Combined Pills

Some of the most common side effects when you start using the pill include nausea, headaches, tender breasts, changes to your mood, bloating and breakthrough bleeding. ^[1]

A lot of the time, these side effects are pretty mild and will normally go away as you continue using the pill, usually after the first two to three months.

But if you get any side effects that concern you, or don’t go away after a couple of months of use, tell us. Our clinician may suggest moving you on to a different pill.

Serious side effects like allergic reactions or blood clots are rare, but you should go to your nearest hospital right away if you get any signs of these.

Combined pills can interact with other medications, so it’s important for you to let us know if you’re currently taking medication for any health issues.

For the most part, antibiotics are safe to take when you’re on the pill — except for rifampin, which is used to treat tuberculosis. These antibiotics can increase the rate at which your body metabolizes the hormones in the combined pill, so your chances of becoming pregnant increase.

Let us know if you’re currently taking medication to treat HIV, as some of these treatments can impact your pill. Medications like Darunavir, Efavirenz and Nevirapine all interfere with the combined birth control pill, so another birth control option may be better for you.

Anti-fungal medications used to treat skin conditions like jock itch may interfere with your pill, as can anti-seizure drugs. Drugs like carbamazepine, phenobarbital and primidone can affect how the hormones in birth control are broken down. If you’re using these treatments, another birth control option should be used instead of the combined birth control pill.

Modafinil (you may know this under the name Provigil) is used to treat sleep issues like narcolepsy and shift work sleep disorder. It can reduce the effectiveness of your pill, so you shouldn’t use a combined birth control method if you’re taking this medication.

Be mindful of herbal remedies too, because they can have an impact on your pill. St John’s Wort (used to treat mild depression or sleep disorders) can affect how estrogen is broken down, so the pill may not work as well and the chances of breakthrough bleeding increase.

Saw palmetto (used for hair loss), alfalfa (for kidney or bladder problems), garlic pills (taken for heart and blood diseases) and flaxseed (for digestion problems) can all impact the effectiveness of your pill. Combined birth control pills will probably not be a good fit for you if you’re using any of these treatments.

As we’ve mentioned, combined birth control pills aren’t suitable for all women to use. That’s why it’s important to share any health problems with our clinician. You should not use combined birth control pills if you:

• have uncontrolled high blood pressure


• are in the first month of breastfeeding your baby


• currently have, or have a history of, deep vein thrombosis or pulmonary embolism


• have a history of stroke or heart disease


• are older than 35 years of age


• smoke


• get migraines with aura (you might see flashing lights just before the migraine begins)


• have liver complications


• have unexplained vaginal bleeding

A lot of the birth control pills you know will probably be branded versions. You’ll know them by name, they’re popular choices and you know what’s in them and what to expect.

But there are also “generic” versions of those pills.

Generic versions have the same ingredients and are tested in the same way as their branded counterparts. So while their name may be different, these options are completely safe for you to use.

The main difference is the company that makes them. For instance, there may be several names for a specific formulation of a pill, in a specific dose, because multiple companies make that pill.

For example, Lutera contains 0.1mg levonorgestrel and 0.02mg ethinyl estradiol. Alesse, Delyla and a number of other pills contain exactly the same hormones in the same amounts, but may look slightly different and come in different packaging. But there shouldn’t be any real difference in how they work. In some cases one version of a pill may be cheaper than the other, because different companies make and market them.

There isn’t a single price for combined birth control pills. Because they’re made by different pharma companies, the price of the pill can vary. But at Treated, we have a number of options at different prices, so you can find a pill that suits you and fits within your budget.