The Pill (Combined Oral Contraceptive Pill)

What is the Pill?

The combined oral contraceptive pill, commonly referred to as the Pill, contains two artificial hormones, oestrogen and progestogen – these are similar to the hormones naturally produced by the body. It is mainly taken to prevent pregnancy; however, there are other reasons why someone may decide to take it, such as to control periods or improve acne.

There are many types of the Pill available; most come in a 28 day packet, containing hormone (active) pills, and up to 7 days of non-hormone (inactive) pills. When taking the inactive pills there is usually a withdrawal bleed, which is like a period.

There is also a pill which is taken continuously for 84 days, followed by 7 days of very low dose active pills. There are different benefits and disadvantages to each type of pill and this can be discussed with a doctor or nurse before starting.


The Pill works by:

  • stopping the release of an egg by the ovary (ovulation)
  • making the mucus (sticky fluid) at the opening of the uterus thicker so sperm can’t get through

The Pill is greater than 99% effective with perfect use, but with typical day-to-day use it is about 91% effective.

The Pill is available on prescription, which can be obtained from your doctor, SHINE SA clinics, community health clinics or youth health clinics.

It is usually advised to begin taking the Pill within the first five days of your period starting. If you start taking an active pill during this time frame then protection against pregnancy is considered immediate. The instructions that come in the packet will tell you exactly how to take it, but if you are not sure you can check with your doctor or nurse.

If you start after the first five days of your period you need to use another form of contraception for seven days before you will be protected from unplanned pregnancy.

If you are taking the Pill ‘Qlaira’, then different rules apply for starting pills. You should check the information on the packet.

Take all the active pills in the packet until you reach the inactive pills. After you have finished taking the inactive pills you should start taking the active pills in your next packet. You should do this even if the withdrawal bleed hasn’t finished.

You may want to keep on using condoms with the Pill because they help to protect you from sexually transmitted infections (STIs) and provide additional contraception.

It is possible to skip the inactive pills and take the hormone pills continuously so that you should not get a bleed. It is safe to do this although some people may experience breakthrough bleeding. Talk to your doctor or nurse to get advice about the best way to do this.

  • Take the Pill every day at a time that’s easy to remember.
  • If you forget your pill you can take it up to 24 hours from the usual time to remain safe (up to 48 hours since your last pill), but it may cause irregular bleeding. See Missed pills for instructions.
  • Keep a spare pill packet with you in case you need it.
  • If you have any side effects, including irregular bleeding, continue to take the Pill. If it hasn’t settled in 2-3 months get advice from your doctor or SHINE SA.
  • Do not stop taking the Pill unless you want to get pregnant or have started another form of contraception.

The Pill may not be effective if:

  • two or more pills are missed (i.e. more than 48 hours since the last pill was taken)
  • vomiting occurs within two hours of taking the hormone pill
  • you have very severe diarrhoea

See Missed pills for instructions.

Always check with your doctor or contact the Sexual Healthline if you are taking other medications, as some drugs may stop the Pill from working (e.g. some antiepileptic medication). This can also include herbal medicines like St John’s Wort. If you are taking one of these medications you will need to use other protection while taking the medication and for one month after stopping.

  • Periods usually become more regular, shorter, lighter and less painful.
  • The timing of bleeding can be controlled.
  • The Pill can reduce the chance of cancer of the uterus and ovaries, benign breast disease, endometriosis and ovarian cysts.
  • The Pill usually improves acne.
  • The Pill can be used as a treatment for Pre-Menstrual Syndrome (PMS).
  • It’s easily reversible and has no effect on future fertility.

The Pill has few side effects. Serious health problems caused by the Pill are rare; the most dangerous is blood clots, usually in the legs or lungs (called thrombosis). You may notice:

  • irregular bleeding
  • headaches (more than normal)
  • an increase in appetite (eating more means you will put on weight)
  • nausea (feeling sick) – try taking the Pill with food or in the evening
  • sore breasts (supportive bra can help)
  • changes in mood, including feeling depressed

If you have any of these side effects continue taking the pills. They will mostly settle after 2–3 months of taking the Pill. If they persist or are very annoying, see your doctor or SHINE SA clinic as a change of the type of Pill may help.

In some people the oestrogen in the Pill can cause patchy brown discolouration to appear on the face, especially if you spend a lot of time in the sun. If this happens when you are on the Pill you can try to limit your sun exposure and use sunscreen. The brown discolouration can take months to fade, even if you stop taking the Pill.

The Pill is safe for most people. In particular, the risks of taking the Pill are less than the risks of being pregnant.

The Pill is not suitable for someone who:

  • has had a stroke, heart attack, blood clot or high blood pressure
  • has certain types of migraine, diabetes or liver disease
  • is over 35 years and smokes
  • is extremely overweight













It doesn’t matter if you forget to take your inactive pills.

If you are taking the Pill ‘Qlaira’, then different rules apply for missed pills. You should check the information on the packet.

If you are worried about having missed a pill, contact a pharmacist, doctor or SHINE SA clinic.

If you are thinking about using Emergency Contraception, it’s best taken as soon as possible, but can be taken up to 5 days after unprotected sex. If you take the Emergency Contraceptive Pill ‘EllaOne’, you should not restart the Pill for 5 days after taking it.