How It Works
The combined pill contains oestrogen and progestogen, which together prevent ovulation, thicken cervical mucus (blocking sperm), and thin the womb lining.Blood Clot (VTE) Risk Factors
| Risk Factor | Effect |
|---|---|
| Smoking (especially over 35) | Significantly increases clot and cardiovascular risk — combined pill often avoided |
| BMI over 35 | Increased risk — alternative contraception often preferred |
| Migraine with aura | Significantly increased stroke risk — combined pill contraindicated |
| Family history of blood clots | May require thrombophilia screening before prescribing |
| Immobility (long flights, surgery) | Temporary increased risk — some advise stopping before major surgery |
Non-Contraceptive Benefits
- Lighter, more regular, less painful periods
- Improvement in acne
- Reduced risk of ovarian and endometrial cancer (persists for years after stopping)
- Reduced ovarian cyst formation
- Can be used to manage endometriosis symptoms
Blood Clot Warning Signs — Seek Emergency CareSudden leg swelling/pain (possible DVT), sudden breathlessness or chest pain (possible pulmonary embolism), or sudden severe headache/vision changes (possible stroke) while on the combined pill require immediate emergency assessment.
Missed Pill RulesIf you miss one pill, take it as soon as remembered and continue as normal — no additional protection needed. If you miss two or more pills, additional contraception (condoms) is needed for 7 days, and emergency contraception may be needed if unprotected sex occurred — check the specific guidance for your pill brand.
Does the pill cause weight gain?
Large studies have not found the combined pill causes significant weight gain for most users, though individual experiences vary and some other hormonal methods have stronger evidence of weight effects.
Can I take the pill continuously to skip periods?
Yes — many women safely take the pill back-to-back (skipping the placebo week) to reduce period frequency or avoid periods for specific events. Discuss the best approach for your specific pill with your doctor.
Who should avoid the combined pill?
Smokers over 35, those with migraine with aura, uncontrolled high blood pressure, history of blood clots, certain liver conditions, and breast cancer should generally avoid it — progestogen-only or non-hormonal options are safer alternatives.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.