The contraceptive pill minefield: combined or progesterone only


Elisha Mans, First Year Politics

The contraceptive pill sounds simple enough; you take a pill that prevents unwanted pregnancy. Here is the reality.

When I first went to the doctors about a year ago to ask to be prescribed it, I thought it’d be nice and easy and ta-dah I’d walk out with the pill. As it turns out, in reality its far more complicated for many women. If you do not fit into the typical contraceptive pill route, then it can feel like you are in a stressful minefield of simultaneously too much information or no information at all.

First, I didn’t even know that there were two types of pill: the combined pill (containing both oestrogen and progesterone hormones) and the POP (containing progesterone hormone only). Secondly, I had no idea of the range of brands that make pills with varying levels of hormones and with varying scary-sounding side-effects. That said, one year on and having tried three different brands to date, I am now certainly more well-informed.

My pill journey started on a pretty regular path of Microgynon 30, which is, to date, the most commonly prescribed pill in Britain. It is a combined pill which you take every day for 21 days and then take a 7-day break in which you bleed – fairly standard. In my experience of talking to other women, given that this is the pill format that most women take, everybody kind of understands this system. Not only that, but there is a plethora of information online which gives insight into the combined pill.


It is from there that things started to get complicated.

Whilst I had never experienced any negative side-effects from Microgynon 30, it was then discovered by my doctor that I had experienced migraines with visual disturbances when I was younger and as such could not take pills with oestrogen in as it would put me at risk of a stroke.

So, here comes pill number two. Cerelle (or, as me and my boyfriend affectionately named it, ‘Cer-hell’) as it came with a whole range of problems for me. Of course, one of the things which makes the contraceptive pill so tricky is that every woman is different so there isn’t really a guidebook of what works and what doesn’t for every individual. That said, after having been prescribed Cerelle, I googled it and the only non NHS information I could find about it was a scathing Netmums thread on its horrific side-effects. I wasn’t hugely excited to try it.

One of the things which makes the contraceptive pill so tricky is that every woman is different so there isn't really a guidebook of what works and what doesn't for every individual.

For the first three months of Cerelle I was fine. As it is a progesterone-only pill (POP), it is to be taken every day with no breaks, potentially making bleeding more or less regular, random or stop completely (it’s a bit like a horrific lottery). Yet, ignoring some slightly random bleeding patterns, it was looking to be fine.

Then came the mental symptoms. Unfortunately, my time on Cerelle coincided with my moving to University which undoubtedly didn’t help my mental health as it is always going to be tough moving to a new place. That said, I started to feel so out-of-character in a way that I knew couldn’t just be caused by homesickness. Usually ever the optimist, I couldn’t seem to find much good in anything and would cry and feel frustrated to the point that I wanted to scream for seemingly no reason at all. I was losing myself. Finally, it got to the point where I couldn’t handle Cerelle with its irregular bleeding and unhealthy mindset and so, having endured it for nine months, I went back to the doctors and asked for something new.

In being unable to take the combined pill due to migraines and in being unable to handle the balance of hormones in Cerelle, my options were already limited. So, I was presented with two options: Noriday (POP) or the coil. I cannot actually speak for the coil as, frankly, I was too scared to consider a surgical contraceptive, so I apprehensively opted for yet another pill. As had become habit from the previous two pills, I googled what other women had to say about Noriday and found even less information than I had for Cerelle. I felt like I was about the only woman on the planet who was taking this drug. And, for someone had had a negative experience with a different pill, this was terrifying.

Thankfully, my three months of experience on Noriday has been positive thus-far. Much like Cerelle, the fact that you take it every day with no breaks can lead to a bleeding pattern which can be described as, at best, irregular but, past that, my mental health has settled into its norm. In fact, in coming off Cerelle, I finally understood the cliché of a fog being lifted because I can now look at situations in a rational way that Cerelle, without me realising, had totally prevented.

There is much to be said for the contraceptive pill; of course, the prevention of pregnancy, but also a multitude of other benefits such as sometimes helping acne, irregular bleeding and aiding sexual liberation. That said, I would urge that it is treated warily as it can affect you in ways that you don’t even necessarily realise whilst you are taking it. I hope that there is more discussion around them, particularly with regard to the less-well known POP so that women can really understand what they are taking. We need openness and honesty around the pill.

Featured Image Unsplash / Simone Van Der Koelen

There are a variety of contraceptive pills with a number of different effects, positive or negative. What works the best for you? Comment below or get in touch!

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