This article explores the combined pill, its advantages and disadvantages. How does the combined pill work? Will it be suitable for you?

What is the combined pill?

The combined pill is a combination of two hormones, progesterone and oestrogen. These pills are usually taken for 21 days and followed by a break of 7 days, during which time you will experience a light vaginal bleed (like a period). You will be given precise instructions from your Family Planning Centre or GP on how to take your pill.

How does the combined pill work?

Each month your ovaries in your pelvis produce an egg, ready for fertilization by sperm during sexual intercourse. This is how you get pregnant.

This pill combination of two hormones prevents your body from producing an egg. Therefore, if taken reliably, it is very unlikely you will get pregnant.

Where can you get the combined pill from?

The combined pill is available on prescription form the Family Planning Centre (FPC) or your family doctor. All women are entitled to contraceptive advice at any age, including under 16. However, your doctor may not think the combined pill is suitable for you, as there are certain risks – see below.

What types of combined pill are available for teenagers?

There are many brands of combined pills available and your doctor will discuss which would be most suitable for you. For example, if you also have acne or painful periods then some hormone combinations will be more effective than others.

How much does the combined pill cost teenagers?

A prescription for the combined pill for under 22 year olds will cost $3. This is available form your family doctor or Family Planning Centre (FPC).

What is the success rate of the combined pill?

In preventing pregnancy

The combined pill is 99% effective if taken correctly. Each packet has precise instructions relating to that particular pill. Therefore if 100 women took the pill for 1 year, one would get pregnant.

If not taken correctly (for example, pills are forgotten) it is only 97% effective in preventing pregnancy.

In preventing Sexually Transmitted Infections – STI

The combined pill is not effective in preventing STIs and needs to be used in conjunction with condoms and lubricant.

What are the risks for teenagers with the combined pill?

The combined pill has received much press in the last 40 years, regarding side effects.

Research has shown there are side effects, but remember that the side effects – for example, blood clots in the leg –  are much more common in pregnancy than while taking the combined pill.

The risks of taking the pill are much greater when this is combined with smoking cigarettes. Smoking related diseases are the highest killers of young women. When this is combined with taking the combined contraceptive pill the risks of blood clots and strokes are increased further.

Risks of cancer of the breast and the cervix are increased by taking the combined pill.

The pill is unsuitable for the following groups of women

  • Those over 35 who smoke
  • Those who are immobile for a period of time, due to a broken leg, for example
  • Women who are overweight
  • Women with a family history (parent, brother, sister) of a blood clot (deep vein thrombosis), heart attack or stroke.

What are the pros of the pill for teenagers?

  • The pill does not interrupt love making – but remember it is only suitable to prevent pregnancy, not sexually transmitted diseases!
  • If taken correctly, it is highly effective in preventing pregnancy.
  • The combined pill can reduce acne.
  • If you are healthy, a non smoker and the pill is working well for you, you can take it successfully for many years.
  • The pill does not affect your chance of getting pregnant, once you stop taking it.
  • If you have experienced heavy and painful periods, the pill may help prevent this, as periods are usually light whilst you are on the pill.
  • Cancer of the ovary and the endometrium (lining of the womb) are reduced by 50%.

What are the cons of the combined pill for teenagers?

Some women will experience uncomfortable symptoms to begin with, while taking the pill. Some side effects might include:

  • Nausea and appetite changes
  • Irregular bleeding or spotting
  • Breast tenderness
  • Headaches
  • Weight changes
  • Mood changes
  • Skin changes – some women notice acne worsening on the pill.

Sometimes these settle after a few months, but sometimes you may need to return to your doctor or FPC to try a different type of combined pill.

The combined pill is unsuitable during breastfeeding, as it affects the milk supply to the baby. However, the progesterone pill (or mini pill) can be taken during breast feeding.

This is not suitable for people with a poor memory. The pill needs to be taken every day, whether you are having sex that day or not, to prevent your body releasing an egg!

What to do if you forget your pill?

If you forget one pill, take it as soon as you remember

If you forget 2 pills within 7 days then you will need to use another form of contraceptive until you have 7 days in a row of taking the pill correctly, every day. Otherwise your body may release an egg, ready for fertilization and pregnancy.

Also follow this 7 day rule of using another contraceptive if you have diarrhoea and vomiting, or you are taking a medicine which affects the combined pill, such as antibiotics.

Always inform your doctor / pharmacist that you are taking the combined pill, before you accept any other medicine.

Useful websites and articles

Remember that the combined pill does not prevent you getting STIs. Visit our article Condoms for Teenagers for more information on condoms and lubricants.

To find your local Family Planning Clinic in NZ visit- www.familyplanning.org.nz

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This information was compiled by the Kiwi Families team.

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