16 pros and cons of the contraceptive pill

The contraceptive pill is one of the most efficient and favoured ways for women to prevent pregnancy.

If you’ve never tried it before, it could be a confusing option to consider with so much information (and misinformation!) out there you may have already read or heard. There’s a reason, though, why the pill is so popular: its benefits for some women often go far beyond contraception itself.

It can help to regulate your cycle, reduce period pain, clear your skin and even lower your risk of certain health conditions. However, like all products, it isn’t suitable for everyone, and you’d need to remember to take it at the same time each day in order for it to be effective.

We’re here to talk you through the potential pros and cons of taking the pill so you can make an informed decision about your choice of contraception. 

Is the contraceptive pill suitable for everyone?

 
No, the contraceptive pill isn’t suitable for everyone. That’s because there are specific medical reasons that prevent some women from being able to safely take the pill.

These reasons differ between the combined contraceptive pill and the progestogen-only pill (mini-pill), but can include:
 

  • Suspected pregnancy
  • Medicines that affect the pill
  • History of blood clots in yourself or your family
  • Unexpected bleeding between periods or after sex
  • Liver disease
  • Breast cancer
  • Heart disease
  • Severe migraines 
  • Stroke 

 

Which type of pill is best?

 
Whether you choose the combined pill or the mini-pill will depend on your medical history and personal preference. One isn’t necessarily better than the other, but you’ll have to choose the one that best suits your needs.

If you’re breastfeeding, for example, the mini-pill should be safe for you to use whilst the combined pill will not. If, however, you’re taking the pill to have more control over your periods, the combined pill would be a better option providing it’s a safe option for you. 

You can find more information about the mini-pill and the combined pill on the NHS website or by reading the patient information leaflet included with the specific pill you’re considering. 

 

The pros of taking a contraceptive pill

 
There’s a lot to learn about the contraceptive pill, but, as promised, it’s time to explore the potential benefits of taking one.

Do bear in mind that these benefits will depend on the type of pill you’re taking (combined or progestogen-only).

 

It’s extremely good at preventing pregnancy

 
The most obvious benefit of taking the contraceptive pill is - you guessed it - the contraception! When taken correctly, both the combined and progestogen-only pills are over 99% effective at preventing pregnancy.

The mini-pill contains only a progestogen, which works by preventing the sperm cells from entering the womb. If the active ingredient in your mini-pill is desogestrel, this has an extra layer of protection with the capability to prevent the egg from ripening.

The combined pill contains an oestrogen as well as a progestogen, which work together in three ways:
 

  • Preventing the release of an egg from your ovaries
  • Preventing the lining of your womb from becoming thick enough for an egg to grow.
  • Making the fluid in your cervix thicker and therefore more difficult for sperm to get through into the womb

 
Whichever type of pill you choose or are able to take, they’re both highly effective methods of contraception as long as you take them as instructed in the patient information leaflet. 

It doesn’t interrupt sex

 
Nothing kills the mood like rooting around for a condom and realising you’ve run out. While barrier contraception like condoms are absolutely vital for preventing sexually transmitted infections[1], they can have their drawbacks.

The pill can be an ideal choice of contraception if you’re in a long-term relationship - after you’ve both tested negative for any sexually transmitted infections, of course. When taken correctly, it’s even slightly more effective than condoms at preventing pregnancy.

Always remember, though, that the pill will not protect you against any STIs like chlamydia, herpes, HIV and more, so you should definitely keep a condom handy particularly if you’re meeting someone new.
 

It can make your periods lighter and less painful

If you’re one of the many women who suffer from intense period pain, taking the contraceptive pill may help to reduce your discomfort.

The pill can prevent ovulation, meaning your uterus shouldn’t contract and cause painful cramps. The ‘period’ that you experience on the pill isn’t actually the same as a menstrual period - it’s actually called withdrawal or breakthrough bleeding and it usually shouldn’t be as heavy or painful as a regular period.
 

It can help to prevent anaemia

As the contraceptive pill should make your periods lighter, it will in turn reduce your risk of iron deficiency anaemia[2]. Anaemia is a common problem in menstruating women, particularly for those with very heavy periods. This is because too much blood can be lost through heavy periods[3], leading to a reduced number of red blood cells.

If you’re someone who suffers from heavy periods and you also experience tiredness, a lack of energy, shortness of breath, pale skin and heart palpitations, you should speak to your GP so they can check for anaemia. If you are anaemic, taking the contraceptive pill may help to reduce further blood loss.

It can reduce the symptoms of PMS

As well as making your periods lighter and less painful, the contraceptive pill can relieve symptoms of premenstrual syndrome (PMS)[4].

PMS refers to the symptoms that usually occur in the weeks or days leading up to a period such as mood swings, tiredness, stomach ache and breast tenderness. The pill can also reduce premenstrual dysphoric disorder (PMDD), a severe type of PMS that causes worsened emotional symptoms like feeling anxious, upset, hopeless or overwhelmed. Whilst taking the pill doesn’t guarantee your PMS or PMDD will disappear, it does help many women and can be worth a try.
 

It can be used to skip a period

The combined contraceptive pill is usually taken for 21 days with a 7-day break where you would experience a period (withdrawal bleed). If you’ve got a holiday or special event coming up that happens to coincide with that 7-day break, you’re able to skip that break and start your new strip of pills straight away.

Every day (ED) pills which include 7 inactive pills will work the same way, you’ll just have to skip the inactive pills and start taking the active pills straight away. This will not affect how they work as contraceptives - they will still prevent pregnancy with the same efficacy.

It can be more difficult to skip your period this way if you take a phasic 21-day pill where the mix of hormones in each pill is different - you’ll need to speak to your GP or pharmacist to make sure you’re taking the pills in the correct order.

Always speak to your GP before taking more than 2 packs without a break. Take note: if you choose to take a mini-pill (progestogen-only), you won’t be able to skip your period. 

It can help with acne

Another benefit of the combined contraceptive pill is the potential reduction of acne. Severe acne is often caused by hormonal changes, so when you use the contraceptive pill to minimise these changes, your skin may start to clear up. Make sure to speak to your GP about your acne before trying the contraceptive pill to clear it up - they’ll be able to help you choose the right one. Do bear in mind that progestogen-only pills won’t help to clear acne, in fact, these types of pills could make it worse.

It can reduce the risk of ovarian cysts

Ovarian cysts[5]can sound scary, but they’re quite common in women with natural monthly periods.

When the ovaries release an egg every month, the egg forms as a follicle that contains fluid to protect the egg as it grows and it bursts when the egg is released. Sometimes, though, the follicle doesn’t release an egg or it doesn’t discharge its fluid and shrink after the egg is released. That can lead to the follicle swelling and becoming a ‘functional cyst’ which, whilst harmless, can cause symptoms such as pelvic pain.

As most contraceptive pills prevent ovulation, they can help to prevent ovarian cysts from forming in the first place.

It can be used to manage endometriosis

Endometriosis is a very painful condition where tissue similar to the lining of the womb starts to grow in other places such as the ovaries and fallopian tubes.

This is the tissue that bleeds during your period, but if it’s located somewhere other than the uterus, it can be difficult for the body to get rid of it and therefore lead to inflammation and pain. The symptoms include pelvic pain, severe period pain, heavy periods, pain during sex, gastrointestinal problems and difficulty getting pregnant.

Whilst there isn’t a cure for endometriosis, it can be managed with treatment options including the combined contraceptive pill. The combined pill helps endometriosis by preventing ovulation and causing the lining of the uterus to become thinner.
 

It can lower the risk of certain cancers

Evidence suggests that taking the combined pill can lower the risk of ovarian and womb cancer. The longer a woman takes the combined pill, the lower her risk of developing these types of cancer, and the reduced risk lasts for years after stopping the pill.

On the other hand, taking the combined pill can slightly increase the risk of breast cancer, but not as much as other factors such as obesity or a family history of the disease. Limited research suggests that the combined pill could also increase the risk of cervical cancer too, but the evidence for this is mixed. All in all, the protective benefits of the combined pill generally outweigh the risks according to Cancer Research UK[6].

Because fewer people take the mini-pill (progestogen-only), there is less evidence around its effect on the risk of cancer.

The accessibility of the contraceptive pill

The contraceptive pill is free on the NHS and very accessible. 

Whether you choose to get the contraceptive pill through your GP, sexual health clinic or pharmacy (via the new NHS pharmacy contraceptive service), there are multiple options, helping to free up capacity in primary care and sexual health clinics (or similar facilities). 

Woman holding pill strip

The cons of the contraceptive pill

Now, let's talk about the flip side of the contraceptive pill: its cons. While it has its perks, there are some downsides to be aware of. 

These can range from minor issues like headaches and mood swings to more serious risks like blood clots or an increased risk of certain types of cancer. 

Remember, the specific drawbacks can vary depending on the type of pill you're on, and whether it's combined or progestogen-only. It's important to consider these factors when deciding if the pill is the right choice for you.

It can cause irregular vaginal bleeding

One downside of the contraceptive pill is irregular vaginal bleeding. 

This means bleeding or spotting at unexpected times outside your usual period, and it often happens when starting a new pill or changing doses. While it usually gets better with time, it can still be bothersome.

The pill can cause nausea and headaches

Getting queasy or headaches after taking the contraceptive pill? It's quite common. These side effects happen because of the hormonal changes caused by the pill. 

While everyone's experience is different, these symptoms often stem from these hormonal shifts. If you're dealing with them, it's likely due to how the pill affects you.

If you suffer from migraines, some contraceptive pills can make these attacks more frequent or worse, whereas some can improve them. It’s all about finding the right pill that agrees with your body.

Sore and tender breasts from the contraceptive pill

Sore and tender breasts happen due to the hormonal adjustments triggered by the pill. While uncomfortable, this side effect is typically temporary and tends to improve over time as your body adjusts to the medication. 

Hormonal acne

Changes to your skin from the pill

While some types of contraceptive pills can help to improve acne, some can make it worse. The hormones in the pill, like oestrogen and progesterone, can affect your skin. They may increase oil production, leading to acne, or alter pigmentation and texture.

Acne is more common in the progestogen-only pill as a lack of oestrogen can sometimes result in elevated levels of androgens, leading to the possibility of hormonal acne[7]. Hormonal acne typically appears on the chin, jawline and lower cheeks.

Mood swings caused by the contraceptive pill

The hormonal changes induced by the pill, particularly fluctuations in oestrogen and progesterone levels, can affect neurotransmitters in the brain, potentially leading to shifts in mood, like depression and anxiety.

Remembering to take your pill on time can be difficult

One drawback of the contraceptive pill is that you have to remember to take it at the same time every day. It's like adding an extra task to your daily routine, and if you forget or take it at different times, it might not work as well. 

This can be a hassle, especially if you're busy or tend to forget things easily. Plus, missing a pill could increase the chance of unexpected bleeding or getting pregnant. So, while the pill can be effective, keeping up with it can sometimes be a bit tricky!

Potential serious side effects

The contraceptive pill, while generally safe for most users, does carry some potential serious side effects. These can include an increased risk of blood clots, particularly in the legs or lungs, which can be life-threatening if not promptly treated. 

Additionally, some individuals may experience elevated blood pressure or develop cardiovascular issues while on the pill. There's also a rare but serious risk of liver problems or certain types of cancer, such as breast or cervical cancer, although the overall risk is generally low. 

It's important for individuals considering the pill to be aware of these potential complications and to discuss any concerns with their healthcare provider before starting the medication. Regular check-ups and monitoring can help prevent these risks and ensure the pill remains a safe option for contraception.

If you’ve been considering trying the contraceptive pill, we hope this guide has helped you to understand the potential pros and cons it could bring. There are a lot of myths surrounding the pill, but it’s generally a safe and popular option for women that lets us take control of our reproductive health.

There are now even two new over-the-counter contraceptive pills, Hana and Lovima, available without a prescription.

These are mini-pills (progestogen-only) and whilst they may not have the exact same benefits as the combined pill, they are extremely effective at preventing pregnancy. All that said, the pill isn’t a suitable option for everyone and you must speak to your GP or Chemist4U pharmacist to see if it’s right for you.

Faye Bonnell - Medical Content Writer
James O'Loan - CEO & Superintendent Pharmacist
James O'Loan , CEO & Superintendent Pharmacist on 27 March 2024
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