Choosing the best contraceptive pill for you

Finding the best birth control pill

Whether you are a first-time contraception user, feeling fed up with spotty skin, or you just don’t want the cramps every month – it’s always good to have an idea of what contraception may work best for you. Some hormonal contraceptives will help these symptoms, but in some cases they may be associated with side effects such as mood swings, acne and weight gain.

If you want to weigh up your options and find the best birth control for you, then look no further than this guide comparing the benefits and side effects of the two types of contraceptive pills: the combined pill and the progestogen-only pill (aka mini-pill).

The main difference between the two is that the combined pill contains two hormones, oestrogen and progestogen, whereas the progestogen-only pill just contains progestogen.

What is the best contraceptive pill for preventing pregnancy?

When we look at how effective a contraceptive pill is we refer to ‘typical’ and ‘perfect’ use. This can be confusing at first, so we’ve come up with an easy to understand in our clinical effectiveness guide. The effectiveness of both types of contraceptive pills is similar. If you look at 100 sexually active pill users who take it for a year, with perfect use less than 1 will get pregnant. But if we look at typical use, around 7 or 8 will get pregnant during that year. 

It is important to consider how well you will remember to take a pill every day when choosing which contraceptive is best for you (but there are apps available to help you remember to take your pill!). We recommend taking your pill when you do something routinely every day, like brushing your teeth, to help build up the habit.

Best contraceptive pill for acne?

Acne is a common problem in many teenagers as during puberty changes in your hormones can result in changes to your skin, like excess oil. However, acne doesn’t just occur during puberty and can be common in your 20s and 30s.

The combined contraceptive pill can improve acne for many individuals as it helps control some of the hormonal changes which can lead to increased grease production in the skin. The best combined pills for acne are ones that help reduce androgen hormones. These include a progestogen called drospirenone, which can be found in Yasmin, Lucette and Eloine. These pills are all available to buy directly from The Lowdown. For more detailed information on managing skin conditions with the pill, check out our detailed guide on the best contraceptive pill for acne.

One of the side effects of the progestogen-only pill is that it may cause or worsen acne (although there’s not much evidence confirming this). However, most people won’t notice a change in their skin with this method. Check out our contraception reviews to see what our community have to say about the mini pill and acne!

Best contraceptive for mood swings?

If you’re in hormonal hell, we’ve got you – check out our guide on how contraception can affect mood for the detailed version, or keep reading for an overview. For some people, their natural hormone cycle causes mood swings which can have an impact on their quality of life. For others, they feel the hormones in contraceptives can lead to changes in their mood and mental wellbeing.

Some people suffer from mood swings and emotional changes linked to the menstrual cycle, aka premenstrual syndrome (PMS). In extreme cases, this is known as premenstrual dysphoric disorder (PMDD) where individuals may experience mood swings, depression, anxiety, extreme anger and even suicidal thoughts. In both of these situations, the combined pill can help reduce the symptoms, especially when used continuously to reduce hormonal fluctuations.

What pill is best if I am overweight?

Being overweight does not necessarily mean you are not healthy. Unfortunately, in the world of contraception there are strict guidelines about using certain pills when you have a BMI over a certain level. 

For those with a BMI of 35 and over, it is advised that progestogen-only pills are safer to use than combined pills. This is because having a higher BMI and using the combined contraceptive pill carries an increased risk of strokes, blood clots and heart attacks. Therefore other progestogen-only or non-hormonal contraceptive options will be considered safer for you. 

Progestogen-only pill brands include: Lovima, Aizea, Cerazette, Cerelle, Desogestrel, Desomono, Feanolla, Hana, Micronor, Norgeston, Noriday and Zelleta.

What pill is best for heavy periods?

Both the progestogen-only pill and combined pill can help with heavy periods. It can take up to three months to notice these benefits, and the pill may cause irregular bleeding or spotting during this time.  

At the time of reviewing, 43% of Lowdown users said the progestogen-only pill stopped their periods and 48% of combined pill users found it made them lighter. So dependent on whether you want your periods to stop altogether or just be made lighter you can choose which suits you best. Remember that you can use the combined pill continuously which can also mean you avoid having a monthly bleed.

What pill is the best for period pain?

Period pain can have a significant effect on on your life and may mean you miss out on work, education or your social life. In some cases there might be reasons for period related pain like endometriosis or adenomyosis. The combined pill can help to reduce pain associated with periods especially when it is used continuously or with less breaks for bleeding.

Which contraceptive pill is best for migraines?

If you suffer from migraines with aura, you should avoid the combined pill. Instead, it would be best to consider a progestogen-only  – such as the Lovima pill – or non hormonal contraceptive method.

‘Aura’ is a term used to describe any sort of neurological disturbance, which can appear before the headache or other symptoms of a migraine. A visual aura is a visual change like flashing lights which happens with or before the migraine.

Taking the combined pill increases your risk of having a stroke if you suffer from migraines with aura so is not advised. If you have migraines but no aura, you can still use the combined pill with caution if you don’t want to use other methods or they’re not suited to you. For more information and advice, check our our full guide to headaches, migraines and contraception

What birth control pill can I take at my age?

If you’re under 50, do not have any health conditions, and do not have other risk factors such as smoking, diabetes or being overweight, you can safely take both types of birth control pill. However, if you are over 50 the risks associated with the combined pill tend to outweigh the benefits, and you will be advised to switch to an alternative like the progestogen-only pill. Check out our guide to contraception in your 40s and 50s for more advice on which contraceptive may be best suited to you.

What pill can I take if I’ve just given birth?

You can get pregnant as early as 3 weeks after giving birth, even if you are breastfeeding and have not restarted your periods. Experts recommend a 12 month gap between having a baby and conceiving again, as this helps reduce complications such as future premature delivery or low birth weight.

You can safely use the progestogen-only pill straight away after delivery. It should ideally be started less than 3 weeks after birth, before you can become pregnant again. If the combined pill is your contraception of choice then it can safely be started from 6 weeks after delivery. Check out our full guide to postpartum contraception options, written by our Medical Director Dr Fran (as she was going into labour!).

What pill can I take if I’m breastfeeding?

If you’re breastfeeding, you can take the progestogen-only pill straight away and can use the combined pill from when your baby is 6 weeks old. 

What contraceptive pills will affect my sex drive?

Sex drive is a difficult thing to measure, therefore it may require a bit of trial and error to find the right contraceptive pill for you. Some birth control pills might lower your sex drive while others can improve it, but this can vary from person to person and may not depend on the pill. Progestogen-only methods seem to have a higher impact on reducing sex drive, but it is an area which needs more research and a better understanding. We do a deep dive on this subject in our blog.

Many things in life can affect our sex drive, not just contraception, and our resident sex coach Lucy has created a guide of practical tips and solutions when you’ve lost your libido. You can also book an appointment with Lucy, a certified sex coach, for further advice.

When it comes to the contraception, at the time of reviewing a reduction in sex drive seems to be highest among users of progestogen-only hormonal contraception – with 51% of progestogen pill users, 51% of implant and 56% of injection reviewers reporting a loss of sex drive.

Contraceptive pill risks and side effects

Every contraceptive pill may have side effects that will vary from person to person. Some side effects take a couple of weeks to subside, and most resolve by 3 months as your body adapts to the pill. 

If you are a first time pill user, you may want to try combined pills Microgynon, Rigevidon, Ovranette or Levest as they have a lower risk of blood clots than other combined pills, and are usually what a healthcare professional will prescribe first time. You can buy Microgynon and all other pill types here at The Lowdown if you already know which one you want to try!

Here’s a quick overview of some side effects from each pill type reported by our community (at the time of reviewing):

So which birth control pill will suit me best?

There’s no perfect contraceptive pill unfortunately, and experiences differ from person to person. If you still haven’t decided on a pill, check out our contraception advice page and our contraception recommender tool to see which method might suit you the best, to minimise going through trial and error.