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Combined hormonal contraceptive (estrogen + progestogen)

Combined Oral Contraceptive: uses, side effects & precautions

Also known as The Pill, COC, Microgynon, Yasmin, Yaz, Loestrin, Marvelon, ethinylestradiol/levonorgestrel.

Deze informatie is uitsluitend bedoeld als algemene richtlijn en vormt geen medisch advies. Raadpleeg altijd een gekwalificeerde zorgprofessional voor persoonlijke medische vragen. Bel in geval van nood uw lokale alarmnummer.

What it is used for

  • Preventing pregnancy
  • Regulating or lightening periods
  • Period pain (dysmenorrhoea)
  • Acne
  • Premenstrual symptoms
  • Symptoms of endometriosis or polycystic ovary syndrome (when prescribed)

How it works

It combines two hormones, an estrogen and a progestogen, which mainly stop the ovaries from releasing an egg each month. It also thickens cervical mucus and thins the womb lining, making it harder for sperm to reach an egg or for a pregnancy to implant.

How it is taken

Usually taken as a daily tablet in a cycle, with some packs including hormone-free or placebo days. Combined hormones also come as a weekly skin patch or a monthly vaginal ring. Take it exactly as your doctor, pharmacist, or the package label directs, at a regular time, and ask what to do if you miss a dose or vomit shortly after taking it.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Nausea
  • Breast tenderness
  • Headache
  • Mood changes
  • Spotting or breakthrough bleeding between periods
  • Bloating
  • Changes in libido

Serious effects — get help

  • Signs of a blood clot in the leg (painful, swollen, warm calf)
  • Signs of a clot in the lung (sudden breathlessness, sharp chest pain, coughing blood)
  • Signs of stroke (face drooping, arm weakness, slurred speech)
  • Severe chest pain or heart attack symptoms
  • Sudden severe headache or migraine with vision changes
  • Yellowing of the skin or eyes

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Some epilepsy and seizure medicines
  • Certain HIV medicines
  • Some antibiotics used for tuberculosis (rifampicin-type)
  • The herbal product St John's Wort
  • Some medicines for hepatitis C
  • Medicines that affect liver enzymes can reduce contraceptive reliability

Who should take care

  • Tell your clinician if you smoke, are over 35, or are very overweight, as this raises clot risk
  • Not suitable for some people with a history of blood clots, certain migraines, some cancers, or uncontrolled high blood pressure
  • Discuss any liver disease
  • Generally not used while breastfeeding in the early weeks
  • Tell every clinician you take it before any surgery or long-distance travel
  • Seek advice on alternatives if pregnancy is planned or suspected

Frequently asked questions

Does it protect against sexually transmitted infections?
No. It only prevents pregnancy. Use condoms as well to reduce the risk of STIs.
What should I do if I miss a pill?
Follow the missed-pill instructions on your packet leaflet or ask your pharmacist, as the advice depends on how many pills were missed and where you are in the pack. Extra precautions or emergency contraception may be needed.
Will it make me gain weight?
For most people it does not cause meaningful weight gain. If you notice changes that concern you, discuss them with your clinician.
Can I use it to skip a period?
Some people skip the hormone-free days to delay a period, but you should only do this on the advice of your doctor or pharmacist, as it depends on the specific pill.
Is Combined Oral Contraceptive safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

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