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Choosing the Right Birth Control Pill

Choosing a Birth Control Pill

Millions of American women use the birth control pill every month. Whatever your reasons for using birth control, you should work closely with your doctor to ensure that you find a pill that suits your needs and lifestyle. Your doctor can help you narrow your options until you find the one that works best for you. There are many options available.

Birth control pills are available as progestin-only minipills, which contain only one hormone, and combination pills, which contain the hormones estrogen and progestin.

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Combination Pills

What Are Combination Pills?

Pills with Less Estrogen
Medical researchers have worked for decades to create birth control pills that have the lowest level of hormones possible while still being effective. Today, low-dose birth control pills are available. The pills contain less than 50 micrograms of estrogen per active pill.

Combination pills come in different ratios, or combinations, of active and inactive ingredients. Common forms of combination pills are:

Conventional Pills
The most common type of combination pill contains either 21 active pills and seven inactive, or placebo, pills or 24 active pills and four placebo pills. Each month, you may have bleeding similar to a regular period while taking the inactive pills.

Extended-Cycle Pills

If you want fewer periods, your doctor may suggest an extended-cycle, or continuous-dose, pill. This pill contains 84 active pills and seven placebo pills. Generally, women who take this type of pill have four periods per year.

Low-Dose Pills

Low-dose pills contain less than 50 micrograms of estrogen per active pill. Low-dose pills are ideal if you are sensitive to hormones. They’re also a good option if you’re just starting birth control.

Although many women have great success with low-dose birth control pills, you may experience more breakthrough bleeding than you would with a higher dose of hormones.

Combination pills are also divided into two other categories based on the dose of hormones. These categories include:

Monophasic Pills

Monophasic pills contain only one phase or level of active hormones. The level of hormones remains the same in each active pill during the month.

Multiphasic Pills

The level of active ingredients varies in multiphasic pills. Where you are in your cycle will determine what level of active ingredients is present.

Common combination pill brand names include:

  • Alesse
  • Apri
  • Aranelle
  • Aviane
  • Azurette
  • Beyaz
  • Caziant 
  • Desogen
  • Enpresse
  • Estrostep Fe
  • Gianvi
  • Kariva
  • Lessina
  • Levlite
  • Levora
  • Loestrin
  • Lybrel
  • Mircette
  • Natazia
  • Nordette
  • Ocella
  • Low-Ogestrel
  • Lo Ovral
  • Ortho-Novum
  • Ortho Tri-Cyclen
  • Previfem
  • Reclipsen
  • Safyral
  • Seasonale
  • Seasonique
  • TriNessa
  • Velivet
  • Yasmin
  • Yaz

Minipills

What Are Minipills?

Minipills are available in one mixture that’s progestin only. Because of this, the minipill is great for women with certain medical conditions and those sensitive to estrogen.

The level of the hormone is the same in each pill, and each pill contains active ingredients. The progestin dose in a minipill is also lower than the progestin dose in any combination pill.

Combination pills are significantly more effective at preventing pregnancy than the minipill.

Common minipill brand names include:

  • Camila
  • Errin
  • Heather
  • Jencycla
  • Jolivette
  • Nor-QD
  • Nora-BE
  • Orthoa Micronor

Read more: What to expect when switching birth control pills »

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Differences

How Are Combination Pills and Minipills Different?

The main difference between combination pills and minipills is that one has estrogen and the other doesn’t. There’s also a noticeable difference in how each pill affects your body.

Combination pills prevent pregnancy in three ways. First, the hormones prevent your ovaries from releasing an egg. Without the egg, sperm have nothing to fertilize. The hormones also cause a buildup of thick, sticky mucus at the opening of your cervix. This makes it harder for sperm to pass through your cervical opening. Some combination birth control pills also thin the lining of your uterus. Without a thick lining, a fertilized egg has a difficult time attaching and developing.

Minipills prevent pregnancy by thickening cervical mucus and thinning your uterine lining. Some minipills can also prevent ovulation, but that’s not the primary function of these progestin-only pills.

Side Effects

What Are the Side Effects?

Many women can use birth control pills safely and without many symptoms or side effects. However, some women will experience issues, especially when they first begin taking the pill.

The side effects of combination birth control pills can include:

  • nausea
  • vomiting
  • a headache
  • weight gain, which is often due fluid retention
  • breast tenderness
  • bleeding between periods

The side effects of progestin-only minipills can include:

  • acne
  • breast tenderness
  • a headache
  • fatigue
  • bleeding between periods
  • ovarian cysts
  • weight gain
  • decreased libido

Read more: How birth control can affect cramping »

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Causes

What Causes These Side Effects?

Birth control pills contain hormones and are designed to keep your level of hormones even throughout your entire cycle. This is what helps prevent ovulation and reduces your chances of having an unplanned pregnancy. Fluctuations in your hormone levels can cause side effects. These fluctuations occur when you begin taking the pill and when you’re late with taking a pill or miss a dose.

Most of these side effects will ease after several weeks or months of taking the pill. Tell your doctor if you still experience these issues after three months of consecutive use. You may need to consider other birth control options.

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Risk Factors

Risk Factors to Keep in Mind

For most women, birth control is safe and effective. Certain risk factors can increase your likelihood of experiencing side effects. Before you begin taking birth control, talk with your doctor about your personal medical history to determine what, if any, medicines you should avoid.

You may be at an increased risk of side effects if you:

  • are older than 35 and smoke
  • have a history of breast cancer
  • have a history of uncontrolled high blood pressure
  • have a history of heart attacks or heart disease
  • have a history of stroke
  • have a history of blood clotting disorders or problems
  • have had diabetes for more than 10 years

If you’re breast-feeding, you may need to consider alternative forms of birth control until you have stopped nursing. The progestin-only minipill may be ideal for some nursing mothers, so talk with your doctor about your options.

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Your Doctor

Talking with Your Doctor

Talk with your doctor if you’re trying to decide between types of birth control. Each type of pill is effective, but your options may change based on your personal health history, your lifestyle, and the results you need.

Weigh the risks and benefits of the two different pill types. Once you’ve made a decision about the type of pill you want, your doctor may have a brand or two they may recommend. However, just because one brand works for someone else doesn’t mean it will work for you. It’s not uncommon for women to change the type or dose of birth control pills several times before finding an option that works best.

Whether you decide to take the combination pill or the minipill, take time to adjust to it and determine how your body reacts. Most doctors recommend giving a particular pill three months before you switch to another pill.

Tell your doctor if you have side effects that interfere with your daily life or become problematic. They may recommend that you switch pills.

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