Sexual health 101: Everything you need to know about the combination pill

Think you know everything about the Pill? Think again.
It's the most common form of birth control, but is it the best?

The combined pill was revolutionary in providing effective and reliable reproductive control for most women around the world. Since the dawn of time, people were (presumably) using the 'pull out method', but there's enough anecdotal evidence (and babies) out there to prove that's not your best option. Srsly.

We then had trusty condoms to keep us safely getting busy. But, y'know, prone to splitting, and sometimes they're just not around when you need them.

The swinging '60s had arguably the biggest breakthrough with the release of the oral contraceptive pill in Australia. It marked a momentous change in women's lives.

No woman can call herself free who does not own and control her own body. No woman can call herself free until she can choose consciously whether or not she will be a mother.
– Magaret Sanger, Woman and the New Race.

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Suddenly, women had control over their own bodies by using a compact pill that was simple to use, easy to hide and more effective than anything we'd had before.

About 50 – 80 per cent of Australian women still use the Pill at some stage of their reproductive lives and it's easily the most common form of birth control, but is it the best for you?

Even if you've chatted to your doctor about it, it's worth having a quick skim through the pros and cons so you can make an informed decision.

What is the combined pill?

Normally known simply as 'the Pill', it contains two hormones: oestrogen and progestogen. It prevents pregnancy by stopping a woman's ovaries releasing an egg each month, which really hinders the whole pregnancy thing.

How do I take it?

Doctors suggest you pop the Pill around the same time every day, but this is more so you make the Pill a habit and you're less likely to go a day without taking it. Thanks to the two hormones situation, you're still protected if you take the Pill a few hours late, but it's essential you take the medication every day.

Do I need to stop taking the Pill to give my body a break?

Providing there isn't a medical reason for you to not take the Pill (we'll get to that later), women can safely use the Pill for as long as they want until they turn 50.

Who can’t take the Pill?

Great question! Although you might have been a-okay to take the Pill when your doctor prescribed it, your situation may have changed. You should not take the Pill if:

• You have had a deep venous thrombosis (blood clot in a vein), stroke or heart attack.
• You have a condition which makes you more prone to blood clots.
• You have severe liver problems.
• You have migraines with aura.
• You are over 35 and smoke.

You may not be able to take it if:

• You have had breast cancer.
• You have unusual bleeding from your vagina that has not been diagnosed.
• You are breastfeeding.
• You have high blood pressure, diabetes, high cholesterol, heart disease affecting your heart valves, active liver disease, lupus, a family history of blood clots, are obese or you are on some other medications.
• You have a body mass index (BMI) of 35 or more.
• You are immobile for a period of time, e.g. after surgery.

But as always, talk to your doctor, because it doesn't automatically exclude you from taking the Pill.

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We chatted to Dr Deborah Bateson, Medical Director at Family Planning NSW, and she told us all about the good and the bad of the Pill.

"Probably the most appealing thing about the combined pill is that women can control when they start and stop taking it and it's easily obtained," she explained.

"Women also have control over their cycle and can choose to skip their period if they wish. Most doctors will say you can skip three periods in a row. Most women can do up to 12 months, but they may experience breakthrough bleeding. If the light bleeding continues for more than three or four days, a four day break from the Pill is recommended.

"The Pill is good for women with heavy menstruation, endometriosis and reducing menstrual pain.

"However, not every woman can use it and it's important to check if you're affected. Its efficiency is also considerably lower than other birth control options. With perfect use it's 99.7 per cent, but women run out and they forget to take it, taking typical use down to 91 per cent," Dr Bateson added.

"Some brands can be expensive and it can have significant hormonal side effects. For some women, the oestrogen in the Pill causes patchy brown discolouration on the face, especially if you spend a lot of time in the sun.

"Contrary to popular belief, there's no evidence the Pill causes weight gain.

"It does, however, reduce the risk of ovarian and bowel cancer, as well as endometriosis. It's also used to manage acne, PMS and polycystic ovary syndrome," she concluded.

But every woman has a different experience when it comes to contraception so we spoke to women who've used the Pill firsthand.

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As always, please remember no matter what your partner says, the Pill doesn't protect against STIs so wrap it up.

Have a click through our other birth control explainers and visit Contraceptive Match to learn more about your options and find helpful information to take to your GP.