Guidance on contraceptive choice can be influenced by many factors starting with whether a hormonal method is appropriate or wanted. Use of a hormonal product may then be influenced by whether the woman wants regular periods or wishes to avoid having a monthly period, or whether period pain or premenstrual syndrome are problematic.¹⁰

Adherence and remembering to take the pill could mean a non-oral method may be more appropriate. A POP is ideally taken at around the same time each day and has a shorter window to catch up with a missed dose of 3 to 12 hours depending on the brand while a COCP can be taken at any time, although it is good practice to take it at a regular time.

POPs have some advantages over COCPs including being eliminated from the body more quickly, and being suitable for women who cannot take oestrogen.

Benefits such as the impact on acne, menopause symptoms, or conditions such as endometriosis or polycystic ovary syndrome (PCOS) may be another factor. Protection against cancers such as ovarian, womb or bowel cancer offered by COCPs may be a priority, but this has to be balanced against increased risk of breast cancer or venous/arterial thromboembolism.

The age of the user may have a bearing as may the woman’s desire to become pregnant at some point. Protection from sexually transmitted infections is another consideration.

Specific disadvantages of oral methods include the possibility of bleeding between periods (spotting) may occur when first starting an oral contraceptive, and headaches, nausea or sore breasts. There can also be changes in mood and libido, and the woman may feel she is more hungry – however, most women will not put on more weight, and one in 10 may even lose some weight.