What type of pill should you take?
There are several brands of pill to choose from and they’re all equally good at preventing pregnancy.
One important difference is their risk of blood clots (thrombosis). We recommend you start with the pill that has the lowest risk of thrombosis and then change if this doesn’t suit you.
Because they contain different amounts and types of oestrogen and progestogen, different pills suit different people.
To help you find the best one for you, we’ve put them into 6 groups based on their ingredients, with the pros and cons of each type.
We’ve shown some examples of the brands available in each group. Check the ingredients of your pill to find out which group they belong to.
Group 1: lowest risk of thrombosis
Ingredients: 30 micrograms of ethinylestradiol (synthetic oestrogen), 150 micrograms of levonorgestrel (synthetic progestogen)
Pros: These pills have the lowest risk of thrombosis, so you should always consider these first.
Cons: If you’ve tried these pills and experienced oily hair or skin, loss of libido or bloating then you might be better off with a brand containing more oestrogen – see group 2 below.
Group 2: possibly better for acne and bloating
Type 1: 30 micrograms of ethinylestradiol (synthetic oestrogen), 250 micrograms norgestimate (synthetic progestogen)
30 micrograms of ethinylestradiol (synthetic oestrogen), 150 micrograms desogestrel (synthetic progestogen)
Pros: Might be better if you experience acne or bloating.
Cons: Might be less good if you suffer from nausea or breast tenderness. If you have side effects, you may be better off with a progestogen-dominant pill from group one.
They also contain a newer progestogen that has a slightly higher - but still very small - risk of blood clots (thrombosis).
Group 3: possibly better for nausea, breast tenderness and breakthrough bleeding
Ingredients: 30 micrograms of ethinylestradiol (synthetic oestrogen), 75 micrograms gestodene (synthetic progestogen).
Pros: These pills may be better for you if you suffer from nausea or breast tenderness. They may also help if you’ve had breakthrough bleeding on other pills, which is bleeding outside your planned pill break.
Cons: They contain a newer progestogen that has a slightly higher - but still very small - risk of thrombosis than the pills in Group 1.
Group 4: possibly better for nausea and breast tenderness
These pills are lower in oestrogen, with 20 micrograms in each, rather than 30 in other pills. So they often have 20 at the end of the brand name.
Ingredients: They all contain 20 micrograms of ethinylestradiol, a synthetic oestrogen, but different types of progestogens.
Pros: These may be better for you if you suffer from nausea or breast tenderness on the combined pill.
Cons: Some people have breakthrough bleeding, which is when you’re bleeding outside of your planned pill break. They contain a newer progestogen that has a slightly higher - but still very small - risk of thrombosis than the pills in Group 1.
Mercilon 20 (150 mcg desogestrel)
Gedarel 20 (150 mcg desogestrel)
Millinette 20 (75 mcg gestodene)
Group 5: marketed as better for acne and bloating
If you don’t get on well with other pills, you could try these.
Ingredients: 0.030 milligrams of ethinylestradiol (synthetic oestrogen), 3 milligrams drospirenone (synthetic progestogen)
Pros: These have been marketed as improving acne and bloating, but there is not convincing evidence to support the claims. If you experience these side effects with other brands, you might wish to try these types.
Cons: They carry a slightly higher risk of thrombosis, so we recommend you only use these if the others haven’t suited you.
Group 6: contain non-active pills to help you keep track
Some combined pills contain 7 non-active pills designed to replace the 7-day break. These non-active pills do not contain any hormones. Sometimes these non-active pills contain iron. These pills are sometimes called everyday pills.
They can help you to keep remembering to take it every day and make it easier to see from the packet if you’ve missed one and when. This is important because the highest risk of pregnancy is just before or after the 7-day break.
Everyday pills can make it a little more complicated if you don’t want a pill break or bleed. If that’s the case, then you need to miss the non-active pills and only take the 21 active pills.
Microgynon 30 ED
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