An honest guide to everything about the pill before you start taking it

The horror stories, the myths and all the answers

5 years ago | UPDATED 5 years ago

Everyone has heard the horror stories: “The pill is the worst thing ever”, “the pill made my periods so irregular”, “coming off the pill was the best thing I ever did“. There are so many mixed reviews of taking the contraceptive pill, it’s understandable that girls don’t know where to start.

But what is the truth about taking the contraceptive pill? What are the side effects? Does it make you gain weight? Are we all finally ditching it as a form of contraception and moving on?

Here is a full, and honest guide to the pill and everything you should know before you start taking it.

What are the different types of pill?

There are two main types of contraceptive pill: the combined pill and the progestogen only pill.

What is the most common contraceptive pill?

The combined pill is the most common type of pill as it’s seen as being “the best” and most suited for more people.

The most common brands of this type of pill are: Microgynon, Cilest, Rigevidon and Yasmin.

These contraceptive pills are taken daily

How effective is taking the contraceptive pill?

No contraceptive is ever 100 per cent effective – but the pill is said to be 99 per cent. It’s more effective depending on the way you use it – for example if you are on a pill where you have to take it at the same time each day, being consistent with it will make it as effective as possible.

What are the side effects of the pill?

There are lots of side effects of the pill. The most common with combination birth control pills include: nausea, vomiting, headaches, weight gain, breast tenderness, bleeding between periods.

The most common side effects of progestogen only pill include: acne, breast tenderness, headaches, fatigue, bleeding between periods, ovarian cysts, weight gain, and changes to your sex drive.

Why does the pill make you gain weight?

For a lot of girls, they say they experience weight gain from the pill.

This isn’t always the case for everyone, and it can’t always be blamed on your birth control.

The main reason behind weight gain on the pill is because of fluid retention. This is caused by too much oestrogen, the hormone in the pill, which can also increase appetite. However, pills now contain much lower dosages – and the NHS say the claim the pill makes you gain weight is a myth .

Will the pill give you blood clots?

There are stories circulating that the pill can give you blood clots.

Research from Nottingham University suggests taking pills such as Yasmin, Femodene and Marvelon could increase your chances of the getting these clots.

The study found newer contraceptive pills can increase your risk of developing a blood clot by four times.

However, studies say the pill doesn’t directly give you blood clots, but the risk for developing one may be increased.

Is the pill free?

As it is a form of contraception, the pill is free. You can get the pill for free from your GP, sexual health clinics and contraception clinics.

You can even get the pill delivered straight to your door.

When should you start taking the contraceptive pill?

Despite the horror stories, for a lot of girls taking the pill is a contraceptive method that works really well for them – and it works absolutely fine.

The pill can help regulate periods, reduce cramps and acne – there are proven benefits for going on the pill.

If you choose to go on the pill, you can start your prescription as soon as you pick it up – but your start date should always be discussed with a medical professional.

What pill is best for me?

The type of pill to take is different from person to person, but there are different brands of pill that are more suited for different needs.

Your GP – or wherever you choose to get the prescription – will be able to discuss these differences with you.

Different brands are recommended to help prevent symptoms such as heavy or unpredictable periods, pains and cramps, weight changes and problems such as acne.

Does alcohol affect the pill?

Alcohol does not directly affect the pill, or its effectiveness.

The only way that alcohol could be seen as having an affect on your birth control is down to the way alcohol affects you. If you’re crazy drunk at the time you’re meant to take your pill, you’re more likely to forget or take it late – which will affect it.

Also, if you’re typically a messy drunk and throw up a lot, this might mean your body doesn’t absorb the pill if you’ve recently taken it.

Some girls also find since being on the pill they get drunker quicker, this is because the hormones in birth control reduce your liver’s ability to metabolise alcohol – but this doesn’t happen to everyone.

Do antibiotics affect the pill?

Most antibiotics don’t affect the pill.

The only ones that do make contraceptives less effective are those that can be used to prevent tuberculosis and meningitis. These are rifampicin and rifabutin.

There has also been r esearch into how Modafinil, the study drug, may affect the pill.

More information about how your current healthcare might affect contraception will be in the guide that comes in the box with the pill, and of course you can discuss with the medical professional that prescribes for you.

How does the pill affect your mental health?

Women are now starting movements to ditch the pill in favour of their mental health.

A study found woman who take the pill are 23 per cent more likely to be treated for depression. The side effects of the pill can include mood changes, and this study found adolescent girls appeared to be at highest risk. Those taking combined pills were 80 per cent more likely and those on progestin-only pills more than twice as likely to be prescribed an antidepressant than those not on the pill.

However, The NHS has debunked this study, and said it doesn’t completely prove a correlation between the pill and depression – instead it just starts a basis to explore this trend further. In order for there to be solid evidence that the pill is related to depression, there would need to be much more evidence.

Other women claim the pill has worsened their anxiety symptoms, and made them paranoid and angry.

There have been investigations into how the pill might cause depression, anxiety and panic attacks. These investigations show there are cases of women who have experienced these side effects, but no concrete conclusion has ever been reached.

How taking the contraceptive pill affects your body

Contraception aside, taking the contraceptive pill can actually serve other purposes. It can be used to treat other health concerns such as menstrual relief, skin changes and hormone imbalances.

There are multiple ways the pill can affect your body. These include: helping to clear acne, changing your bone density, possible blood clots, there is debate it may increase the risk of breast cancer and affecting your sex drive.

For more information on how taking the contraceptive pill might affect your body, see here.

How long does it take for the pill to work?

If you’re taking the combined pill on the first day of your period, you should be protected straight away. However, if you don’t begin your pill pack until after your period has started, you’ll protected after seven days.

With the progestogen only pill, you are protected after two days.