Contraceptive Pill: What It Is and How to Pick One

The contraceptive pill is a daily medicine that prevents pregnancy. Most pills use hormones to stop ovulation or make the body less friendly to sperm. You’ll see two main types: the combined pill and the progestin-only pill. Knowing the difference helps you choose what fits your life and health.

Types and how they work

The combined pill contains estrogen and progestin. It prevents the ovary from releasing an egg and changes the cervical mucus so sperm can't reach an egg. The progestin-only pill (the mini-pill) has no estrogen and mainly thickens cervical mucus; it can also stop ovulation in some people. Progestin-only is a good option if you can’t take estrogen — for example, if you’re breastfeeding or have a history of blood clots.

Both types are effective when taken correctly. Typical use failure rates differ: combined pills are about 7% failure per year with typical use, while perfect daily use cuts that much lower. The mini-pill needs stronger timing — take it the same time each day for best results.

Side effects, risks, and interactions

Common side effects include nausea, spotting between periods, mood changes, and breast tenderness. Most side effects improve after a few months. Serious risks are rare but real: the combined pill slightly raises the risk of blood clots, especially if you smoke and are over 35. If you have migraines with aura, certain medical conditions, or a history of clotting, your clinician may advise a non-estrogen option.

Some medicines lower pill effectiveness. Common culprits are certain antibiotics, seizure drugs, and herbal products like St. John's Wort. If you start a new medication, check with your provider or pharmacist about interactions. If in doubt, use a backup method (condoms) for a short while.

Missed pills matter. For combined pills, missing one active pill usually means take it ASAP and protect yourself for seven days. For the mini-pill, missing by more than three hours can reduce protection — follow the packet instructions and use condoms for two days if timing was off.

How to choose: talk to a clinician about your health, smoking status, blood pressure, and any meds you take. If you want lighter periods, some pills reduce bleeding and cramps. If weight, mood, or acne are concerns, discuss options — different brands affect people differently.

Getting the pill: you’ll usually need a prescription. Many clinics and telehealth services can prescribe and send it to your home. When buying online, use licensed pharmacies and check for a valid prescription requirement. If anything feels off — strange packaging, no pharmacist contact — don’t buy it.

If you experience sudden leg pain, severe chest or head pain, fainting, or jaundice, seek medical care right away. Otherwise, most people find a pill that fits within a few tries. Talk openly with your provider — small changes can make a big difference in comfort and safety.