Birth Control Pills Singapore

Authored By: Dr. Jana Lim
Last updated: June 5, 2025

Birth control pills, or oral contraceptives, are medications taken daily to prevent pregnancy and regulate reproductive health. They work by delaying ovulation and thickening cervical mucus, reducing the likelihood of conception. Some types of birth control pills can also help reduce cramps, and improve hormonal balance.

While birth control pills are used for ongoing pregnancy prevention, emergency contraception (morning-after pills) is taken after unprotected intercourse to reduce the risk of pregnancy, and period delay pills are used to postpone menstruation for short-term scheduling needs.

Birth control pills prevent pregnancy through mimicking natural hormones, oestrogen and progestin, which affects ovulation, cervical mucus, and the uterine lining. They work in three primary ways:

1. Suppressing Ovulation – The pill maintains steady levels of oestrogen and progestin, which prevent the surge of luteinising hormone (LH) and follicle-stimulating hormone (FSH), the hormones essential for egg maturation and release during ovulation.
2. Thickening Cervical Mucus – Higher levels of progestin cause cervical mucus to become denser, creating a barrier that makes it more difficult for sperm to reach the egg.
3. Altering Uterine Lining – Increased levels of the hormones prevent the endometrium, the inner lining of the uterus that thickens in preparation for pregnancy, from developing fully. This makes it less receptive to implantation if fertilisation occurs.

The effects of birth control pills are temporary and will stop once you discontinue the medication, allowing your natural menstrual cycle and fertility to resume.

Combination Pills

Combination pills contain both oestrogen and progestin, which work together to suppress ovulation, thicken cervical mucus, and alter the uterine lining. They are typically taken in cycles, such as 21-day or 28-day packs.

In a 28-day pack, the first 21 or 24 pills contain active hormones, while the remaining placebo pills are inactive and do not contain hormones, triggering a withdrawal bleed that mimics a period. In a 21-day pack, there is a seven-day break after finishing the active pills, during which bleeding occurs.

Beyond pregnancy prevention, oral contraceptive pills can also be used to treat a range of menstrual and hormonal concerns:

• Menstrual Regulation – Can help regulate irregular periods, relieve painful cramps (dysmenorrhoea), and reduce heavy menstrual bleeding (menorrhagia).
• Premenstrual Relief – Certain formulations may ease symptoms of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) by stabilising hormonal fluctuations.
• Polycystic Ovary Syndrome (PCOS) – By lowering elevated androgen levels and restoring hormonal balance, the pill may improve symptoms such as irregular periods, acne, and excessive hair growth.
• Endometriosis Support – May relieve pelvic pain associated with endometriosis by suppressing ovulation and limiting endometrial tissue activity.
• Hormonal Migraines – Continuous or extended-cycle pills may reduce the hormone shifts that trigger menstrual-related migraines in some individuals.

These uses vary between individuals and depend on the specific formulation prescribed. It is advisable to consult a doctor for personalised medical guidance on whether birth control pills are suitable for your condition.

While birth control pills are generally well tolerated, some individuals may experience side effects due to the way synthetic hormones influence the body's natural processes. These effects can include:

• Nausea or headaches – Caused by fluctuations in oestrogen levels, which can affect the digestive system and blood vessels.
• Breast tenderness – Occurs due to fluid retention and hormonal changes that affect breast tissue.
• Mood changes – Result from the way oestrogen and progestin interact with neurotransmitters such as serotonin, which help regulate mood.
• Breakthrough bleeding or spotting – Light bleeding that occurs between periods, especially in the first few months, as the body adjusts to hormone levels that alter the menstrual cycle and thin the uterine lining.

Long-term side effects of birth control pills may include an increased risk of venous thromboembolism (VTE), high blood pressure, stroke, or myocardial infarction. These risks are higher in individuals with pre-existing conditions such as high blood pressure, a history of blood clots, smoking, or cardiovascular disease.

If you have any underlying conditions or concerns about long-term use, it is best to consult a doctor to determine if birth control pills are a suitable option for you.

At ATA Medical, we offer birth control pills, morning-after pills, period delay pills, and hormone tests at the following prices:

For reliable protection, take your birth control pill at the same time every day. There are two common regimens: the 21-day pack and the 28-day pack.

21-Day Regimen:

1. Take one active pill daily for 21 days in a row.
2. Stop taking pills for 7 days to allow for withdrawal bleeding.
3. Start your next pack on day 8, even if the bleeding hasn’t stopped.

28-Day Regimen:

1. Take one pill every day for 28 days without a break.
2. The last 4 to 7 pills are placebo pills, which do not contain hormones and trigger a withdrawal bleed.
3. Begin your next pack immediately after finishing the previous one.

If you begin taking the pill more than 5 days after your period starts, you should use additional contraception (such as condoms) during the first 7 days.

If you're switching from another method (e.g. injection, implant, patch), speak with a doctor to ensure a seamless transition and continuous coverage.

Missing a dose can lower the effectiveness of birth control pills, especially if the delay exceeds 12 hours or multiple pills are missed. Here’s what to do if you forget a dose of a combined birth control pill:

Less than 12 hours late:

1. Take the missed pill as soon as you remember.
2. Take the next pill at your usual time (you may need to take two pills in one day).
3. No other contraception is required.

More than 12 hours late:

If you missed a pill and more than 12 hours have passed, refer to the instructions below based on which week of your current pill pack you are in:

If vomiting or severe diarrhoea occurs within 3 to 4 hours after taking your pill, the hormones may not be absorbed properly. In this case, treat it as a missed dose and follow the relevant instructions.

When unsure, check the medication leaflet that comes with your pills or consult your doctor for guidance regarding your situation.