Birth Control

The Combination Pill

2 min read

What is it? How does it work?
The combination pill, also known as “oral contraception,” is a tiny pill taken at the same time every day. This is the pill that most people refer to when saying that they are taking oral birth control. It contains the hormones estrogen and progestin. Estrogen and progestin prevent the body from releasing an egg for fertilization every month. The hormones also thicken the cervical mucus to prevent sperm from reaching an egg.  Combination pills are different from the minipill. You can learn more about the minipill here.

How effective is it?
The combination pill is 91% effective with typical use. With perfect use, the pill’s effectiveness shoots up to over 99% effective! “Perfect use” means taking the pill at the same time every single day.

What are the side effects?
Some people experience positive side effects, some experience negative side effects, and some do not have any side effects at all! Not everyone has the same experience with the pill. And to complicate things further—sometimes people experience different side effects with different types of pills. Below, we list the most commonly reported side effects. But remember, it is important to listen to how your own body feels on the pill!

The good:

  • Can help with cramping
  • Can improve acne
  • Regulates menstrual cycles
  • Lighter periods
  • Offers ability to control the timing and length of your period
  • Offers protection against anemia and ovarian cysts
  • Helps control polycystic ovary syndrome and endometriosis

The not-so-good:

  • Spotting
  • Headaches
  • Nausea
  • Breast tenderness
  • Bloating/Increased appetite
  • Slightly increased risk of blood clots while on the pill

The totally random:

  • Some people experience weight gain or weight loss, but most experience no fluctuation in weight
  • Can increase or decrease libido
  • Most people experience a slight improvement in mood or no change at all, but a few have reported feeling down while on the pill

Any long-term benefits?
+Reduces risk of endometrial cancer.
+Reduces risk of ovarian cancer.
+Reduces risk of colorectal cancer.

Any long-term risks?
Unclear. There may be a slightly increased risk of breast cancer but the data is mixed.

When thinking about cervical cancer, it is important to note the difference between correlation and causation. Cervical cancer is caused by HPV, a sexually transmitted virus, that is passed along through unprotected sex. The rates of unprotected sex are higher among people using the pill, which is likely correlated with the slight increased risk of cervical cancer. So in addition to preventing pregnancy with the pill, condoms should be used to protect against STIs.

What are some common myths about the pill? Is there any truth behind them?
MYTH: “The pill causes infertility.” The pill does not cause infertility. Many years of research demonstrate that most people return to fertility immediately after stopping the pill. Also, the data shows that people who took the pill get pregnant after stopping the pill just as quickly as those who did not use any form of hormonal birth control.

MYTH: “The pill causes abortions.” The pill does not cause abortions. Once an egg is fertilized and implanted in the uterus, the pill will not affect the pregnancy. Research has shown that taking the pill doesn’t even harm a developing fetus.

MYTH: “The pill is not as effective when I’m taking antibiotics.” Commonly prescribed antibiotics have no effect on the pill. The only antibiotic that interferes with the pill is rifampin (Rifadin), a drug that treats tuberculosis. But your doctor will warn you about the reduced effectiveness before prescribing this medication.

Does it protect me against sexually transmitted infections?
It is important to remember that the pill does not protect against sexually transmitted infections (STIs), so a barrier method (external condom, internal condom, dental dam) should be used in addition to the pill.

Looking for more personalized info? Message a doctor through Twentyeight to get medical advice based on your needs and lifestyle.

With the participation of
Dr. Alejandra Moscoso

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