This is about 2%. The main reason is forgotten pill intake other reasons include women taking antibiotics or having vomiting or diarrhoea rendering the pill ineffective, therefore, with these conditions additional method of protection is advised.

• Good control of menstrual cycles, less heavy and less painful
• Improve facial hair and acne
• Treatment of pelvic congestion and endometriosis
• Prevent ovarian cyst development

Pills are safe, however, possible side effects are:

• Very rare association with cardiovascular disease and deep vein thrombosis
• Unestablished association with breast cancer
• Weight gain very minimal if any
• Headaches, nausea, bleeding between periods and breast tenderness all temporary and subside after a few weeks

The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. Side effects are vaginal irritation, discharge and higher failure rate.

Evra is a self adhesive oestrogen and progestogens patch applied once weekly for three weeks every month and having a week break to allow a period. It can be applied to the arm or buttocks. Side effects are allergy to skin, DVT and cardiovascular disease.