Women's health
Choosing the right pill: an evidence-based guide
7 min read · By Aidan, Pharmacist at Blackrock Meds
When it comes to oral contraception, the sheer number of options can feel overwhelming. As a pharmacist, I speak with women every day who are unsure which pill is the right fit for their lifestyle and health profile. The contraceptive pill remains one of the most popular and effective methods of preventing pregnancy in Ireland, but finding the one that suits your body best requires a tailored approach. In this guide, we will explore the differences between the two main types of oral contraceptives, how to choose between them, and what you need to know about accessing them through the Irish healthcare system.
Understanding the two main types of pill
The two primary categories of oral contraceptives are the combined oral contraceptive pill and the progestogen-only pill. The combined pill contains synthetic versions of two hormones naturally produced in the body, oestrogen and progestogen. This combination works primarily by preventing the ovaries from releasing an egg each month, while also thickening the cervical mucus to make it difficult for sperm to reach an egg. The progestogen-only pill, often referred to as the mini-pill, contains only progestogen. It works mainly by thickening the cervical mucus and thinning the lining of the womb, though some newer versions also stop ovulation.
Choosing based on your health profile
Choosing between these two options depends heavily on your individual health profile and medical history. The combined pill is often favoured for its ability to make periods lighter, more regular, and less painful, making it an excellent choice for women who experience heavy menstrual bleeding or conditions like endometriosis. However, the oestrogen component means it is not suitable for everyone. Women who experience migraines with aura, those with a history of blood clots, or individuals who smoke and are over the age of thirty-five are generally advised against taking the combined pill due to an increased risk of cardiovascular complications. For these women, the progestogen-only pill offers a safe and highly effective alternative, as it carries no increased risk of blood clots and can be safely used during breastfeeding.
| Feature | Combined Pill | Progestogen-Only Pill |
|---|---|---|
| Hormones | Oestrogen and Progestogen | Progestogen only |
| Suitability | Ideal for regulating periods and reducing menstrual pain | Suitable for those who cannot take oestrogen, including smokers over 35 |
| Common Irish Brands | Microlite, Yasmin, Ovranette, Marviol | Cerazette, Noriday, Azalia |
| Missed Pill Window | Usually 24 hours | 3 to 12 hours depending on the brand |
| Key Risks | Small increased risk of venous thromboembolism (VTE) | Irregular bleeding patterns |
Managing side effects and risks
When starting any new medication, it is important to be aware of potential side effects. With the combined pill, some women may experience temporary side effects such as breast tenderness, mild nausea, or mood changes during the first few months of use. A more serious, though rare, risk associated with the combined pill is venous thromboembolism, or blood clots. It is crucial to seek immediate medical review if you experience sudden severe chest pain, breathlessness, or painful swelling in your leg. The progestogen-only pill is generally very well tolerated, but the most common side effect is unpredictable or irregular menstrual bleeding, which often settles after a few months of use.
Accessing contraception in Ireland
Accessing contraception in Ireland has become significantly more straightforward and affordable in recent years. Under the Health Service Executive's Free Contraception Scheme, the cost of prescription contraception, including the pill, is fully covered for women aged seventeen to thirty-five. This scheme covers the cost of the doctor's consultation, the prescription itself, and the dispensing fee at your local pharmacy.
Currently, obtaining the contraceptive pill in Ireland requires a prescription from a General Practitioner or a family planning clinic. However, the landscape of pharmacy practice is evolving, and legislation is currently being introduced that will soon allow pharmacists to prescribe continuing contraception. This progressive step will make it even easier for women to maintain their contraceptive routine without needing to schedule a doctor's appointment for repeat prescriptions.
If you are considering starting the pill or feel that your current prescription is no longer suiting you, I highly recommend booking a consultation with your GP to discuss your options. Remember that finding the right pill can sometimes involve a period of trial and error, and your healthcare provider can guide you through this process safely. As always, our team at Blackrock Meds is here to answer any questions you might have about your medication, side effects, or how to take your pill correctly.
Take care and stay healthy, Aidan
