Spoilt for choice? A quick guide to which combined pill is right for you

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#1

Most people know that there are two different types of contraceptive pill

the combined pill

  • containing 2 hormones (oestragen and progestagen) and typically provided in packs of 21 tablets.

the progestagen only pill

  • containing 1 and typically provided in packs of 28 tablets.

What many people don’t usually know is that there are a lot of different types and brands of combined pill.

Each contain similar, but slightly different types of hormones - it is usually the progestagen that is different.

It is important to say that many people get no side effects on the pill or they get positive effects like a reduction in period pain or an improvement in acne. But if you are experiencing problems the information below may help you to decide what to try next.

Here’s a quick guide that might help you find the right type for you

WHERE TO START?

Most people start with a pill that has ‘30 micrograms of ethinyloestradial and 150 micrograms of leveonorgestrel’ hormone.
Example brands include Microgynon, Ovranette, Levest, Rigevidon.
We usually recommend starting with one of these as they have the lowest risk of thrombosis and they are good at controlling your cycle.

But if you get symptoms such as low mood, loss of libido, oily skin/hair then you may wish to try a different type of progestagen:

WHAT TO TRY NEXT?

In this case, you might consider a pill with ‘ethinyl oestradiol’ and a progestagen called ‘norgestimate or desogestrel’.
Example brands include Cilest, Lizinna, Marvalon, Gedarel 30.
These pills can be associated with slightly different side effects (nausea, breast tenderness).
They also tend to be good for your skin and can help if you have acne.

ARE THERE OTHER OPTIONS?

If you are still experiencing troublesome side effects then there are other options.
It might be worth going to a specialist contraception clinic to discuss your options. Keeping a diary of the side effects that you experience can be helpful when choosing a pill otherwise its quite hard to remember how you felt on a particular pill a couple of months ago.


This information can be difficult to communicate - please reply to this thread if I can help explain anything further.

P.S
I’d like to be able to recommend a good way of keeping track of side effects - does anyone know a good contraceptive side effect tracker app?

Thanks!
Paula


Are the horror stories true?
#2

I was switched from Gederal 30 to Gederal 20 about 7 years ago, but I can’t remember/ didn’t really understand why. What is the difference between these pills?


#3

Hi @Ellie
Thanks for your question. The difference between the two is the difference in the amount of Gedarel 30 has 30 micrograms of synthetic oestrogen ( this is the standard does that most pills have) and Gedarel 20 has 20 micrograms of synthetic oestrogen.

Why would you go with a pill with a lower amount of oestrogen? Well you may make this change if you experience oestrogen related side effects such as breast tenderness or nausea. The down side of pills that have 20 micrograms of synthetic oestrogen is that some people experience spot bleeding between periods when on these pills.

Can you remember whether you felt different on Gedarel 30 and Gedarel 20?

Thanks

Paula


#4

That’s interesting. I had a vague memory of it being about mood, does the amount of oestrogen affect that? Nausea and the breast tenderness aren’t things I’ve ever experienced on the pill. I think I felt better after the switch, I felt like I was less emotional. However it was a long time ago and now I don’t know if it was more to do with what else was happening in my life at the time.

Will there be any difference in how effective they are (20 vs 30)?


Copper or Jaydess coil
#5

Hi @Ellie
There should be no difference in the effectiveness of the two pills. I agree, its complicated to work out what symptoms are due to the pill and what are due to other things going on in your life. It sounds like this pill suits you and that you are fairly happy with it.
Paula


#6

Hi, I want to stay protected, continue to have regular periods but have my sex life back., since being in the pill I don’t orgasm the way I used to.

My natural periods are very regular so really want to come off. But my boyfriend and I hate condoms. I tried the desogestrel pill but that made my periods come too far apart and I spent a lot of time thinking I was about to have a period.

Any suggestions? I prefer pills, but would consider other suggestions that would keep my period regular and not make me gain weight or have mood swings. I am in my early thirties.


#7

Hi @Random.
Good question. The only contraceptive methods that are likely to give you a regular bleed are the combined hormonal methods - the combined pill, the patch, the ring. All of these have two hormones - synthetic oestrogen and synthetic progestagen.

Its not really a period that you get on these methods but whats called a withdrawal bleed. When you stop the hormones in the pill/patch/ring free week then you lose the lining of the womb as the hormone level drops. So if you take them for 3 weeks you get a bleed after 3 weeks, if you take them for 4 weeks you get a bleed after 4 weeks etc.

If you are looking to stay on the pill but want something that does not affect the way you have sex then you could try pills in the order that we suggested in this post Spoilt for choice? A quick guide to which combined pill is right for you . We have tried to group the pills into different types so that you can switch in a logical way. I think you suggested Flo as a way to monitor the side effects on each one.

If you are looking for something different but that still controls your periods you could consider the patch - see here for more information https://www.sh24.org.uk/contraception/patch

Or the vaginal ring - see here for more information https://www.sh24.org.uk/contraception/ring

If you would like to come off hormones the a copper coil will not interfere with your cycle - yours is regular so this might work. Your periods can be a bit longer and heavier on the copper coil.

What are your thoughts on these?

Paula