Combined Pill


What is it?

Combined pills contain the hormones estrogen and progesterone.

Some brands contain 21 pills with hormones and 7 without hormones (placebo pills). Your period comes when you’re taking the hormone-free pills. Newer brands have more hormone pills. Other brands have fewer (or even zero) placebo pills.

How well does it prevent pregnancy?

An effective form of birth control, but not as reliable as implant, hormonal IUD, copper IUD, or sterilization for men or women.

About 7 out of 100 women using combined pills get pregnant in a year of use.


Prevents the release of an egg from the ovaries each month (ovulation). Progesterone also thickens the mucus in your cervix. This stops sperm from entering the uterus. The lining of the uterus also becomes thinner.


Many brands and generics are available.


  • Effective birth control.
  • Sex can be spontaneous.
  • Reversible. Stop taking the pills if you want to try to get pregnant.


  • You need to remember to take your pill every day. If you don’t, you could become pregnant.
  • If privacy is a concern, you may prefer another method.
  • Because birth control containing estrogen may lessen breastmilk supply, many experts recommend using other methods of birth control while breastfeeding, particularly during the first six months. Talk to your doctor about what is best for you, your milk supply, and your baby.
  • Not safe if you are a smoker over age 35.
  • No-go with some health issues:
    • History of blood clots
    • Breast or endometrial cancer
    • Stroke
    • Coronary artery disease
    • High blood pressure
    • Serious liver disease
    • Migraine with aura
    • Advanced diabetes or certain types of lupus


Possible side effects (mostly short-term) include:

  • Breast tenderness
  • Headache
  • Nausea
  • Weight gain

Risks include:

  • Blood clots
  • High blood pressure


  • Can reduce heavy menstrual bleeding, painful periods, and anemia.
  • Can allow you to have periods less often than once a month. Ask your doctor how to do this.
  • Lowers risk for colon, ovarian, and endometrial cancers.
  • May improve:
    • Acne
    • Endometriosis
    • Menstrual migraine without aura
    • Irregular periods

Consider keeping emergency birth control (“morning-after pill”) at home to use as backup. It works best to prevent pregnancy if taken as soon as possible after unprotected sex or birth control mishaps, but may work if taken up to 5 days afterward. Brands include Plan B, ella, and others.

Use with condom to avoid getting or spreading sexually transmitted diseases or infections, including HIV.

Forgetting to take pills daily can result in pregnancy. If you miss one pill, you’ll need to take it as soon as you remember. If you miss two or more, you’ll need to take the rest of your pills on schedule and use a backup method for seven days.