Feature Article

A practical guide to contraception. Part 1: Contraceptive pills and vaginal rings

Kathleen McNamee, Caroline Harvey, Deborah Bateson



The shorter-acting contraceptives – the combined hormonal methods (combined oral contraceptives and the vaginal ring) and the progestogen-only pill – are discussed in this first article in a three-part series on contraception. Other contraceptive methods will be discussed in subsequent articles.

A correction for this article was published in the August 2013 issue of Medicine Today. The full text PDF of this article (see link above) has been corrected.

Key Points

  • Combined hormonal contraceptives (CHCs), which contain an oestrogen and a progestogen, are available as combined contraceptive pills and the vaginal ring.
  • The advantages of CHCs include beneficial effects on acne, decrease in menstrual pain and bleeding and the ability to manipulate menstrual cycles.
  • CHC use is associated with some serious risks but the absolute risk is low for most women of reproductive age.
  • No serious risks have been associated with use of the progestogen-only pill, although evidence is limited.
  • The option of long-acting reversible contraceptives (intrauterine devices and subdermal implants) should be discussed with women renewing CHC scripts.
  • Contraceptive methods requiring consistent action (condoms and pills) are less effective than long-acting methods requiring minimal ongoing action on the part of the user (implants and intrauterine devices).