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The Combined Pill

The combined pill is usually just called the pill. It contains two hormones - an oestrogen and a progestogen. These are similar to the natural hormones women produce in their ovaries. There are a variety of types of combined pill.

How effective is the pill?
How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions.

If 100 sexually active women don't use any contraception, 80 to 90 will become pregnant in a year. If the pill is taken according to instructions it is over 99% effective. This means that less than one woman in 100 will get pregnant in a year. If the pill is not taken according to instructions, more women will become pregnant.

How does the pill work?
The main way the pill works is:

• It stops your ovaries releasing an egg each month (ovulation). It also:
• Thickens the mucus from your cervix. This makes it difficult for sperm to move through it and reach an egg.
• Makes the lining of your womb thinner so it is less likely to accept a fertilised egg.

Where can I get the pill?
Family planning doctors, nurses and most GPs provide contraception. You can go to any other GP if you prefer not to see your own doctor. fpa Helpline 0845 122 8690 9am to 6pm, Monday to Friday.

Can anyone use the pill?
Not everyone can use the combined pill and your doctor or nurse will need to ask you about your own and your family's medical history. Do mention any illness or operations you have had. Some of the conditions that may mean you should not use the combined pill are:

• you think you might already be pregnant
• you smoke and are 35 or older

You have now or have had in the past:

• thrombosis (blood clots) in any vein or artery
• a heart abnormality or circulatory disease, including raised blood pressure
• very severe migraines or migraines with aura
• breast cancer
• active disease of the liver or gall bladder
• diabetes
• unexplained bleeding from your vagina (for example, between periods or after sex)

What are the advantages of the pill?
Some of the advantages of the pill are, it:

• doesn't interfere with sex
• usually makes your periods shorter, lighter and less painful
• can help with pre-menstrual symptoms
• protects against two types of cancer - cancer of the ovary and cancer of the womb
• protects against some pelvic infections
• reduces the risk of fibroids (tumours in the womb that are not cancer), ovarian cysts and breast disease that is not cancer

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