What happens when you use contraceptive pills for the first time?
Reviewed by Dr Bhavini Shah
Contraceptive pills are one of the most common forms of contraception in the UK. There are three different kinds; combined, low-dose combined and the mini pill (progestogen-only pill) which all work to stop you getting pregnant.
If you’ve not used the pill before you may have a lot of questions. In this article explain what happens when you take the pill for the first-time including side effects. And helpful tips like how to remember to take your pill.
Pregnancy protection may not be immediate
You can take the contraceptive pill at any point during your menstrual cycle, as long as you’re not already pregnant. When you take the pill can affect how soon they stop you getting pregnant.
If you take:
- The combined pill or the progesterone-only pill on the first day of your period you’ll be protected immediately
- The combined pill up to and on the fifth day of your period you’ll be protected straight away
- The combined pill at any other time during your menstrual cycle you won’t be protected. You’ll need to use condoms for 7 days.
- The progesterone-only pill more than 5 days after your period has started you won’t be protected straight away. You need to use extra contraception, like condoms, for 2 days.
Find out more about taking the combined pill.
Contraceptive pills do have side effects
It’s possible to experience side effects from contraceptive pills. Not all women experience these side effects – and those who do usually find that symptoms improve within a few months. Side effects occur due to fluctuating hormones as your body adapts to the pill.
The most common side effect is a change to your periods:
- Your periods might be more irregular
- Your periods might be lighter or heavier and/or shorter or longer
- You might experience spotting between periods
- Your periods might stop altogether
Other side effects include:
- Mood changes e.g. feeling depressed
- Decreased sex drive
- Headaches
- Nausea
- Acne
- Breast pain
- Weight gain
"Side effects are commonly experienced when starting a new pill and tend to improve over time. If you’re worried about your side effects, their severity, or if they last longer than three months or more, contact your GP and they should be able to help.” - Dr Bhavini Shah
Intermittent spotting is normal
Spotting, also known as breakthrough bleeding, is any bleeding outside of your withdrawal bleed. When taking the pill for the first time or taking a pill you’ve not used before many people experience spotting.
It’s common in the first few months and should stop once your body has got used to the pill. In studies up to 70% of people taking the progestogen-only pill reported spotting in one or more menstrual cycle.
“If you’re worried about the amount of spotting you experience or how often it’s happening speak to your GP. If you have been prescribed a contraceptive pill by us, you can message our team in your Patient Record.”
Positive health benefits
Many women experience positive side effects when they start to take the pill. These depend on the type of pill you’re taking.
Benefits of the pill may include:
- More regular periods
Contraceptive pills can help you to regulate your periods. When you’re taking the pill, you’ll experience withdrawal bleeding. This is different to a period.
- Less heavy periods
Spotting or breakthrough bleeding is common in the first few months. However, depending on the type of pill you take, many women find their periods are lighter and shorter when using the pill. Some don’t have periods at all.
- Milder cramps
“It is normal for you to experience some cramping when starting a new pill, however the pill should help reduce monthly cramping during menstruation. If you feel that the cramps are becoming severe or experience other symptoms, such as dizziness, nausea or fever, you should stop taking the pill and consult a medical professional immediately.”
- Regulated mood
“While hormonal birth controls can have an impact on mood, researchers don’t have enough evidence to suggest that they can cause anxiety or depression. Current research may indicate that the pill may have more of an impact on women who already suffer from mood disorders, but more studies are needed.”
- Reduced acne
“If you have acne, the combined pill may be able to help you. Many people who get spots suffer from hormonal acne - where changing hormones produces a build-up of sebum, blocking hair follicles and creating a spot.”
If you’re worried about your side effects, their severity, or if they last longer than three or four months, contact your GP and they should be able to help.
Daily reminders will help the pill’s effectiveness
If you’ve not taken the pill before you’ll want to make sure you take it at a time that works for you. For example, when you first wake up or before you go to bed.
- The combined pill doesn’t need to be taken at the same time every day to be effective
- The progestogen-only pill needs to be taken within the same 3-hour or 12-hour window each day, depending on the type of pill
“If taken correctly, contraceptives pills are 99% effective at preventing pregnancy. When taken imperfectly they’re 91% effective, so make sure to follow the instructions of your pill.”
Daily reminders can help you to remember to take the pill. Find out more about what you should do if you miss a pill.
Is one contraceptive pill better than others for first time users?
There are different types of contraceptive pill including the combined pill, low-dose and progesterone-only. One type may be more suitable for you than other. Compare each pill below:
Combined pill
| Hormones in the pill | Oestrogen Progesterone |
| Not suitable for | Women over 35 who smoke Those who experience migraines If you have a family history of breast cancer |
| Advantages | Up to 99% effective |
| Disadvantages | Mild headaches and nausea |
| Available pills |
Progesterone only pill (mini pill)
| Hormones in the pill | Progestogen |
| Best suited for | Women who cannot medically take the combined pill Breastfeeding women Women over 40-years-old Those who have high blood pressure Women who are overweight Women who have severe migraines Women over 35-years-old and smoke |
| Advantages | Up to 99% effective |
| Disadvantages | Has to be taken every day with no seven-day break |
| Available pills |
Low dose pill
| Hormones in the pill | Less oestrogen than in regular combined pill |
| Best suited for | May be an option for older women who do not want the mini pill |
| Advantages | Less likely to cause health issues |
| Disadvantages | Breakthrough bleeding |
| Available pills |
Conclusion
The right contraceptive pill for you will depend on a number of factors. If you’re thinking of taking the pill for the first time speak to your GP, a doctor or nurse at your local sexual health clinic. You can also get contraception from online services like ours.
References
https://pubmed.ncbi.nlm.nih.gov/8982741/
https://www.nhsinform.scot/healthy-living/contraception/combined-pill/
https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill
https://pubmed.ncbi.nlm.nih.gov/39826/
