What is the pill?
The pill is the longest-used method of hormonal contraception. It is a very effective method of contraception when used correctly.
It is taken daily, and each tablet contains two hormones similar to those produced by the ovaries:
- estrogen (synthetic or natural)
- progesterone
What types of pills are there?
There are different types of pills with the aim of adapting to each woman, taking into account her age and her medical history. Thus, the pills differ from each other due to:
- dosage
- type of hormones that make them up
In addition, there are also combined oral pills that are composed of estrogens and progestogens, which include:
- Monophasic regimen – all tablets have the same dosage
- Multiphasic regimen – tablets have different dosages throughout the month
There is also the contraceptive pill composed only of progestogens, and it is indicated for women who:
- can't take oestrogens
- are breastfeeding
- have contraindications to the use of oestrogens have
- oestrogen-related side effects from the combined pill
- intend to maintain the oral and daily contraceptive regimen
- prefer to take a pill with only one hormone (progestins)
How does the pill work?
The pill prevents pregnancy by preventing ovulation. In other words, the hormones released cause the ovaries to rest and therefore inhibit ovulation. A woman who takes the pill does not have a fertile period, so she is effectively protected from unwanted pregnancy.
How is the pill used?
There are several pill regimens:
- 21 tablets daily: a week's break and when the woman has withdrawal bleeding (menstruation)
- 28 tablets a day: 24 tablets with medication and 4 tablets with placebo (without any substance), and during this dose the woman has withdrawal bleeding
- 28 tablets taken daily without a break: the dose is consecutive and there is no interval between packs, and all tablets contain medication. Most women don't have withdrawal bleeding, i.e. they don't menstruate (this is the progestin pill regimen)
The pill, whatever the regimen, should be taken daily, preferably at the same time.
I'm going to take the pill for the first time. What should I do?
If you are going to use the contraceptive pill for the first time, you should take the first pill on the first day of menstruation. In this way, its effectiveness is guaranteed from that day.
If for any reason you start taking it on another day of the menstrual cycle, you should use a condom for the first 7 days, so that there is no risk of unwanted pregnancy.
Can all women take the combined pill?
The combined pill can be taken by any healthy woman of childbearing age, but there are some situations in which the use of other contraceptive methods is advised. Therefore, before starting to take this contraceptive, it is advisable to consult a health professional.
I'm a smoker. Can I take the pill?
Smoking habits associated with taking the combined pill increase the risk of developing cardiovascular disease. The risk is higher the older you are and the more cigarettes you smoking. In these cases, the probability of having a cardiovascular event (infarction, cerebrovascular accident (CVA)) is high.
In this situation, you should seek advice from a healthcare professional.
What is the most suitable method for women smokers?
First and foremost, you should consider quitting smoking. However, women who smoke should opt for an oestrogen-free method of contraception (pill, implant or intrauterine device). The World Health Organization advises estrogen-free contraception from the age of 35, for those who smoke.
How effective is the pill?
The effectiveness of the pill is 99% when used correctly.
What are the advantages of taking the pill?
In addition to the high degree of safety in preventing unwanted pregnancy, the pill (especially the combined pill) has the following advantages:
- Does not interfere with sexual intercourse
- Can regularize menstrual cycles
- decrease heavy periods, preventing anemia associated with heavy blood loss
- Improves premenstrual tension and menstrual pain
- Acne and excess hair control
- decreases the risk of Pelvic Inflammatory Disease (PID)
- Reduces the risk of ovarian and endometrial cancer by 50%
- Decreases the incidence of functional ovarian cysts and polycystic disease
- does not affect fertility
What are the disadvantages of this contraceptive method?
The main disadvantages of using this method are:
- does not prevent sexually transmitted infections
- It requires a woman's daily commitment
- Some women experience side effects such as headaches, breast tightness or fluid retention (more common in combined pill users)
- Efficacy may be affected by gastrointestinal disorders such as vomiting and/or diarrhoea and taking some medicines
In what situations should the combined pill not be used?
The combined pill should not be used in situations of:
- confirmed pregnancy
- Smokers over 35 years of age
- women who have:
- high blood
- migraine with aura
- obesity (BMI ≥ 35 kg/m2)
- hormone-dependent cancer
- diabetic women with vascular complications
- abnormal genital bleeding without conclusive diagnosis
- liver tumor or chronic liver disease
- women with a history of venous thromboembolism, stroke, or cerebral or coronary artery disease
What are the side effects of the pill?
Although uncommon, the following side effects may occur:
- mood swings
- breast tenderness (sore breasts)
- headaches
- Reduced sex drive
- irregular bleeding (so-called "spotting")
- nausea
- changes in weight
Where can I buy the pill?
This method of contraception can be purchased in pharmacies. You can also get it for free at most health centres.
How much does the pill cost?
The cost varies greatly depending on the type and brand. With a medical prescription they can have a 69% reimbursement, although there are others that are not reimbursed (usually the most recent ones or those that have estrogens other than ethinyl estradiol).
Is it important to create a routine?
yes. To always take the pill at the same time and not forget, you can choose to associate it with something you do daily, such as brushing your teeth, or after dinner...
What if I forget to take the pill?
A delay of 12 hours does not affect its effectiveness. However, a delay of more than 2 days requires the use of a barrier method of contraception, e.g. a condom, for the next 7 days and emergency contraception if unprotected intercourse has occurred.
So, if the delay:
- if it is less than 12 hours, you should take the tablet as soon as you have forgotten it and continue taking the pill as normal, taking the next tablet at the usual time
- If it is more than 12 hours, this forgetfulness can compromise the effectiveness of the pill. In this case, you should refer to the package leaflet on the appropriate procedure
If you still have questions, you can:
- contact a healthcare professional, or
- call Sexuality Online – 800222003
Are there any medications that interfere with the effect of the pill?
Most over-the-counter medications do not interfere with the effectiveness of the pill (combined and progestin-only medications). However, there are medications (for example, some medications used for epilepsy) that can interfere with the effectiveness of the pill.
If you are prescribed a medicine, ask your doctor about whether it interferes with the effectiveness of the pill.
Does vomiting or diarrhoea cancel out the effect of the pill?
In either situation, if they occur:
- Within 4 hours of taking the pill, you should take another tablet from a spare pack and continue taking the pill as usual. Thus, contraceptive protection will be maintained
- More than 4 hours after taking the pill, contraceptive efficacy is assured and remains protected against unwanted pregnancy. You should continue to take the pill as normal
Does the pill prevent any disease?
The use of the pill appears to have some health benefits, namely in decreasing the risk of:
Can blood loss occur outside of the break week?
yes. During the first three months of using the pill, minor bleeding may occur outside of the break days. These bleeds, usually of low intensity, are called "spotting" and usually disappear spontaneously.
It just means that the body is adapting, but the effectiveness of the pill is maintained. If you continue spotting beyond three months, it is advisable to consult a healthcare professional, as you may need to change the type of pill. While waiting for your appointment, you should not stop taking the pill.
Source: Sociedade Portuguesa da Contracepção (SPDC)