Finding the Best Contraceptive Pill:

Choosing the right contraceptive pill can be a daunting task, but it doesn’t have to be. With so many options on the market, it’s important to know what to look for when considering which pill is best for you. Here, we’ll break down the top options and help you determine which one is the best contraceptive pill for your needs.

Safest Contraceptive Pills

Different contraceptive pills have different safety risk profiles. When determining which t contraceptive pill is safest for you, you need to consider two different perspectives. Firstly, the contraceptive pills that have the lowest risk of potentially serious complications such as blood clots*, and secondly, the contraceptive pills that offer the most protection against pregnancy.

We’ll explore both aspects so you can decide what’s best for you.

*This should be considered in the context of the potential risks associated with becoming pregnant.

The Contraceptive Pill and Blood Clots

As we know, there are two different types of contraceptive pill – the combined pill containing both oestrogen and progesterone, and the progesterone-only pill (mini pill). Developing a potentially harmful blood clot as a result of using hormonal contraceptives is rare, but can have significant implications, especially at a young age. However, the risk of developing a blood clot as a side effect of using combined contraception is significantly lower than if you were pregnant or during the postpartum period.

All types of combined hormonal contraceptives will increase your risk. This includes combined contraceptive pills as well as the contraceptive patch and contraceptive ring. Each type of combined contraception will have a different risk profile, some have a higher risk than others. Although there is some increased risk when using a progesterone-only pill, this is much less.

The risk of developing a blood clot is greatest in the months immediately after starting a combined contraceptive or when restarting it after a break of at least one month. This risk reduces over the first year of use and then it remains stable. For this reason, frequent starting and stopping of combined contraceptives should be avoided. Other things that can increase your risk of developing a blood clot when using a combined contraceptive include:

• Being overweight
• Smoking
• Increasing age (from 35 years and older)
• Having a family member with a blood clot aged <45 years
  Postpartum (6-12 weeks post-delivery)
• Reduced mobility (even temporarily)

The more of these risk factors that apply to you, the greater the risk.

As mentioned, there are some contraceptive pills that have relatively lower risk profiles than others. Similarly, combined contraceptives like the ring and patch have different risk profiles. Current evidence suggests that contraceptive patches and contraceptive rings may have up to twice the risk compared to some other combined contraceptives.

For these reasons, we suggest always seeking additional advice if you are:

• Having a procedure or surgery of any type
• Planning a long-haul flight
• Planning a holiday to an area of high altitude
• Immobilised for a prolonged period of time

Symptoms of Blood Clots

Blood clots can be very serious and in very rare cases, they can be fatal. It’s important to see a doctor immediately if you develop any of the following symptoms when taking the combined pill:

• Pain or swelling of the legs
• Severe chest pain
• Breathlessness or coughing up blood
• Bad fainting attack or collapse
• Unusual headaches or difficulty with speech or sight
• Numbness or weakness of a limb

The Most Effective Contraceptive Pill

If you’re concerned about different contraceptive pills and their effectiveness against preventing pregnancy, we have some good news – both the combined contraceptive pill and the progesterone-only pill (aka the mini pill) offer the same protection. When used correctly, both the combined pill and the mini pill are more than 99% effective. With typical use (allowing for user error e.g. missed pills), they are less than 95% effective – therefore, it is extremely important to take your pill as directed by your doctor.

Interestingly, other types of hormonal contraceptives offer the same level of protection:

• Contraceptive patch is 99% effective when used correctly, it is less than 95% effective with typical use
• Contraceptive Ring is 99% effective when used correctly, it is less than 95% effective with typical use
• Contraceptive injection is 99% effective when used correctly, it is less than 95% effective with typical use

Some contraceptives that are more than 99% effective when used correctly:

• Contraceptive implant (lasts up to 3 years)
• Intrauterine system or IUS (lasts up to 5 years)
• Intrauterine device or IUD aka copper coil (lasts 5-10 years)
• Female sterilisation (permanent)
• Male sterilisation or vasectomy (permanent)

In contrast barrier methods are less effective:

• Male condoms are 98% if used effectively every time you have sex
• Female condoms are 95% effective if used every time you have sex
• Diaphragms with spermicide are 92%-96% effective if used every time you have sex

This is with ‘perfect’ use, so in reality these methods are less effective.

It is important to note that only male and female condoms offer protection against STIs. You can use barrier methods in conjunction with hormonal contraceptives to increase your contraceptive cover and protect against STIs

Best Contraceptive Pill Without Side Effects

Unfortunately, no contraceptive pill is completely free of side effects, but some pills have fewer side effects than others. Every pill type and brand will have varying amounts and types of hormones. In addition, everybody is different and so, contraceptive pills can affect people in different ways.

Generally speaking, most contraceptive pills are very well-tolerated. Some people might find that they experience side effects when they start taking the pill. Usually, these side effects are temporary and they will settle with time, as your body adjusts to the hormones. However, if you are still experiencing side effects after 3 months or if you’re finding it difficult to deal with the side effects, please speak to your doctor about switching pills. It can just be a case of trial and error to find the right pill for you.

When it comes to the combined pill vs the progesterone-only pill, the right pill for you will depend on your body and your individual needs (including your medical history).

The mini-pill is generally very well-tolerated but it does not offer the same cycle control as combined pills. This means that periods can become irregular – more frequent, less frequent or stop entirely. The mini-pill may cause some of the following side effects, but they are rare:

• Headaches
• Migraines
• Breast tenderness
• Acne
• Nausea
• Mood changes
• Low sex drive
• Ovarian cysts (these are usually harmless and usually go away without treatment)

Combined contraceptives can cause spotting (bleeding between periods) but generally speaking, offer far better cycle control than progesterone-only pills. Combined contraceptives can also cause:

• Headaches
• Migraines
• Breast tenderness
• Acne
• Nausea, bloating
• Fluid retention
• Increase in blood pressure
• Increased risk of blood clots
• Slight increased risk of breast cancer

Some of these symptoms are caused by the type of oestrogen in the contraceptive medicine, and some as a result of the type of progesterone.

If you’re worried about potential side effects when choosing the right contraceptive pill, we recommend speaking to your GP for tailored advice.

Best Contraceptive Pill Brand

There are many contraceptive pill brands on the market, but some are more popular than others. There is no one “best” contraceptive pill brand as this will differ from person to person. For instance, a progesterone-only pill might be better for one person while a combined pill might be better for someone else.

The best contraceptive pill for you is one that you can take correctly with ease, with the least amount of side effects. So, if you find it easier to take a pill every single day, without breaks, as you tend to forget to take it after your pill-free break, a progesterone-only pill might be better for you as you take it continuously. Similarly, you might find that you prefer a combined pill as it offers better cycle control and you can delay your period if needed.

It is worth noting that some progesterone-only contraceptive pills are safe to take if you are breastfeeding.

Best Contraceptive Pill for Weight Loss

No birth control has been designed for or scientifically proven to cause weight loss or weight gain. Although weight gain is one of the most reported side effects of birth control pills, there is little evidence to suggest that hormonal contraceptives (except the contraceptive injection) cause weight gain or loss. Some people may experience weight gain when they first start taking the pill, but this is often fluid retention.

Although weight gain is often reported, it might not be linked to the contraceptive pill. Weight is linked to many factors such as diet, lifestyle, and age which can all change over time. For instance, if you start taking the pill in your late teens/early twenties, you might notice weight gain over the course of the next few years. This isn’t necessarily because of your contraceptive though!

No medical studies have linked contraceptive pills to weight loss or weight gain. Generally speaking, methods of weight loss are the same, whether you’re taking birth control pills or not. Therefore, you can still manage your weight effectively by adopting healthy habits, such as regular exercise and a balanced diet.

Which Contraceptive Pill is Best for Me?

Choosing the best contraceptive pill for your needs is a personal decision that depends on many factors. Your age, medical history, lifestyle, and personal preferences are all important considerations. It’s also important to consult with your doctor to determine which pill is best for you.

Through our online prescription service, we provide prescriptions for more than 20 different brands of contraceptive pill, patch and ring and our GPs are on hand to help you find the best fit for you. If you are seeking a prescription for the pill for the first time, we recommend speaking to one of our Irish-registered GPs so we can provide advice that is tailored to your needs.

If you already have a prescription for a contraceptive pill, patch or ring and you need to renew your prescription, you can do it quickly and conveniently through our online prescription service – there’s no need to make an appointment with a GP. Simply fill in a short and secure suitability questionnaire and one of our doctors will review your request to make sure it’s safe for you. Once approved, we’ll send your prescription directly to an Irish pharmacy of your choice. Visit our Contraceptive Pill, Patch & Ring patch to get started.