How to know which contraceptive pill is right for you as NHS scraps GP prescription rule

The contraceptive pill will soon be available without GP prescription. (Getty Images)
The contraceptive pill will soon be available without GP prescription. (Getty Images)

The NHS is set to scrap its rule on contraceptive pill prescriptions and instead make the medicine available over the counter.

From December, women in England will be able to obtain the contraceptive pill from their local pharmacy, with no prior health checks needed for women on the mini (progestogen only) pill. However, pharmacists will need to check the blood pressure and weight of women who opt for the oestrogen and progestogen pill.

Pharmacies will need to sign up for the service, but the NHS estimates that nearly half a million women will be able to access the pill without GP approval by 2024, in a move designed to free up GPs.

"[It] will free up GP appointments and make better use of the skills and expertise within community pharmacies," health secretary, Victoria Atkins, said in a statement.

NHS chief executive Amanda Pritchard added that the move means women can "simply pop into their local pharmacy when they need or want to access contraception".

Yet, with the move to pharmacy-only access for contraceptive pills, how do you know what pill is the right one for you and whether you should be taking it in the first place?

How to know which method of contraception is right for you

According to the NHS, there are 15 different forms of contraception, including two permanent contraception options (sterilisation) for men and women.

Contraception techniques against a pink background.
There are 15 different kind of contraceptive methods in the UK. (Getty Images)

The vast majority of these are geared towards women and include the contraceptive implant, injection, patch, intrauterine device or coil (IUD), caps and the contraceptive pill.

The health service says deciding which method works best for you depends on your age, whether you are a smoker, your medical and family history, and what medicines you are taking.

The pill is the most popular form of contraceptive in the UK, closely followed by condoms, but how do you know if the pill is right for you?

"If the pill is right for you, you should feel well on it, with a regular withdrawal bleed, no unscheduled bleeding, and no troublesome side effects," Dr Deborah Lee of Dr Fox Online Pharmacy, says.

"You should also not be having trouble remembering to take it, and have no missed pills. It can be hard to remember to do this every day. But if you are regularly forgetting, a long-acting contraceptive method (LARC) – which includes the injectable, implant and IUD/IUS – would have advantages. These methods have a failure rate of less than 1%, can be left in place for 3 -5 years and don’t require any input on the part of the user."

The different types of contraceptive pills

With more than 40 pill brands to choose from, it can feel overwhelming to know which type of contraceptive pill you should be taking.

The first thing to know is that there are two main types of pills that you can take in the UK: the combined oral contraceptive pill (COC) and the progestogen-only pill (mini pill).

Close up of woman holding contraceptive pill and glass of water at home
There are two main types of contraceptive pills you can take. (Getty Images)

Combined oral contraceptive pill

The NHS says, when taken correctly, this pill is 99% effective, but that this pill is not suitable if you are over 35, a smoker, take certain medicines, or are overweight. Speaking to a chemist or healthcare professional will allow you to understand which pill is right for you.

"The COC works because when you take a small dose of synthetic oestrogen every day, this suppresses the normal hormonal changes in the monthly cycle that would normally lead to ovulation. The main contraceptive effect of COC is by preventing ovulation," Dr Fox explains.

"As a consequence, there is very little thickening of the endometrium (womb lining), and hence in the seven-day break, the withdrawal bleed is much lighter, and periods are much less painful than in a normal cycle. Taking the pill often improves painful, heavy periods."

If you do decided to take the COC, there are several brands available, each with differing doses of oestrogen, so you can play around with it until you find the right dosage for you. Talk to your doctor or pharmacist who can help you make the right decision.

Progestogen-only pill

The mini pill is also 99% effective when taken correctly, and the NHS says the way it works is that it prevents pregnancy by thickening the mucus in the cervix to create a barrier and stop the sperm from reaching the egg.

If you are otherwise healthy you can take the mini pill until you reach menopause. Some reasons why the NHS advises against taking this pill is if you have heart disease, liver disease, breast cancer, or liver tumours.

As with any medication, speak to a medical professional such as a pharmacist before deciding if this is the correct pill for you.

Young woman is patient in hospital clinic discussing healthcare options with doctor
Speak to your pharmacist before deciding which pill to take. (Getty Images)

Side effects of the pill

Dr Fox says side effects for women on the pill are common, and these can improve in time. They include:

  • Nausea

  • Headaches

  • Mood swings

  • Weight gain

  • Irregular bleeding

"Bleeding can be a problem due to the progesterone in the pill and if it doesn't settle, the pill needs changing," Dr Fox advises.

"The pill does not give protection from STIs. Always use a condom carefully if you have sex with a new partner. Many women use COC plus a condom regularly to keep themselves safe."

Reproductive health: Read more

Watch: Women to get contraceptive pill from chemists in England