Types of Contraception
| Feature | Combined Oral Contraceptive (COC) | Progestogen-Only Pill (POP) |
| What it is | A contraceptive pill that contains both oestrogen and progestogen. | A contraceptive pill that contains only progestogen (synthetic progesterone). |
| How it works | Prevents ovulation, thickens cervical mucus, and thins the uterine lining. | Thickens cervical mucus and may alter the uterine lining to prevent pregnancy. |
| Effectiveness | Over 99% effective with perfect use. | Around 99% effective with perfect use. |
| How to take it | Typically taken daily, in a 21-day cycle with 7 days of no pills or placebo pills. | Taken daily, ideally at the same time each day. |
| Side effects | Can include headaches, migraines, nausea, mood changes, breast tenderness, fluid retention, change in libido, temporary disturbances of bleeding patterns and weight gain. | Can include irregular bleeding, headaches, change in mood, acne, weight change and breast tenderness. |
| Who can use it | From menarche up to and including 49 years of age.
Suitable for most women, but not for those with certain health conditions, such as a history of blood clots. |
From menarche and up to and including 54 years.
Suitable for women who cannot take oestrogen (e.g., smokers over 35, those with certain medical conditions). |
| Age Considerations | Typically recommended for women under 35 who are healthy and not smokers. | Suitable for women upto 54 years of age. Over 35 and smoke, those who cannot tolerate oestrogen. |
| Contraindications | Should not be used by women with a history of blood clots, certain types of cancer (e.g. breast cancer), liver disease, significant or prolonged immobility, severe migraines. Not recommended for women over 35 who smoke. Body Mass Index (BMI) equal to or greater than 35kg/m². Certain cardiac conditions. |
Should not be used by women with unexplained vaginal bleeding, liver disease or a history of breast cancer. |
| Benefits | Regulates periods, reduces menstrual cramps and offers acne control. | Suitable for women who are breastfeeding or those who cannot take oestrogen. |
| Drawbacks | Needs to be taken consistently, can have side effects and not ideal for women over 35 who smoke. | May cause irregular bleeding, less effective if not taken consistently. |
Choosing the Right Contraceptive
Medication Available Available to Be Supplied
Please click on the picture of the relevant medication for more information. This will take you to patient information leaflet of each medication.
Combined Oral Contraceptive Pill
Progesterone Only Pill
Side Effects of Medication
Combined Oral Contraception Potential Side Effects
- Nausea
- Headaches
- Breast tenderness or swelling
- Mood changes (e.g., depression, irritability)
- Spotting or breakthrough bleeding between periods
- Weight gain or fluid retention
- Decreased libido (lower sex drive)
- Changes in menstrual cycle (lighter or missed periods)
- Vomiting (in severe cases)
- Increased blood pressure
- Acne (or, in some cases, improvement in acne)
- Changes in skin pigmentation (dark spots or melasma)
- Changes in vaginal discharge
- Dizziness
- Fatigue or tiredness
- Changes in appetite
- Thickened cervical mucus
- Hair loss or excessive hair growth (hirsutism)
- Blood clots (Deep vein thrombosis, pulmonary embolism, stroke)
- Severe abdominal pain or bloating
- Sudden vision problems or loss of vision (could indicate a blood clot)
- Chest pain, shortness of breath, or severe leg swelling
- Severe headaches or migraines (especially with visual disturbances)
- Liver problems (yellowing of the skin or eyes, upper abdominal pain)
If you experience any of these side effects, especially the serious ones, it's important to seek medical advice right away. Your healthcare provider can help determine if the COC is the right choice for you or suggest alternatives.
Progesterone Only Pill Potential Side Effects
- Irregular bleeding or spotting (between periods or during the first few months)
- Headaches
- Breast tenderness
- Nausea
- Mood changes (e.g., irritability, mood swings)
- Acne
- Decreased libido (lower sex drive)
- Weight gain
- Changes in menstrual cycle (e.g., missed periods or very light periods)
- Vaginal discharge changes
- Hair loss or excessive hair growth (hirsutism)
- Dizziness
- Abdominal pain or bloating
- Severe abdominal pain or bloating (could indicate ectopic pregnancy)
- Chest pain, shortness of breath, or leg swelling (could indicate blood clots)
- Severe headaches or migraines (especially with visual disturbances)
- Liver problems (yellowing of the skin or eyes, upper abdominal pain)
If any of the serious side effects occur, seek medical help immediately. For irregular or bothersome side effects, consult your healthcare provider to determine if the POP is right for you or if an alternative method would be better.