Combined pill

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Here’s what's included in the price:

Consultation

Answer a few questions about your health so we can get to know you better.

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Aftercare

We’ll check in with you regularly to see how your treatment is going.

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Combined pills: essential info
The details
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FAQ

What are combined birth control pills?

They’re pills that combine two hormones: estrogen and progestin. These hormones affect how and when your body prepares for pregnancy.

There are several different types of combined birth control pill and they’re all just about equally effective at preventing pregnancy. However, some contain higher doses of hormones than others, or use different types of progestin and estrogen. This means one pill might be ideal for easing specific PMS symptoms, while another pill works great for women who are extra-sensitive to hormones.

It can feel a bit overwhelming, so we’re here to help.

How does the combined pill work?

The combined pill works in three ways to prevent pregnancy. Here’s the big one: it stops ovulation. That’s when your ovary releases an egg, and it happens once a month. Each egg has the chance to become fertilized, leading to pregnancy. If fertilization doesn’t happen, the lining of your womb breaks down and the whole thing happens again next cycle (lots of fun, we know).

Because the combined birth control pill stops ovulation, your chances of becoming pregnant are significantly reduced.

The combined birth control pill also protects you by making the mucus in your cervix thicker. “Thick mucus” isn’t something you normally want to hear but in this case, it’s great news. When it’s thicker, sperm have a much harder time reaching the egg.

The pill also makes your uterine lining thinner. This lining builds throughout the month and then breaks down during your period. When you’re using birth control, the lining doesn’t build in the same way. And so the period you have while taking the pill should be lighter and more manageable.

Which birth control pills are combined pills?

Any that contain two active ingredients, a progestin and an estrogen. To find out if your pill is a combined pill, just check the active ingredients.

In the leaflet that comes with your pill, the ingredients should be clearly listed at the top underneath the name of the drug. For combined pills you should see two ingredients, front and center, that are progestin and estrogen.

With Loestrin, for example, the active ingredients are norethindrone acetate and ethinyl estradiol. This pill is clearly stated as a progestin-estrogen combination.

We offer a range of combined birth control pills, so there’s plenty of choice for you. But if you can’t take combination pills, for any reason, it’s important to share this with us for your safety.

Medically reviewed by

Ms Laurenmarie Cormier

Nurse Practitioner

on August 02, 2022.

Meet Laurenmarie

This page was medically reviewed by Ms Laurenmarie Cormier, Nurse Practitioner on August 02, 2022. Next review due on August 01, 2024.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

How effective are combined birth control pills?

There are two ways of measuring how effective pills are at preventing pregnancy. One way is according to perfect use. This means you take the pill exactly as you should, every day, without making a mistake. The level of effectiveness of the combined oral birth control pill when taken like this is over 99%. So in a whole year, fewer than 1 in 100 women taking the combined birth control in that time will become pregnant.

The other way is typical use. This is when you take the pill but make realistic errors, such as forgetting the occasional pill or taking it late. It’s 91% effective when taken like this, which means about 9 in 100 women taking it over a year will become pregnant.

The best way to make sure the pill is effective then is to follow the instructions as closely as you can when you take it.

When to start taking the combined pill

It depends on whether you’re taking the pill for the first time, coming back after a break, or switching from a different type of birth control. If you’re using the pill for the first time, you can start on any day.

When you start using the pill on the first day of your period, you’re protected from becoming pregnant immediately — so you don’t need to worry about using a condom. You’ll also be protected immediately if you start taking the pill before the fifth day of your period.

If you start using the pill after the fifth day of your cycle, you won’t be protected right away. Use a back-up birth control method (like condoms) for seven days while the pill starts to work.

Another option is the Sunday start approach. If you start taking the pill on the first Sunday after your period begins, you avoid withdrawal bleeding on a weekend (if you want to skip having your period on a weekend, this is the way to go).

When to start the combined pill if you’re already on birth control

You shouldn’t leave a gap when you’re switching from one birth control method to the combined pill. If you’re already taking a hormonal birth control pill, start your new prescription the day after you finish your last pill.

If you’re using a transdermal patch like Xulane, start the pill a day before you’re due to take off the patch. If you’re using the vaginal ring, start the pill a day before you’re set to take out the ring.

If you normally have the Depo-Provera injection, you can start taking your pill up to 15 weeks after your last shot.

And if you have an IUD (copper or hormonal), you should begin your combined birth control pill pack a week before having your IUD removed.

Medically reviewed by

Ms Laurenmarie Cormier

Nurse Practitioner

on August 02, 2022.

Meet Laurenmarie

This page was medically reviewed by Ms Laurenmarie Cormier, Nurse Practitioner on August 02, 2022. Next review due on August 01, 2024.

How we source info.

Combined pill: FAQ

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

What side effects can I get on the combined pill?

Answer:

Some of the most common side effects when you start using the pill include nausea, headaches, tender breasts, changes to your mood, bloating and breakthrough bleeding.

A lot of the time, these side effects are pretty mild and will normally go away as you continue using the pill, usually after the first two to three months.

But if you get any side effects that concern you, or don’t go away after a couple of months of use, tell us. Our clinician may suggest moving you on to a different pill.

Serious side effects like allergic reactions or blood clots are rare, but you should go to your nearest hospital right away if you get any signs of these.

Can I take combined pills with other medications?

Answer:

Combined pills can interact with other medications, so it’s important for you to let us know if you’re currently taking medication for any health issues.

For the most part, antibiotics are safe to take when you’re on the pill — except for rifampin, which is used to treat tuberculosis. These antibiotics can affect your periods, making them irregular, so your chances of becoming pregnant increase.

Let us know if you’re currently taking medication to treat HIV, as some of these treatments can impact your pill. Medications like Darunavir, Efavirenz and Nevirapine all interfere with the combined birth control pill, so another birth control option may be better for you.

Anti-fungal medications used to treat skin conditions like jock itch may interfere with your pill, as can anti-seizure drugs. Drugs like carbamazepine, phenobarbital and primidone can affect how the hormones in birth control are broken down. If you’re using these treatments, another birth control option should be used instead of the combined birth control pill.

Modafinil (you may know this under the name Provigil) is used to treat sleep issues like narcolepsy and shift work sleep disorder. It can reduce the effectiveness of your pill, so you shouldn’t use a combined birth control method if you’re taking this medication.

Be mindful of herbal remedies too, because they can have an impact on your pill. St John’s Wort (used to treat mild depression or sleep disorders) can affect how estrogen is broken down, so the pill may not work as well and the chances of breakthrough bleeding increase.

Saw palmetto (used for hair loss), alfalfa (for kidney or bladder problems), garlic pills (taken for heart and blood diseases) and flaxseed (for digestion problems) can all impact the effectiveness of your pill. Combined birth control pills will probably not be a good fit for you if you’re using any of these treatments.

Who can’t use combined birth control pills?

Answer:

As we’ve mentioned, combined birth control pills aren’t suitable for all women to use. That’s why it’s important to share any health problems with our clinician. You should not use combined birth control pills if you:

have uncontrolled high blood pressure

are in the first month of breastfeeding your baby

currently have, or have a history of, deep vein thrombosis or pulmonary embolism

have a history of stroke or heart disease

are older than 35 years of age

smoke

get migraines with aura (you might see flashing lights just before the migraine begins)

have liver complications

have unexplained vaginal bleeding

What is a generic birth control pill?

Answer:

A lot of the birth control pills you know will probably be branded versions. You’ll know them by name, they’re popular choices and you know what’s in them and what to expect.

But there are also “generic” versions of those pills.

Generic versions have the same ingredients and are tested in the same way as their branded counterparts. So while their name may be different, these options are completely safe for you to use.

The main difference is the company that makes them. For instance, there may be several names for a specific formulation of a pill, in a specific dose, because multiple companies make that pill.

For example, Lutera contains 0.1mg levonorgestrel and 0.02mg ethinyl estradiol. Alesse, Delyla and a number of other pills contain exactly the same hormones in the same amounts, but may look slightly different and come in different packaging. But there shouldn’t be any real difference in how they work. In some cases one version of a pill may be cheaper than the other, because different companies make and market them.

How much do combined pills cost?

Answer:

There isn’t a single price for combined birth control pills. Because they’re made by different pharma companies, the price of the pill can vary. But at Treated, we have a number of options at different prices, so you can find a pill that suits you and fits within your budget.

Why should I buy combined pills with Treated?

Answer:

We like to keep “the pill” simple. Consult with our clinicians about your health, and they’ll advise you on suitable (and safe) combined pill options.

Once you’ve chosen your pill, and let us know how often you’d like us to deliver it to you (and in what quantity), we’ll ship your medication to you.

We’ll reach out to you regularly to find out how you’re getting on with your pill. So if you have any questions about your treatment, or if you’d like to make any changes (or both), our medical experts will be on hand to help you.

Change, pause or cancel your plan whenever you like.

This page was medically reviewed by Ms Laurenmarie Cormier, Nurse Practitioner on August 02, 2022. Next review due on August 01, 2024.

Search treatments Clear

Combined Pills: Here's what we've got.

Apri

Desogestrel, ethinyl estradiol

Pill with a "regular" estrogen dose. Very similar to Isibloom and Viorele.

Starting from CAD93.00

Start now

Aviane

Levonorgestrel, ethinyl estradiol

The same active ingredients as Lutera. A birth control pill you take every day.

Starting from CAD93.00

Start now

Yasmin

Drospirenone and Ethinyl Estradiol

Well known pill that reduces PMS symptoms and can help to make your periods more regular.

Starting from CAD108.00

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Yaz

Drospirenone and Ethinyl Estradiol

Like Yasmin but in a lower dose. 28 day pill you take without a break.

Starting from CAD127.00

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Loestrin

Norethindrone Acetate and Ethinyl Estradiol

The combined pill with a low amount of estrogen. You can choose to take it with or without a pill-free break.

Starting from CAD180.00

Start now

Portia

Levonorgestrel and Ethinyl Estradiol

Safest category pill that reduces heavy bleeding. Same hormone mix as Aviane and Lutera but a higher dose.

Starting from CAD92.00

Start now

Seasonique

Levonorgestrel and Ethinyl Estradiol

Extended cycle pill that comes in a larger pack.

Starting from CAD263.00

Start now

Mr Paul Zemlak

Pharmacy Registrar and Clinical Prescriber

Registered with ACP (No. 2382)

Meet Paul

Dr Daniel Atkinson

GP Clinical lead

Registered with GMC (No. 4624794)

Meet Daniel

Ms Laurenmarie Cormier

Nurse Practitioner

Registered with NPI (No. 1700446366)

Meet Laurenmarie

Some treatments can cause side effects

Always read the leaflet that comes with your medication and tell us about any side effects you get.

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Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Combined pill

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