The term “contraceptive pills” is often used to describe all forms of oral contraception. These can be divided into two main groups:
- Combined pills: Contain two hormones, estrogen and progestogen.
- Progestogen-only pills (POP): Contain only one hormone, progestogen.
Overview of all products (in Norwegian)
- The Norwegian Pharmaceutical Product Compendium provides a list of all hormonal contraceptives used in Norway (in Norwegian, felleskatalogen.no)
- List of hormonal contraception products recommended by the Norwegian Medical Products Agency (in Norwegian, dmp.no).
Before you start using contraception
Your GP, public health nurse, or midwife will ask about your health, and whether you or your family have had blood clots, heart disease, or other conditions that may influence which contraceptive method is suitable for you. Because of this, you may be advised to use a different method than the one you initially wanted.
For many (especially younger women) long-acting contraceptives like implants or hormonal IUDs are the best option.
Information about using contraceptive pills
You’ll receive instructions from your GP, public health nurse, or midwife. Each pack includes a patient leaflet with important information that you should read when starting the pills. You can also access digital leaflets by scanning the package at felleskatalogen.no.
Take the pills exactly as instructed by your provider or as described in the leaflet. Contact your provider if you have any questions.
If you're unsure whether the contraception is working (for example, if you’ve missed one or more pills) you should avoid unprotected sex. In such cases, asking your partner to use a condom is a good alternative.
Combined pills
Combined pills suppress ovulation and thicken the mucus in the cervix, making it harder for sperm to pass through.
How effective are combined pills at preventing pregnancy?
They are very effective when taken correctly, but in practice, their effectiveness is lower due to the risk of forgetting doses.
Benefits of combined pills
- Reduce menstrual discomfort.
- Provide regular bleeding.
- Continuous use allows you to delay menstruation. Studies show no advantage to having a pill-free week, nor are there adverse effects from using pills continuously for more than three weeks.
- Reduce the risk of serious infections in the fallopian tubes by thickening cervical mucus, which blocks bacteria.
- May prevent cancer of the uterus, ovaries, and colon.
- Can reduce acne.
Disadvantages of combined pills
They may cause harmless but bothersome side effects, such as:
- nausea
- tender breasts
- headache
- reduced libido
- vaginal dryness
- spotting
- leg cramps
These side effects often subside, but if they are bothersome, you may need to switch to another type of pill or contraceptive.
Slightly Increased Risk of Cardiovascular Disease
Combined pills slightly increase the risk of cardiovascular conditions. If you have high blood pressure, are overweight, smoke, or are over 35 years old, consider using an IUD or implant instead.
Slightly Increased Risk of Breast and Cervical Cancer
Combined pills slightly increase the risk of breast- and cervical cancer.
Slightly Increased Risk of Mood Changes and Depression
Combined pills may slightly increase the risk of low mood and depression. Talk to your GP, nurse, or midwife if you feel down or sad while using them.
Slightly Increased Risk of Blood Clots
Combined pills increase the risk of blood clots. Some pills carry a higher risk than others. Although rare, this is a serious side effect. Progestogen-only pills do not increase the risk of blood clots.
All women should start with combined pills that carry the lowest risk of blood clots. This risk gradually decreases during the first six months of use. If you stop taking pills for more than four weeks, the risk returns to its original level. For this reason, avoid repeatedly starting and stopping contraceptive pills.
Advice to Reduce the Risk of Blood Clots
- Choose pills with hormone combinations that carry the lowest clotting risk.
- Take the pills consistently and avoid unnecessary breaks.
- Don’t borrow pills from others.
- Avoid smoking.
- Talk to your GP, nurse, or midwife if you have questions.
Signs of Blood Clots
Blood clots can occur in veins in the legs or arms. Sometimes, clots can travel to the lungs. In rare cases, clots may occur in arteries.
Common symptoms of blood clots:
- swelling in one arm or leg
- sudden shortness of breath
- heart palpitations
- dizziness
- chest pain
- vision disturbances
- numbness in an arm or leg
Contact your GP, nurse, midwife, or emergency services immediately if you experience any of these symptoms.
Progestogen-only pills (estrogen-free)
These pills thicken the mucus in the cervix, making it harder for sperm to reach the uterus. They may also suppress ovulation. Other names for these pills include mini-pills and POP (progestogen-only pills).
How effective are progestogen-only pills?
They are effective when used correctly, but in practice, they are less effective due to missed pills.
Benefits of progestogen-only pills
- Do not increase the risk of blood clots
- Lower the risk of serious infections in the fallopian tubes
- Reduce menstrual symptoms and bleeding; some may stop bleeding altogether
- May prevent uterine and ovarian cancer
Disadvantages of progestogen-only pills
They may cause harmless but sometimes unpleasant side effects, such as:
- nausea
- tender breasts
- headache
- reduced libido
- vaginal dryness
- irregular bleeding
These side effects often improve, but if they are troublesome, you may need to switch to another contraceptive method.
Progestogen-only pills often cause changes in bleeding patterns. Bleeding may become irregular, lighter, or stop altogether. These pills do not allow you to delay your period.