your age and your lifestyle also play a part.

For example, they won't recommend a combined pill if you have recently given birth, have a history of heart problems, or are over 35 and smoke. Equally, they won't prescribe the mini-pill if you have certain liver conditions or experience bleeding from the womb with no identifiable cause.

Types of contraceptive pill

Contraceptive pills contain different doses of synthetic hormones. There are combined preparations and single-hormone preparations. In a blister pack, the last seven tablets are inactive and contain no hormones.

EVERYTHING about the contraceptive pill ➤ Risks and benefits of the pill ➤ How many types are there? ➤ Answers to your questions ➤ Find out more here!

Combined pills come in various forms:

Monophasic pills. Every active tablet contains the same amount of hormones; the inactive tablets are taken in the final week of the cycle so that bleeding occurs. There are, however, also preparations containing only active tablets – once you've finished the pack, you can take a 7-day break;
Multiphasic pills (biphasic or triphasic preparations). These contain differing amounts of hormones, but as with monophasic preparations, the final week of the cycle is reserved for the inactive tablets.
Extended-cycle pills. These are used with cycles of 13 weeks: for the first 12 weeks you take active tablets, and in the 13th week inactive ones, after which bleeding occurs.

Single-hormone pills

These contain progestogens only and are also known as the "mini-pill". They are particularly recommended for women who cannot take oestrogen. What do they look like? Similar to other pills, except that they contain only active tablets. Bleeding with this form of contraception varies from woman to woman: bleeding may occur at the end of the cycle – or it may not.

How effective is the contraceptive pill?

When used correctly, the contraceptive pill is 99% effective. But nobody's perfect, and sometimes you forget to take it – in which case effectiveness drops to around 91%.

The main reason the pill fails is not taking it every day. But there are other factors that can reduce its effectiveness:

Vomiting or diarrhoea lasting more than 48 hours (2 days)
Certain antibiotics
Certain antifungal medicines
Certain HIV medicines
Certain medicines used to treat mental health conditions

From when are you protected once you start the pill?

The protection the pill offers depends on when you start taking it and which preparation you use. In principle, you can start the pill on any day of the month. However, it may be necessary (and advisable) to use additional contraception – such as condoms – for the first few weeks or up to the first month.

Combined pills

If you start the combined pill within 5 days of the first day of your period, you're protected against pregnancy straight away. If you start at any other time, you'll need to wait the first 7 days for protection to kick in.

Mini-pill

With progestogen-only pills you can start on any day of the month: protection begins after 48 hours. It's therefore sensible to use additional contraception during the first few days.

But don't worry: your doctor can help you work out the best time to start so that your contraception works reliably.

When do people take contraceptive pills?

Although the pill's main job is to protect against pregnancy, it can also be prescribed in other situations, for example:

To regulate the menstrual cycle
To relieve cramps (during ovulation or menstruation)
To reduce the risk of anaemia with heavy bleeding
To ease the symptoms of premenstrual dysphoric disorder
To improve acne
To reduce migraines associated with dysmenorrhoea (painful periods)

Which pill should I take?

You've decided to go on the pill, but you don't know which preparation is right for you? Your doctor will recommend the appropriate option, taking your medical history into account. Together you'll consider your menstrual symptoms, your cardiovascular health, any chronic conditions and any medicines that may interact with the pill.

You should also find out about the benefits, as well as any side effects that may occur.

Benefits of the contraceptive pill

The benefits include protection against pregnancy as well as more regular, less painful and lighter bleeding. The drawbacks, on the other hand, include the lack of protection against sexually transmitted infections and the effects of synthetic hormones on your health.

Some women report more tender breasts, breakthrough bleeding (spotting), raised blood pressure and blood clots. Other side effects include:

Nausea
Sore or swollen breasts
Light bleeding or spotting between periods
Mood swings
Mild headaches
Vomiting
Fatigue
Period pain
Reduced libido
Changes in vaginal discharge

These complaints are usually harmless. Some symptoms, however, point to an emergency – in that case, contact a doctor immediately:

Abdominal pain
Chest pain
Severe headaches
Blurred vision
Swelling or pain in the legs and thighs

Drawbacks of the contraceptive pill

As already mentioned, the drawbacks are that the pill does not protect against sexually transmitted diseases and infections, and that synthetic hormones can affect your hormonal balance.

How long does the pill take to work?

In theory the pill works immediately and you're protected against unplanned pregnancy if you start taking it within 5 days of your period starting. Otherwise it takes 7 days for protection to begin.

Bear in mind, though, that your body may need up to a few months to adjust to the new hormone levels and for your cycle to settle.

The morning-after pill and the contraceptive pill – what's the difference?

Emergency contraception in tablet form can be taken up to 120 hours after intercourse. That means you can take the morning-after pill up to 5 days after unprotected sex. There are two types of emergency contraception, containing the following active ingredients:

Levonorgestrel. Can be used up to 3 days afterwards and is available from pharmacies (and free from NHS sexual health clinics and some GPs)
Ulipristal acetate. Can be used up to 120 hours afterwards and is available on prescription only

So what exactly does the morning-after pill do? It prevents or delays ovulation (the release of an egg), thereby reducing the chance of an egg being fertilised.

Important to know: neither emergency contraception nor the combined pill can end a pregnancy that has already begun. If a fertilised egg has already implanted in the womb, the tablet will have no effect whatsoever on the existing pregnancy. We've written more about the morning-after pill in this article!

Here are some of the key differences between the morning-after pill and long-term hormonal contraception:

→ The morning-after pill does not provide ongoing protection against pregnancy. It only helps prevent pregnancy up to 72 hours after unprotected sex. If you have sex again after taking emergency contraception, you are no longer protected. You should therefore consider another form of contraception to prevent pregnancy in future.

→ The contraceptive pill is more effective than emergency contraception. Taken within 24 hours of intercourse, emergency contraception is 95% effective. Taken correctly, the contraceptive pill is 99% effective.

→ If you find yourself needing the morning-after pill more than two or three times a year, you should think about a long-term method of contraception, as emergency contraception is less reliable than regular contraception.

Taking it correctly – how do you take the pill?

When your doctor prescribes the pill, only taking it every day will reliably prevent an unplanned pregnancy. If you take it regularly, your hormones stay at a constant level. What's more, sperm survive for up to 5 days, so your fertile window lasts longer than a single day: it can span up to 6 days a month. If you take the pill regularly, though, you've nothing to worry about: it's 99% effective.

If, on the other hand, you occasionally forget a tablet, the risk of pregnancy rises to 9%.

Myths about the contraceptive pill:

Just as every woman experiences her period differently, experiences with the contraceptive pill can also vary greatly from person to person. That's one of the reasons why so many myths about the pill have sprung up – and we'll be putting the most common ones under the microscope below.

"The pill makes you put on weight"

According to studies, contraceptive pills do not in themselves directly cause weight gain. It is possible, however, that the hormonal changes affect appetite and increase feelings of hunger. That can lead to eating more often or more heavily, and therefore to a calorie surplus that ultimately causes weight gain.

Myth: "The pill causes breast cancer"

There are indeed studies suggesting a slightly increased risk of breast cancer in women who have taken the pill for more than 5 years. Some research also points to an increased risk of cervical cancer, but the findings are not conclusive, and one of the causes may be infection with the HPV virus.

On the other hand, studies show that the contraceptive pill can significantly reduce the risk of ovarian and womb cancer. So always discuss the risks and options with your doctor in order to make the best decision.

Myth: "The pill affects fertility"

No, the pill does not cause infertility. It only prevents pregnancy while you're taking it, not beyond. The contraceptive pill does not affect a woman's ability to conceive later on, once she stops taking the hormones.

According to studies, around 79% to 96% of women become pregnant within 12 months of stopping the pill. If you'd like to improve your chances of conceiving, read our articles on how your fertile days and the calendar method can help.

Myth: "After a certain age you no longer need contraception"

This statement is incomplete. It's true that doctors don't recommend the pill for people over 35 who smoke, as it can increase the risk of high blood pressure and blood clots. Pregnancy later in life, however, is often associated with various health problems and congenital abnormalities, which is why contraception is generally recommended up to the age of 55–60.

Myth: "All contraceptive pills are the same"

Not all pills contain the same active ingredients or work in the same way. There are several types of contraceptive pill, differing in their composition. Some contain progesterone only, others a combination of oestrogen and progesterone. Your doctor will take your individual needs into account in order to recommend the right preparation for you.

Myth: "The pill affects your libido"

There are indeed women who report that one of the pill's side effects is a drop in libido – along with less sexual pleasure and less interest in intimacy.

Studies have not confirmed this, however, and it's impossible to say for certain whether a change in libido is down to the pill or to other factors such as lifestyle, stress levels or age. If you notice your desire for sex waning, we discuss the best positions that might help you in our article HERE.

Myth: "The pill must be taken at exactly the same time every day"

Of course, there's nothing wrong with taking the pill at the same time each day. The truth, though, is that most contraceptive pills are equally effective regardless of the time of day, as long as you take them daily.

But there's an exception here too: the mini-pill, or single-hormone preparations, must be taken each day within a three-hour "window".

What should I do if I've forgotten my pill for a day?

If you've missed a tablet, don't worry: you can take it as soon as you remember. If you've forgotten the pill for 2 days, you can take two tablets on the day you realise and two the following day – but it's advisable to consult a doctor.

Risks of using contraceptive pills

As a rule, risks and complications arise against a background of pre-existing conditions. In rare cases, taking the pill can increase the risk of:

Thrombosis
Blood clots
Heart attack
Stroke
Pulmonary embolism

Worsening of symptoms

You can also take the pill if you have the following conditions, but they may get worse:

Fibroids of the womb
Kidney disease
Gallstones
Cardiovascular disease
Diabetes mellitus
Depression

Contraindications of the contraceptive pill

And while we're on the subject of contraindications: you shouldn't take a contraceptive pill if:

you are pregnant
you have thrombophlebitis or thromboembolic disorders
you have high blood pressure
you have had a heart attack
you have had a stroke
you have liver disease
you have breast cancer
you are over 40
you smoke and are over 35

Other methods of contraception

If the contraceptive pill isn't a good option for you, a doctor can help you find other methods of contraception.

Contraceptive methods available without a prescription

You can choose a method that doesn't require a prescription, for example:

Male condom
Female condom (femidom)
Contraceptive sponge

Contraceptive methods requiring a prescription

Talk to your doctor to settle on another prescription method of contraception:

Diaphragm. A flexible disc that blocks sperm from reaching the cervix. Before use it is coated with spermicide; effectiveness is 88%.
Cervical cap. Flexible, it is placed over the cervix and is around 80% effective.
Implant. A plastic rod (about the size of a matchstick) inserted under the skin, which works like a hormonal contraceptive by releasing progestogen. It affects ovulation and is 99% effective.
Intrauterine device (coil). A tiny, T-shaped device inserted into the womb during a gynaecological examination, which is 99% effective. We've written about the different types of coil, their effectiveness, benefits and risks in this article.
Contraceptive patch. A patch stuck onto the skin that releases oestrogen and progesterone, with an effectiveness of 92%.
Three-monthly injection. Injections given every 90 days at the gynaecology clinic, with an effectiveness of 98%.
Vaginal ring. It is inserted into the vagina and can stay there for up to three weeks; effectiveness is 92%. It releases oestrogen and progesterone.

And don't forget: the contraceptive pill protects against pregnancy only! It does not protect against sexually transmitted infections or diseases. Condoms, on the other hand, do protect you against sexually transmitted viruses and infections.

Sources:

All About Women - https://www.allaboutwomenmd.com/knowledge-center/birth-control-myths.html
healthline - https://www.healthline.com/health/birth-control/how-long-does-birth-control-take-to-work
National Library of Medicine - https://pubmed.ncbi.nlm.nih.gov/1100993/
National Library of Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307935/
National Library of Medicine - https://www.ncbi.nlm.nih.gov/books/NBK430882/
Choose the Right Birth Control - https://health.gov/myhealthfinder/healthy-living/sexual-health/choose-right-birth-control
Birth Control - https://www.fda.gov/consumers/womens-health-topics/birth-control#ShortActingHormonalMethods
Birth Control Methods by CDC - https://www.cdc.gov/reproductivehealth/contraception/index.htm

Planned Parenthood - https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/birth-control-pill-side-effects

WRITTEN BY

Bianca Camenita

Bianca is a freelance copywriter from Romania, passionate about women's health and fostering a gentler relationship with one's body through a body neutrality approach. She writes about menstruation, intimate health, and the different stages of a woman's life, aiming to make information about our bodies clearer and easier to find. Outside of writing, she is passionate about fitness, nutrition, and psychology.

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