Wellness & Nutrition Womens Health

The Contraceptive Pill: Demystifying Long-Term Usage Effects and Understanding the Difference Between the Combined and Mini-Pill


When it comes to contraception, it’s essential to understand the options available. In this comprehensive article, we’ll explore the two primary types of contraceptive pills – the combined pill and the progestogen-only pill (commonly known as the mini-pill). We’ll delve into the nuances of each, examining their unique advantages, disadvantages, and the crucial factors to consider when choosing between them. Finally, we will investigate what research has to say regarding the long-term usage effect of the pill.


1. The Combined Pill:

This pill contains two hormones – oestrogen and progestogen. It works by It inhibiting monthly ovulation, preventing the release of an egg from the ovaries.


  • Regulation of menstrual cycles.
  • Reduction of premenstrual syndrome (PMS) symptoms, including mood swings, headaches, and bloating.
  • Decreased risk of ovarian and endometrial cancers due to the prevention of ovulation.


  • Potential side effects such as weight gain, nausea, breast tenderness, acne, and mood changes.
  • Slight increase in the risk of blood clots, heart attacks, and strokes (although the risk is minimal).


2. The Progestogen-Only Pill (Mini-Pill):

This pill contains only one hormone – progestogen. It works by altering cervical mucus at the entrance of the uterus, making it difficult for sperm to pass through and fertilize an egg.


  • Suitable for individuals who cannot tolerate oestrogen or need contraception while breastfeeding.
  • Appropriate for those with specific health concerns (e.g., high blood pressure or a high risk of blood clots) and can be taken at any age.


  • Some women may experience irregular menstrual bleeding.
  • Potential side effects include decreased libido, acne, and increased facial and body hair.
  • Requires strict adherence to the daily schedule (more so than the combined pill).


Long-Term Safety

Given the widespread use of birth control pills, many people wonder about the potential long-term effects. The bottom line is that research suggests birth control pills are generally safe for long-term use (Sanghvi, 2021). As long as a medical professional has prescribed them, and they are not causing adverse side effects, it’s generally safe to continue using them. However, it’s important to be mindful that as you age, your body and lifestyle may change, potentially altering your medical needs.

It’s noteworthy that the combined pill, which contains both oestrogen and progestogen, may not be suitable for certain individuals, particularly women who are 35 years or older and smoke, or have quit smoking within the past year, those who are significantly overweight, or those taking specific medications.

For further peace of mind, let’s consider the risk associated with birth control pills in a broader context, as found in a study published by the National Library of Medicine: “The annual risk of death for a non-smoking young woman aged 15 to 34 years taking the pill is 1 in 1,667,000; the risk of a rare event like dying from a lightning strike is 1 in 2,000,000. This lower-risk situation describes most pill users today. We are now extremely cautious about the use of the pill in women who smoke, especially as they age. Even if a woman is a smoker older than 35 years, her risk of death from using the pill is 1 in 5,200. For comparison, the risk of dying in a car accident is 1 in 5,000.” (Liao & Dollin, 2012).


Final Thoughts

Both the combined and progestogen-only pills offer effective contraception with their unique sets of advantages and disadvantages. Finding the most suitable pill may require trying different brands and formulations. While contraceptive pills generally pose minimal risks, if you experience significant side effects, consulting a healthcare professional is essential to receive personalised medical guidance. In the realm of birth control, a thorough understanding empowers individuals to make informed choices aligned with their specific needs and circumstances.




  • Liao, P. V., & Dollin, J. (2012). Half a century of the oral contraceptive pill: historical review and view to the future. Canadian family physician Medecin de famille canadien, 58(12), e757–e760.
  • Sanghvi, D.S. (2021). What are the long-term side effects of birth control pills?, Long Term Effects Of The Pill | LloydsPharmacy Online Doctor UK. Available at: https://onlinedoctor.lloydspharmacy.com/uk/contraception-advice/contraceptive-side-effects-long-term-use
  • UK meds. (2019). What’s The Difference Between The Combined Pill & The Mini Pill? | UK Meds. Available at: https://www.ukmeds.co.uk/blog/whats-the-difference-between-combined-pill-and-mini-pill
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