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Combination birth control pills, the pill for short, are oral contraceptives that prevent pregnancy.

If you’re considering your birth control options, the pill is one of the most common and most effective. According to Planned Parenthood, birth control pills are 99 percent effective when taken perfectly.

Birth control pill prescriptions are relatively easy to get and are typically covered by health insurance. There are many online birth control services that deliver the pill straight to your doorstep each month.

The pill contains a combination of synthetic hormones — hence the name — that work in two main ways.

First, the pill stops the ovaries from releasing an egg each month (aka ovulation). The pill also thins the lining of the uterus and thickens cervical mucus, both of which work to make implantation less likely.

Estrogen and progestin are the two main hormones in the combination pill. The estrogen in birth control pills may result in better control over your period, though it’s also associated with some risks.

“Taking estrogen continuously throughout the active pills suppresses the ovarian formation of a mature follicle (the sac within which the egg grows), thereby suppressing ovulation,” explains Rashmi Kudesia, MD, a fertility doctor in Houston.

“The hormonal components of combination pills also keep the cervical mucus unfavorable — reducing sperm entry into the uterus and Fallopian tube — and keep the uterine lining thin — reducing chances of implantation.”

The amount of estrogen in combination pills may vary, though low-dose pills are available and quite common.

Birth control pills are taken orally every day. For maximum effectiveness, the pill should be taken around the same time every day.

There is no specific time of day that you have to take your pill. However, taking the pill in the evening or with a meal may decrease nausea.

As long as you meet the medical eligibility, there is no limit on how long you can be on the pill. If you want to become pregnant, you should stop taking the pill.

The chance of becoming pregnant while taking the pill is low. Planned Parenthood estimates that 9 percent of birth control users get pregnant. When taken perfectly, the chance of pregnancy while on the pill is 1 percent or less.

Aside from pregnancy, there are other risks and side effects associated with the combination pill.

“The most common side effect… is irregular bleeding in the first few months of use,” says Katharine White, MD, a gynecologist and associate professor of OB-GYN at the Boston University School of Medicine.

“Your bleeding patterns will regulate with time — but if irregular bleeding doesn’t improve by your fourth pack, talk with your doctor about changing which pill you’re taking. A different combination of hormones may work better for you.”

If you want to switch birth control pills, chat with a medical professional about how to switch without having gaps in your birth control plan.

According to White, the risks of the combination pill are much lower than the risks of pregnancy, which includes blood clots, high blood pressure, heart attack, stroke, and liver tumors.

The pill may be right for you if you menstruate, meet the medical eligibility, and can remember to take the pill on a daily basis.

“Anyone who meets medical eligibility is a good candidate,” Kudesia explains. “Those who may not be good candidates would include those with a personal or family history of blood clots, or those with high blood pressure, migraines with aura, or who use tobacco.”

Kudesia says your physician can review your eligibility in more detail, but most people who menstruate are eligible for combination pills.

The best way to determine if the pill is right for you is to discuss it with your doctor or healthcare professional.

The combination pill requires a prescription.

If you don’t have health insurance or don’t want to make an in-office appointment, these online birth control services make it easy to get combination pills delivered to you.

Nurx

  • Price: $0 with insurance or $15 per pack out of pocket
  • Insurance accepted: Yes
  • Physician support included: Yes. A licensed medical provider will review your health history and write a prescription if medically appropriate.
  • Discreet packaging: Yes
  • Other notes: Automatic refills and renewals are available, so there are no gaps in birth control. There are other services offered, including acne treatment, anti-aging retinoid cream, and STI testing.

Pandia Health

  • Price: $0 with insurance or $15 out of pocket
  • Insurance accepted: Yes
  • Physician support included: Yes. A doctor will review your health form and determine if they’re going to write a prescription.
  • Discreet packaging: Yes
  • Other notes: Free shipping is available to all 50 states.

The Pill Club

  • Price: $0 with insurance or $15 per pack out of pocket
  • Insurance accepted: Yes
  • Physician support included: Yes. A doctor will review your consultation and write a prescription accordingly.
  • Discreet packaging: Yes
  • Other notes: Free goodies come in every delivery.

SimpleHealth

  • Price: $0 with insurance or $9–$10.66 per pack out of pocket
  • Insurance accepted: Yes
  • Physician support included: Yes. A doctor will review your consultation to determine your prescription.
  • Discreet packaging: Yes
  • Other notes: Student discounts are offered.

Do combination pills work right away?

You can start taking combination pills at any time, if you meet medical criteria.

According to Planned Parenthood, starting within 5 days of your period offers immediate protection. If you start at any other time in your menstrual cycle, the pill is effective after 7 days of daily use.

What brands are combination pills?

Some combination pill brands 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

Do you get your period on a combination pill?

Skipping your period is only possible with combination birth control pills. You can skip your period by continually taking the birth control pills and skipping the hormone-free placebo pills.

According to the Centers for Disease Control and Prevention (CDC), birth control pills are the most common form of female contraception after sterilization. Of the birth control options out there, the combination pill is an effective one.

Using online birth control services is an accessible and affordable resource for people interested in the pill.

However, birth control is not one-size-fits-all. Many people who menstruate are great candidates for the pill, but there are risks, side effects, and contraindications. To determine if the combination pill is right for you, talk with a doctor.


Lacey Bourassa is a health, wellness, and beauty writer based in Southern California. She holds a BA in English. Her work has appeared in digital publications like Livestrong, Verywell, Business Insider, Eat This Not That, and others. When she’s not writing, Lacey is likely pursuing her other interests: skin care, plant-based cooking, pilates, and traveling. You can keep up with her by visiting her website or her blog.