The COC usually comes in a calendar pack containing 21 tablets. One tablet is taken each day for 21 days, followed by a 7-day tablet-free interval during which bleeding occurs. You also have contraceptive protection during the tablet-free interval.

It is also possible to take hormone-free tablets (so-called placebos) for 7 days instead of the tablet-free interval. This means that the usual routine of 'one tablet daily' is not interrupted.

You should always take the pill at the same time of day (e.g. every morning or every evening).

Different types of combined pill

Since the introduction of the combined pill in 1961 the hormone doses, particularly the estrogen dose, have been substantially reduced. Preparations containing less than 0.050 mg estrogen are called low-dose pills.

There are different ways in which the estrogen and progestin can be combined.

In fixed-dose (monophasic) preparations each active tablet contains both an estrogen and a progestin in a fixed ratio. This is the most common way of combining the hormones.

In phasic pills the hormone doses are varied to mimic the hormonal situation in the (natural) menstrual cycle. In a woman not taking an oral contraceptive estrogen is the predominant hormone in the first half of the cycle. In the second half of the cycle chiefly progesterone is produced. In phasic OCs the estrogen and progestin doses match this cyclic pattern. This type of hormone combination can be beneficial for some women.

With such a wide variety of preparations available (different dosages, different hormones, different tablet-taking regimens) every woman can find the pill that is right for her. If one type of pill does not suit you you can switch to another. Speak to your doctor.

When should I take the first pill?

You should take the first pill on the first day of your period. The contraceptive action begins immediately. You do not need to take any additional precautions.

If you have previously been using a different type of hormonal contraceptive (e.g. a progestin-only pill or an injectable contraceptive) you should inform your doctor as there are certain rules to be observed when switching from one hormonal method to another.

After giving birth

You should usually wait till you have your first normal menstrual period before your start taking the combined oral contraceptive again. Your doctor will tell you when it is suitable to start taking the pill again.

There are special recommendations for breast-feeding mothers.

However, the combined oral contraceptive (estrogen-progestin pill) is not recommended for women who are breast feeding as estrogens can suppress milk production. If you want to use a hormonal method of contraception the minipill (progestin-only pill, POP) is more suitable.

If you have had a miscarriage or an abortion your doctor will advise you when you can start using oral contraception.