Hormonal Pills

So Many Contraceptive Pills, So Many Choices!

There are so many contraceptive pills and so many choices! How does a girl choose?

First of all, we need to consider that there are different types of oestrogen, different types of progesterone, all in different doses. This can impact on potential side-effects. The most common side-effects of the Pill relate to mood concerns. But many women can take the Pill without any concerns at all.

Secondly, consider that some types of the Pill have a consistent dose of hormones ‘monophasic’ pills’, and some have variable doses of hormones ‘triphasic’ or ‘quadriphasic’ pills. This can impact on the potential for break-thru bleeding, or spotting through the month.

Benefits of the Pill:

  • Makes periods lighter and less painful
  • Can reduce pre-menstrual tension and premenstrual dysphoric disorder
  • Continuous use after surgery to remove endometriosis can reduce the chance of endometriosis returning
  • Reduces the acne, hairiness and irregular periods of Polycystic Ovarian Syndrome (PCOS)
  • Decreases the risk of ovarian and uterine (womb) cancer – the risk decreases the longer you take The Pill and persists for many years after stopping
  • Reduces the risk of bowel cancer

Disadvantages of the Pill:

  • Current use increases the risk of clots in the legs or lungs (known as VTE or venous thromboembolism) – this depends on the dose of oestrogen and the type of progesterone – but the absolute risk is very small
  • It can also increase the risk of heart attack or stroke – again, this depends on the dose of oestrogen, and the absolute risk is very small
  • There is a small increased risk of breast cancer while taking the Pill, but this risk reduces once you stop taking it – and the risk is higher with higher doses of oestrogen.
  • There is also a small risk of increased cases of cervical cancer – again, this reduces once you stop taking it
  • Some women experience low libido because of the testosterone suppression – but the testosterone suppression is how the Pill works to decrease acne and hirsutism (hairiness)

It’s very important to have a detailed conversation with your doctor about your particular contraceptive needs, medical and family history. As well as any issues with your periods in order to choose exactly the right contraceptive method.

This is likely to change over your lifetime. For example, considering changing from the Pill to a Mirena IUD from age 35 in order to reduce your breast cancer risk is a very good move. Or, it may be that changing the dose, or the type of oestrogen as you get older is the best option.

While a woman’s fertility declines significantly after 40 years of age, reliable and safe contraception is still an important health issue. Certainly, women over the age of 50 should not be using the oral contraceptive pill. Read more here: Contraceptive needs in the perimenopause.

Further reading – What’s New with the Combined Oral Contraceptive Pill?


Dr Tonia Mezzini has been helping women to chose the best method of contraception for many years.  If you would like expert advice on contraception, make an appointment to see Dr Tonia Mezzini today.

Dr Tonia Mezzini is known for offering the best possible advice and treatment options for a person’s sexual health care needs. In particular, she cares for patients with: