Reviewed by Usama Ali, MPharm (GPhC: 2224726). April 2026.
There is no single best pill. The right contraceptive pill for you depends on your medical history, your body, and what matters most to you. Some people want predictable periods. Some want help with acne or bloating. Some need to avoid oestrogen. Some just want the widest possible window for taking it each day.
Through the NHS Pharmacy Contraception Service, you can access a free phone consultation with a clinician who will help you find the right fit. This guide walks you through the same thinking your clinician uses, so you go into your appointment with a clearer picture of your options.
Every contraceptive pill available in the UK falls into one of two categories.
The combined pill contains two hormones: an oestrogen (usually ethinylestradiol) and a progestogen. You usually take it for 21 days, then have a 7 day break during which you get a withdrawal bleed. It is over 99% effective with perfect use.
The mini pill (also called the progestogen only pill) contains just one hormone. Most types are taken every day without a break. It is also over 99% effective with perfect use.
Neither type protects against sexually transmitted infections. If you need STI protection, use condoms as well.
Before prescribing any pill, your clinician checks your suitability using the UK Medical Eligibility Criteria (UKMEC). The main factors are:
Your medical history, including any history of blood clots, stroke, heart disease, liver conditions, or breast cancer.
Your blood pressure. For the combined pill, a recent reading is required. A reading at or above 140/90 mmHg means the combined pill would not normally be prescribed.
Your BMI. A BMI of 35 or above is a reason not to prescribe the combined pill. The mini pill is suitable at higher BMIs.
Whether you smoke. If you smoke and are 35 or over, the combined pill is not recommended.
Your migraine history. Migraine with aura is a reason not to prescribe the combined pill at any age.
Whether you are breastfeeding. The combined pill is not recommended in the first six weeks after birth.
Your current medications. Some medicines reduce the pill's effectiveness.
Your age. Through the NHS Pharmacy Contraception Service, the combined pill is available up to and including age 49. The mini pill is available up to 54 for most types.
Desogestrel 75 micrograms is the most commonly prescribed mini pill in the UK. It stops ovulation in most cycles and has a 12 hour timing window. Brands include Cerelle, Cerazette, Feanolla, Zelleta, and unbranded generic desogestrel.
Slynd (drospirenone 4 milligrams) is a newer mini pill with a 24 hour timing window and anti-androgenic properties.
Norgeston (levonorgestrel 30 micrograms) is a traditional mini pill with a strict 3 hour timing window.
Noriday (norethisterone 350 micrograms) is also a traditional mini pill with a 3 hour timing window.
The first choice combined pills contain ethinylestradiol with levonorgestrel. These have the most safety data and the lowest risk of blood clots. Examples include Microgynon 30, Rigevidon, and Ovranette.
Combined pills containing ethinylestradiol with norgestimate or norethisterone carry a similar risk profile.
Combined pills containing ethinylestradiol with desogestrel or gestodene carry a slightly higher risk of blood clots but may improve skin.
Combined pills containing ethinylestradiol with drospirenone (such as Yasmin or Lucette) can help with acne, bloating, and PMS.
A combined pill containing desogestrel or drospirenone may help. On the mini pill side, Slynd is the only option with anti-androgenic properties.
Drospirenone (available as Slynd or in combined pills like Yasmin) has anti-mineralocorticoid properties that can counteract water retention.
The combined pill is often more helpful for heavy or painful periods. You can also run packs back to back to skip periods entirely.
Slynd has the widest timing window at 24 hours. The desogestrel mini pill gives you 12 hours. The combined pill and traditional mini pills are less forgiving at 3 hours.
Only the mini pill is suitable while breastfeeding. The combined pill is not recommended during the first six weeks after birth.
Some medicines speed up how your liver processes the pill, making it less effective. These include certain epilepsy medicines, rifampicin, and St John's Wort.
If you take lamotrigine for epilepsy, the combined pill can reduce lamotrigine levels in your blood.
If you have a current or past meningioma, desogestrel should be avoided.
If you take a weight loss injection such as semaglutide, there is a potential for reduced absorption of oral medications.
Your clinician reviews your medical history, checks your eligibility, and rules out any reasons not to prescribe. They then narrow down the options to a safe shortlist based on your health and preferences.
Your clinician can discuss alternatives and refer you to the appropriate service. Long acting reversible contraception (LARC) is more effective than the pill in typical use.