What is the combined pill?
The combined pill, which is also commonly referred to as the “birth control pill” or “the pill,” is a small tablet that comes packaged for each month. Some people call it “oral contraception.” You take it once a day, at the same time every day. Many different kinds of combined oral contraceptive pills are available, and new options keep being added to the market. The combined pills contain small doses of the synthetic hormones estrogen and progestin, similar to the hormones estrogen and progesterone naturally found in a woman’s body.
How does the combined pill work
The pill works by:
1. preventing ovulation (the release of eggs from the ovaries); the hormones keep your ovaries from releasing eggs.
2. thickening the cervical mucus; this makes it hard for sperm to get into the uterus to fertilize an egg.
3. making the lining of the womb thinner; this prevents a fertilized egg from attaching itself to the womb.
Effectiveness
The ability of the pill to prevent pregnancy depends on the user. You are more likely to become pregnant if you delay starting a new pack by three or more days or if you fail to take three or more pills within the beginning or end of a pack of pills.
When the pills are used correctly – meaning that no pills have been missed, pills are restarted on time (after the non-hormonal pills/or no-pill week), and a backup method is used when necessary – the pill can be 93% effective in preventing pregnancy. In cases where hormonal pills are taken continuously, without a seven-day break, the pill can achieve 99% effectiveness in preventing pregnancy.
How are the combined oral pills different from the progestin-only pills?
Unlike the progestin-only pills which contain 1 synthetic hormone(progestin), the combined pills have 2 synthetic hormones(estrogen and progestin).
The combined pill can be found under different brands and comes in a pack of 21 or 28 pills. A typical monthly combination 28-pill pack contains three weeks of hormone-based pills and a week of hormone-free pills, although there are some with a shorter duration without hormones (24 days with/4 days without). You will notice that the last pills are a different color. This is because these pills do not contain hormones. You will take the hormone-free pills while you wait for your period each month. You will find an instruction leaflet inside the package whenever you buy a packet of pills. Always read the instructions carefully and make sure that you understand what you need to do in case you miss a pill or experience nausea [1].
Some pills give you a regular period every month, others allow you to have your period once every three months, and some let you skip your period for an entire year. You can also choose to skip periods by taking only hormone-containing pills of almost any brand. Since there are many different types of pills available on the market, and finding the right fit can be a bit confusing, a healthcare provider or trained community health worker can help you figure this out [2].
