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Combined Contraceptive Pill

 Quick Facts

  • The combined oral contraceptive pill is also calledjust “the pill.”
  • Combined oral contraceptives are on the WHO’s List of Essential Medicines.
  • Regimen: If the pack contains 28 tablets, you must take the pill every day, preferably at the same time. However, a 21-pill pack is also available if there is a 7-day break.


When taken correctly, the pill is over 99% effective at preventing pregnancy. Out of 100 couples who use the combined contraceptive pill as the only contraceptive method, fewer than one woman gets pregnant in 1 year. Typical use is that it happens in real life. The combined pill’s failure rate is about 9 percent in a year of typical use.

Combined Pill 91%

Key Benefits 

  • They give you protection 24 * 7
  • They are highly effective.
  • Widely available and easy to use.

What is a combined contraceptive pill’?

The combined oral contraceptive pill comprises synthetic versions of female hormones estrogen and progesterone. These hormones are produced naturally in female bodies. Pregnancy happens when the sperm fuses with an egg (ovum). The pills try to stop conception primarily by blocking the release of an ovum. It also thickens the mucus, making it more challenging for sperm to reach an ovum. There is thinning of the uterus lining, reducing the chances of implantation.

There are main types of combined contraceptive pills.

Every day pills (28 pills)

The 28-pill pack has 21 active and seven inactive (dummy) pills. The two kinds of tablets look different from each other. You must take one pill daily, with no break between packets. The 21 tablets contain hormones, and seven pills may contain iron. 

21-day pills (Monophasic)

These are the most common types of pills. Each pill contains the same amount of hormones. You must take one tablet daily for 21 days, and then there is a break for the next seven days.

21-day pills (Phasic)

Phasic pills have  2 or 3 types of different colored pills in a package. Each variety contains a different amount of hormones. You must take one tablet daily for 21 days, and then there is a pill break for the next seven days. You have to take these pills in the correct order.

How to use it correctly?

28 pills packet

  • It would be best to start taking the pill on day one of your menstrual cycle (periods), although you may begin at any point. You may need additional contraception depending upon the day of the ‘start.’
  • Take the first pill from the part of the pack marked as “start.” It will be an active pill containing hormones.
  • You should have one pill daily, in the correct order, until you finish the pack (28 pills). Try to take the pill at the same time every day.
  • During the last seven days, you will have bleeding.
  • Continue with the next pack of pills on the 29th You must start it even if you are still bleeding.

21 pills pack

  • Have the first pill from the pack marked with the right day of the week in monophasic pills.
  • In the case of phasic pills, take the 1st pill of the 1st color).
  • You should have one pill daily, in the right order, until you finish the pack (21 pills).
  • Stop taking the pill for the next seven days. You may have a bleed during this period.
  • Continue with the next pack of pills on the 29th day. You must start it even if you are still bleeding. It will be the same day of the week you started taking pills on the first day.


  • Your sex life is active. The sex doesn’t get interrupted in fear of getting pregnant or having a condom at the moment.
  • Such pills reduce the risk of cancer in the womb, colon, and ovaries.
  • It may improve symptoms of premenstrual syndrome.
  • Your natural fertility isn’t disturbed. Once you discontinue the pill, you can become pregnant naturally.
  • They may regulate your bleeding to regular, lighter, and less painful
  • It may help reduce acne
  • They protect  one from pelvic inflammatory disease
  • It may decrease the risk of fibroids and ovarian cysts.


  • Minor side effects such as nausea, headache, mood swings, and breast tenderness may occur. They usually subside in a few months.
  • There’s a very low risk of severe side effects.
  • They can not protect you from sexually transmitted infections (STIs)
  • It may increase your blood pressure
  • Spotting and breakthrough bleeding are expected during the first few months of starting the pill.

Essential Tips

  • You have to take the pill at around the same time daily.
  • Some medications interact with the pill to make it less effective. See your doctor if you are on any other medicines.
  • Try to quit smoking. It may increase the risk of severe side effects from pills, including stroke and heart attacks.
  • Store the packet containing pills at room temperature and out of reach of children.
  • Strictly follow the instructions that come written along with the pack.
  • Missing pills will make them less effective.
  • Special instructions exist for having pills after childbirth, abortion, or miscarriage. Please consult a healthcare provider regarding it.

Additional contraception during the first month:

It depends upon the day of the menstrual period you start to take pills.

Start on the 1st day of the cycle. Suppose you start taking the pills on day 1 of your menstrual cycle (period). In that case, you will not need additional contraception protection.

Start on the 5th day or before the cycle. Suppose you start taking the pills on day five or before your menstrual cycle (period). In that case, you still need no additional contraception protection.

Start after the 5th day of the cycle. You will need additional contraception until you have had the pill for at least seven days. If you feel that you were pregnant when you started the pills, you must take a pregnancy test 3 weeks after you had unprotected sex the last time.

Recommended to use if

You may use the pills as the method of contraception if:

  • You are less than 40 years of age and a non-smoker.
  • You are ready to take the pills continuously.
  • If there are no medical reasons (contraindications), you can have the pills until your menopause.

Not Recommended if

One must consult a doctor and be advised not to use the pills  if one suffers from the following:

  • Severe hypertension and stroke.
  • Ischaemic heart disease or angina
  • Diabetes with vascular complications
  • Focal migraine
  • Diseases of the liver, such as a tumor or active liver disease
  • Have major surgery or prolonged immobilization
  • If you just had a baby, it is advised to consume the pill after six weeks as you are breastfeeding your baby. (Note: You can take the pill only after five days of birth if you are not breastfeeding.)
  • Breast cancer

Side Effects 

  There are sporadic chances of noticing the following side effects:

  • Discoloration of the skin (Pale)
  • Sudden chest pain
  • Abdominal pain
  • Worsening of headaches
  • Difficulty in breathing
  • Severe throat infection
  • Pain and swelling in legs
  • Breast tenderness (Likely to improve after a few days; if not, see your doctor)
  • Continuous mood swings
  • A decrease in sex drives

     If you feel any of the above side effects for months, you must visit your doctor once.

In Short

A combined pill contraceptive is much more effective and accessible nowadays. If you take the combined pill in a strictly followed manner, you will likely enjoy your sex life without getting pregnant.




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