Millions of Americans use birth control pills each month as a means of contraception or as a way of easing painful periods. No matter your reason for taking birth control, it’s important to talk with your doctor before choosing a brand. They can help you make the best decision for your needs and lifestyle.
Here’s a quick primer so you can go into your doctor visit informed and ready to make a decision.
Combination pills contain synthetic types of the hormones known as estrogen and progestin. They come in different ratios, or combinations, of active and inactive ingredients.
The combination pill is more than 99 percent effective when taken as intended.
The most common type of combination pill contains either 21 active pills and 7 inactive pills, or 24 active pills and 4 inactive pills. Each month, you may have bleeding similar to a regular period while taking the inactive 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.
Common monophasic pill brand names include:
- Estrostep Fe
- Lo Ovral
The level of active ingredients varies in multiphasic pills. Where you are in your cycle will determine what level of active ingredients is present.
Biphasic pills include:
Triphasic pills include:
- Ortho Tri-Cyclen
Quadriphasic pills include:
If you want fewer periods, your doctor may suggest an extended-cycle, or continuous-dose, pill. These include 84 active pills and 7 inactive pills. Generally, if you take this type of pill, you’ll have four periods per year.
Common extended-cycle pill brand names include:
Low-dose pills contain less than 50 micrograms of estrogen per active pill. Low-dose pills are ideal if you’re sensitive to hormones. They’re also a good option if you’re just starting birth control.
Although many people have great success with low-dose birth control pills, you may experience more breakthrough bleeding than you would with a higher dose of hormones.
Common low-dose pill brand names include:
- Lo Ovral
Minipills are available in one mixture that’s progestin only, with no estrogen. Because of this, the minipill is great for people with certain medical conditions and people who are sensitive to estrogen.
The level of the hormone is the same in each pill, and each pill contains active ingredients. Unlike the combination pill, there are no inactive pills included. So, you may experience a period or you may skip a period while using this form of birth control pill. The progestin dose in a minipill is also lower than the progestin dose in any combination pill.
Minipills are also more than 99 percent effective when taken correctly.
Common minipill brand names include:
- Orthoa Micronor
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.
Many people can use birth control pills safely and without many symptoms or side effects. However, some people will experience these health concerns, especially when they first begin taking the pill.
The side effects of combination birth control pills can include:
- a headache
- weight gain, which is often due fluid retention
- breast tenderness
- bleeding between periods
The side effects of progestin-only minipills can include:
- breast tenderness
- a headache
- bleeding between periods
- ovarian cysts
- weight gain
- decreased libido
What causes birth control pill side effects?
Birth control pills contain hormones. They’re designed to keep your level of hormones steady throughout your entire cycle. This is what helps prevent ovulation and reduces your chances of pregnancy.
Fluctuations in your hormone levels can cause side effects. These fluctuations occur when you begin taking the pill, when you’re late taking a pill, or when you 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 health concerns after 3 months of consecutive use. You may need to consider other birth control options.
For most people, 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, medications 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 high blood pressure
- have a history of heart attacks or heart disease
- have a history of stroke
- have a history of blood clotting disorders
- have had diabetes for more than 10 years
If you’re chestfeeding, you may need to consider alternative forms of birth control until you’ve stopped nursing. The progestin-only minipill may be ideal for some people who are nursing, so talk with your doctor about your options.
|Brand name||Generic name||Type||Schedule (active/inactive)|
|Alesse||levonorgestrel and ethinyl estradiol||monophasic||21 days/7 days|
|Apri||desogestrel and ethinyl estradiol||low-dose monophasic||21 days/7 days|
|Safyral||drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate||monophasic||21 days/7 days|
|Lo Loestrin FE||norethindrone acetate and ethinyl estradiol, ethinyl estradiol||low-dose monophasic||26 days/2 days|
|Seasonique||levonorgestrel and ethinyl estradiol||extended cycle||84 days/7 days|
|Yaz||drospirenone and ethinyl estradiol||low-dose monophasic||24 days/4 days|
|Yasmin||drospirenone and ethinyl estradiol||low-dose monophasic||21 days/7 days|
|Enpresse||levonorgestrel and ethinyl estradiol||triphasic||21 days/7 days|
|Azurette||desogestrel/ethinyl estradiol and ethinyl estradiol||biphasic||21 days/7 days|
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.
Before visiting your doctor, it may be helpful to have an idea of which type of birth control pill sounds right for you.
Consider if you are comfortable using a combination pill that includes mostly active pills (hormone-containing pills) or if you’d like to use minipills, which are progestin-only pills.
Minipills can be helpful if you aren’t able to consume estrogen. You may or may not have a period on this type of birth control pill, which is another important aspect to consider.
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 people to change the types or doses of birth control pills several times before finding an option that works best for them.
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 3 months before you switch to another pill.
Tell your doctor if you have side effects that interfere with your daily activities or become problematic. They may recommend that you switch pills.
What’s the most common birth control pill?
The combination pill and the minipill are the most common birth control pill types.
What’s the cheapest birth control pill brand?
It depends. You should be able to get free or low-cost birth control pills anywhere in the United States. Check out our guide here for more information.
Do I need to contact a doctor to get birth control pills?
Generally, yes. In most cases, a prescription is needed for birth control pills, meaning contacting a doctor, nurse, or Planned Parenthood centers. A few states allow you to get a prescription online or from a pharmacist.
Where can I get birth control pills?
Once you have a prescription, you can get birth control pills from a pharmacy or online.
Combination pills and minipills are the most common types of birth control pills.
Deciding which is best for you will come down to certain factors like if you want to take mostly hormone-containing pills or if you are more comfortable with a pill that does not contain estrogen. Side effects, cost, and how your body responds to each form and brand will vary for each individual.
Talking with your doctor can help you find the birth control pill that is best for you.