# The combined pill

> The classic – how it works, ways to take it and what to expect.

Category: Contraception · 5 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/contraception/combined-pill

## Quick answer

- Contains oestrogen and progestogen; stops ovulation.
- You can take it with breaks, without breaks or tailored.
- Side effects often settle within 3 months.
- Know the warning signs of a blood clot.

The combined pill contains two [hormones](https://splash.care/learn/cycle-basics/hormones-explained), [Oestrogen](https://splash.care/learn/glossary/oestrogen) and [Progestogen](https://splash.care/learn/glossary/progestogen), and works by stopping your ovaries releasing an egg each month. It’s over 99% effective with [perfect use](https://splash.care/learn/glossary/perfect-use) and 91% with [typical use](https://splash.care/learn/glossary/typical-use).

## Ways to take it

- 21-day pill: 21 active pills, then a 7-day break
- Everyday (ED) pill: active pills plus dummy pills, so you never stop
- Tailored regime: shorter, fewer or no breaks – ask a pharmacist or [doctor](https://splash.care/learn/conditions/talk-to-your-doctor)

The bleed during the break is a [Withdrawal bleed](https://splash.care/learn/glossary/withdrawal-bleed), not a real period – so skipping it with a [Tailored regime](https://splash.care/learn/glossary/tailored-regime) isn’t harmful and can reduce [headaches](https://splash.care/learn/period-care/migraines) and bleeding-related symptoms.

## Possible perks

- Can help [acne](https://splash.care/learn/body-literacy/acne-skin)
- Can help heavy or painful periods and [PMS](https://splash.care/learn/glossary/pms)
- Can help [endometriosis](https://splash.care/learn/glossary/endometriosis) symptoms
- Lowers the risk of womb, ovarian and bowel cancer

## Possible downsides

- Breakthrough bleeding in the first few months is common
- Some people get headaches, [mood changes](https://splash.care/learn/mind-mood/why-mood-shifts), nausea or sore breasts
- Can raise blood pressure in a small number of people
- Very small risk of blood clots – up to 1 in 1,000 users
- Slightly raised breast and cervical cancer risk, back to normal 10 years after stopping

**Myth:** The pill makes you gain weight.

**Fact:** The NHS says there’s no evidence the combined pill causes weight gain or changes your sex drive.

> **Splash says:** give a new pill 3 months to settle. Still not happy after that? A different brand might suit you better.

### When to see a doctor

Get urgent help if you’re on the pill and have: pain or swelling in one leg, chest pain or breathlessness, coughing up blood, a sudden severe headache, or weakness or numbness on one side of your body. These can be signs of a blood clot. Call 999 for chest pain or stroke signs.

> Only condoms (external and internal) help protect against STIs. Every other method on this page prevents pregnancy only.

## Sources

1. [NHS – What is the combined pill?](https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/what-is-it/)
2. [NHS – How to take the combined pill](https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/how-to-take-it/)
3. [NHS – Side effects and risks of the combined pill](https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/)
4. [NHS – How well contraception works at preventing pregnancy](https://www.nhs.uk/contraception/choosing-contraception/how-well-it-works-at-preventing-pregnancy/)

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).