Birth control pills - combination
Oral contraceptives use hormones to prevent pregnancy. Combination pills contain both progestin and estrogen.
Birth control pills help keep you from getting pregnant. When taken daily, they are one of the most effective methods of contraception. For most women they are extremely safe. They also have a number of other benefits. Some of these include:
- Improve painful, heavy, or irregular periods
- Treat acne
- Prevent ovarian cancer
Combination birth control pills contain both estrogen and progestin. Some combination birth control pills allow you to have fewer periods each year. These are called continuous or extended-cycle pills. Ask your health care provider about dosing options to decrease the frequency of your menstrual cycles.
Birth control pills come in packages. You take pills from a 21-pack once a day for 3 weeks, then you do not take pills for 1 week. It may be easier to remember to take 1 pill every day, so other pills come in a 28-pack of pills, with some having active pills (containing hormones) and some with no hormones.
There are 5 types of combination birth control pills. Your provider will help you choose the right one for you. The 5 types are:
- One phase pills: These have the same amount of estrogen and progestin in all the active pills.
- Two phase pills: The level of hormones in these pills changes once during each menstrual cycle.
- Three phase pills: Every 7 days the dose of hormones changes.
- Four phase pills: The dose of hormones in these pills changes 4 times each cycle.
- Continuous or extended cycle pills: These keep the level of hormones up so you have few or no periods.
- Take your first pill on the first day of your period.
- Take your first pill on the Sunday after your period starts. If you do this, you need to use another birth control method (condom, diaphragm, or sponge) for the next 7 days. This is called backup birth control.
- Take your first pill any day in your cycle, but you will need to use another birth control method for the first month.
For continuous or extended cycle pills: Take 1 pill every day, at the same time each day.
Take 1 pill every day, at the same time of day. Birth control pills only work if you take them every day. If you miss a day, use a backup method.
If you miss 1 or more pills, use a backup method of birth control and call your provider right away. What to do depends on:
- What type of pill you are taking
- Where you are in your cycle
- How many pills you missed
Your provider will help you get back on schedule.
You may decide to stop taking birth control pills because you want to get pregnant or change to another birth control method. Here are some things to expect when you stop taking the pill:
- You might become pregnant right away.
- You may have mild spotting of blood before you get your first period.
- You should get your period 4 to 6 weeks after taking your last pill. If you do not get your period in 8 weeks, call your provider.
- Your period may be heavier or lighter than usual.
- Your acne may return.
- For the first month, you may have headaches or mood swings.
Use a backup method of birth control, such as condom, diaphragm, or sponge if:
- You miss 1 or more pills.
- You are not starting your first pill on the first day of your period.
- You are sick, throwing up, or have loose stools (diarrhea). Even if you take your pill, your body may not absorb it. Use a backup method of birth control for the rest of that cycle.
- You are taking another medicine that may keep the pill from working. Tell your provider or pharmacist if you take any other medicines, such as antibiotics, seizure medicine, medicine to treat HIV, or St. John's wort. Find out if what you take will interfere with how well the pill works.
Call your provider if you have any of the following symptoms after starting to take the birth control pills:
- You have swelling in your leg
- You have leg pain
- Your leg feels warm to the touch or has changes in skin color
- You have fever or chills
- You are short of breath and it is hard to breathe
- You have chest pain
- You cough up blood
- You have a headache that gets worse, especially a migraine with aura
The pill - combination; Oral contraceptives - combination; OCP - combination; Contraception - combination; BCP - combination
Allen RH, Kaunitz AM, Hickey M, Brennan A. Hormonal contraception. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 18.
Glasier A. Contraception. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 134.
Isley MM. Postpartum care and long-term health considerations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.
Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Browse the Encyclopedia
Thanks to the plethora of options at your disposal, choosing the right birth control can feel like you’re blindfolded and trying to pin the tail on the contraceptive donkey. Even if you narrow your focus to just the pill, you still have a lot of possible choices out there. But if you do your homework—and are prepared to possibly engage in some trial and error—you can pinpoint the best birth control pill based on your needs.
First things first, there are two main kinds of birth control pills: ones with estrogen and ones without.
Birth control pills that contain a mixture of estrogen and progestin (combination pills) are the most common type out there.
So, how do combination pills work to keep you pregnancy-free? During your typical menstrual cycle, there’s a hormonal surge that triggers the release of an egg to potentially be fertilized, Justine P. Wu, M.D., a family planning expert and assistant professor in the department of family medicine within the department of obstetrics and gynecology at the University of Michigan, tells SELF.
"[Estrogen] overrides that normal hormonal surge, and because of that, there's no egg released,” says Dr. Wu, who is also a board chair member of the Association of Reproductive Health Professionals. Progestin does its part by thickening your cervical mucus to make it harder for sperm to move and thinning your uterine lining, which makes it less likely for any egg that does get fertilized to attach to it.
Different brands of combination pills can differ in many ways, including how much estrogen and progestin they contain within each 28-pill pack and how often (if at all) those levels fluctuate throughout the month. There’s also the fact that many, but not all, combination pills have placebos at the end of the month to allow for a withdrawal bleed that simulates your period. We’ll dive into why these distinctions might matter in more detail later, but for right now, just keep in mind that combination pills contain estrogen and progestin and all work in the same way across the board.
Then there are birth control pills without estrogen, which are known as progestin-only pills (also called the minipill). These come in packs of 28 active pills (no placebos) and deliver a steady dose of progestin to thicken your cervical mucus and thin your uterine lining. If you still have enough uterine lining to shed, you may experience a withdrawal bleed (your period) at some point during the month. (It won’t necessarily come in the last week of the pack the way it would with combination pills, since you take these pills every day.)
Research shows that birth control pills are over 99 percent effective at preventing pregnancy—if you use them perfectly.
With perfect use (which means taking them consistently and correctly every single time), research estimates that the birth control pill has a failure rate of 0.3 percent. This indicates that fewer than one woman out of every 100 will get pregnant in the first year of taking birth control pills perfectly. When you incorporate human error (which researchers refer to as “typical use”), the failure rate for birth control pills is thought to be about 9 percent, according to the Centers for Disease Control and Prevention, meaning nine out of every 100 women getting pregnant in the first year of taking the pill this way.
Are Low-Dose Birth Control Pills Right for You?
Birth control pills have been the leading method for preventing pregnancy in the United States since they were approved by the U.S. Food & Drug Administration (FDA) in 1960. They’re effective, readily accessible, and inexpensive.
Birth control pills are generally considered safe for most women. While they do have some risks, newer low-dose birth control pills can reduce those risks.
Most birth control pills today are considered low-dose. This includes both combination pills (estrogen and progestin) and the minipill (progestin only).
Low-dose pills contain 10 to 30 micrograms (mcg) of the hormone estrogen. Pills that only have 10 mcg of estrogen are classified as ultra-low-dose. Estrogen is in most birth control pills, and it’s linked to an increased risk of health problems, such as blood clots and stroke.
The exception is the minipill. It’s available in only one dose that contains 35 mcg of progestin.
Birth control pills that aren’t low dose may contain up to 50 or so mcg of estrogen. These are rarely used today, as lower doses are available. By comparison, the first pill to enter the market contained .
How birth control pills work
The hormones estrogen and progesterone signal your body to produce eggs and prepare for pregnancy.
If a sperm doesn’t fertilize the egg, the levels of these hormones fall steeply. In response, your uterus sheds the lining that had built up. This lining is shed during your period.
Birth control pills contain either a combination of synthetic estrogen and synthetic progesterone or synthetic progesterone alone. This manmade version of progesterone is also known as progestin.
Estrogen and progestin work in different ways to prevent pregnancy. Both work to prevent the pituitary gland from producing hormones that trigger ovulation.
Progestin also thickens your cervical mucus, making it harder for sperm to reach any released eggs. Progestin thins the uterine lining as well. This makes it harder for an egg to implant there if the sperm fertilizes it.
Low-dose combination birth control pills
Combination birth control pills contain estrogen and progestin. When they’re taken correctly, combination birth control pills are 99.7 percent effective in preventing unwanted pregnancy. With typical use, such as missing a few doses, the failure rate is about .
Common brands of low-dose birth control pills include:
- Apri (desogestrel and ethinyl estradiol)
- Aviane (levonorgestrel and ethinyl estradiol)
- Levlen 21 (levonorgestrel and ethinyl estradiol)
- Levora (levonorgestrel and ethinyl estradiol)
- Lo Loestrin Fe (norethindrone acetate and ethinyl estradiol)
- Lo/Ovral (norgestrel and ethinyl estradiol)
- Ortho-Novum (norethindrone and ethinyl estradiol)
- Yasmin (drospirenone and ethinyl estradiol)
- Yaz (drospirenone and ethinyl estradiol)
Lo Loestrin Fe is actually considered an ultra-low-dose pill, as it only contains 10 mcg of estrogen.
Low-dose progestin-only birth control pills
The progestin-only pill is often called a “minipill.” This type of birth control is also 99.7 percent effective when taken correctly. The typical failure rate is about .
If you miss a dose or don’t take the minipill at the same time each day, your chance of becoming pregnant is greater than it would be if you used low-dose combination pills. When minipills aren’t taken correctly, their effectiveness becomes even lower.
Although minipills can produce side effects, particularly bleeding or spotting between periods, the side effects often improve or disappear after a few months. The minipills can also shorten the length of your period.
Common brands of low-dose progestin-only birth control pills include:
These pills contain a form of progesterone called norethindrone.
Effects of low-dose minipills
Progestin-only pills may be a good option if you have risk factors that prevent you from taking estrogen, such as smoking or a history of heart disease.
There are other advantages of low-dose progestin-only pills:
- You can take them if you’re breastfeeding.
- They reduce your risk of endometrial cancer or PID.
- You may have fewer periods.
- You may experience less cramping.
The disadvantages of low-dose progestin-only pills can include:
- spotting between periods
- periods that are more irregular
Other side effects include:
- weight gain
- sore breasts
- ovarian cysts
Pain, the pill, and sex
A study of nearly 1,000 women at New York University Langone Medical Center found that women taking low-dose birth control pills were more likely to experience pain and discomfort during sex than women taking standard birth control pills.
If you take your birth control pills at the same time every day, a low-dose or progestin-only birth control pill may be right for you.
Most doctors recommend progestin-only pills if you’re breastfeeding. The minipill is often used in this case because it contains only progestin.
If you aren’t as diligent about taking your pills at the same time every day, you may find that alternative options such as the contraceptive implant, injection, or intrauterine devices are a better option.
Talk with your doctor about your health history and your birth control goals. Together, you can select the best birth control option for you.
The best birth control pill for you: A guide to contraceptive options
Since it was first legalized in the U.S. in the 1960s, the birth control pill has become one of the most popular forms of female contraception. Sixty percent of all women of childbearing years are estimated to use some type of birth control to avoid pregnancy. Many women opt to use birth control pills thanks to their ease of use, availability, safety, limited side effects, additional health benefits, and effectiveness.
Types of birth control pills
Birth control pills contain synthetic versions of hormones, estrogen and progestin, that your body produces naturally. Which specific pill is best for you depends on your body’s needs, plus the recommendation of your healthcare provider.
Here’s a brief explanation of the various types of pills on the market:
- Combination pills: Taken orally at the same time each day, combination pills regulate your menstrual cycle with a blend of the hormones estrogen and progestin.
- Extended cycle pills: A combination pill that contains both estrogen and progestin, these pills are designed to allow for longer menstrual cycles. For example, instead of having twelve periods per year, a female on an extended cycle pill will have her period every twelve weeks, so only four periods a year.
- Progestin-only pills:Also called the minipill, this birth control pill only contains the hormone progestin (a synthetic version of the natural hormone, progesterone). Like combination pills, it is taken orally daily.
- Low-dose pills:Available as both combination or progestin-only, low-dose pills contain a lower dose of hormones. Just as effective as high-dose pills, low-dose pills are believed to cause fewer side effects.
- Emergency contraception:Unlike other pills, these are used after sexual intercourse to prevent pregnancy, usually in the case of unprotected sex or a broken condom. There are various types, including combination, progestin-only and antiprogestin pills.
What is the best birth control pill?
It’s no secret, everyone’s body is different. That’s why, in order to determine the right birth control pill for you, you’ll need to have an open conversation with your doctor or gynecologist. There are many factors to consider when choosing a birth control pill, including your health history, how you respond to treatment, and your lifestyle and preferences. The journey to finding the best birth control pill for you can often take some trial and error and requires an open dialogue with your physician.
Combination birth control pills
Combination pills are a blend of two hormones, estrogen and progestin, typically taken once a day at the same time each day. The combination birth control pill prevents pregnancy in three ways:
- Preventing sperm from reaching the egg and fertilizing it. Sperm is stopped thanks to a thickening of cervical mucus.
- Suppressing ovulation. If eggs are not released, they are not there to be fertilized.
- Thinning the uterus’ endometrial lining so if an egg is fertilized, it cannot implant.
There are four types of combination pills currently on the market in the U.S: conventional combination pills, extended cycle combination pills, monophasic combination pills, and multiphasic combination pills. The conventional combination pill contains the two hormones estrogen and progestin, and follows a standard dosing schedule. This generally includes 21 days of the active pill along with seven pills that are inactive. This means that you’ll get your period each month when you take your inactive pills. When a combination pill contains the same amount of estrogen and progestin in each pill, it’s called monophasic. When the hormone levels vary in each combination pill to mimic a woman’s natural hormone changes through her cycle, it’s called multiphasic.
Combination birth control pills are 99% effective at preventing pregnancy if used correctly. However, if not taken perfectly, the combination birth control pill is only 91% effective. For maximum pregnancy prevention, make sure to take your pills at the same time daily and start new pill packs on time. If you want to be extra careful, use a backup method of contraception, such as condoms.
Pros of the combination pill may include the following:
- Shorter, lighter and more regular periods
- Less severe menstrual cramps
- Improved acne
- Less severe PMS
- Preventing period-related anemia (due to less intense periods)
- Reducing risk of ovarian cancer
Cons of the combination pill may include the following:
- Breast tenderness
- Breakthrough bleeding or irregular menstruation
- Nausea and weight gain
- Slight increased risk for heart attack, stroke and blood clots
- Combination birth control pills can cost anywhere from $5 to $50 a pack, depending on your script and prescription coverage. Fortunately, SingleCare can help you save on your birth control prescription. Try searching for the lowest priced options available in your area.
Popular combination birth control pills
Consider these common combination birth control pill brands as options when comparing pills for pricing and side effects:
RELATED: Yaz vs. Yasmin
Extended cycle pills
Extended cycle pills are a type of combination pill, however, they create longer cycles and are designed to be taken over longer periods of time. Unlike the standard combination birth control pill, extended cycle combination pills are typically prescribed for 12 to 13 weeks of continuous active pills followed by a full week of an inactive pill. This extended cycle pill still allows you to get your period, just less often.
Depending on your body and dosing schedule, you may only get your period three or four times a year on this pill. If you are looking to skip your period altogether, continuous dosing may be prescribed at the discretion of your healthcare provider, although some women may still experience spotting. A continuous dosing schedule includes taking a combination pill every day without taking any breaks from the hormones.
As a combination pill, the effectiveness of extended cycle pills are considered 99% effective at preventing pregnancy if used correctly. However, effectiveness drops to 91% if not taken correctly. One way to help ensure maximum pregnancy protection is to set a daily alarm on your phone that reminds you to take your pill at the same time each day, and set an alert you when to need start your new pill pack. Some women use a backup method of contraception, like condoms, if they want additional protection against pregnancy.
Advantages of extended cycle pills are much the same as for conventional combination pills, with the addition of:
- Fewer periods
- Potentially lighter, shorter periods
As a type of combination pill, cons of extended cycle pills are also similar to conventional combination pills, with the addition of:
- Potential spotting between periods
- Possibility of heavier periods
Popular extended cycle birth control pills
There are a few extended cycle birth control pills available, including:
Progestin-only birth control pills (minipills)
The minipill is a birth control pill that only contains the hormone progestin, which is a synthesized version of the naturally occurring hormone, progesterone. Unlike the combination birth control pill, the minipill does not contain estrogen.
Minipills prevent pregnancy in a similar way: it stops sperm from reaching a female egg by thickening cervical mucus. On the off chance sperm does reach and fertilize an egg, the minipill also thins the uterus’ endometrial lining so the fertilized egg cannot implant. Minipills, however, do not prevent eggs from being released as consistently as a combination pill.
Progestin-only birth control pills are oral contraceptives that are taken every day, and must be taken at the same time each day to maximize effectiveness.
The minipill is just as effective at preventing pregnancy as the combination pill (about 99%) if taken perfectly. However, because the minipill must be taken at the same time each day, it has a higher failure rate than the combination pill. If it is not taken at the same time, for example 9 a.m. Monday, then 11 a.m. on Tuesday, your risk of pregnancy is increased for about 48 hours. About 13 females in every 100 get pregnant when on the minipill, in comparison to nine in 100 women on the combination pill.
If you miss taking your scheduled dose on any day, consider abstaining from sex or use additional protection, such as a condom, over the next 48 hours or more. This added precaution can help to prevent any unplanned pregnancies during the interruption of doses.
Why would the minipill be used?
There are a few reasons why your doctor may recommend a progestin-only pill instead of the more-common combination pill. For starters, the minipill contains no estrogen, so this could be a perk if you are sensitive to this hormone. Your physician may prescribe a progestin-only pill for you if you notice that you are sensitive to the estrogen in a combination pill. You may also be prescribed the minipill if you have a family or personal history of blood clots. Lastly, your physician may prescribe the minipill if you are currently breastfeeding, as it is safe to use immediately after giving birth. As always, consult your doctor if you are breastfeeding and looking for the best birth control option for you.
Pros of the progestin-only pill may include the following:
- Safer option if you are at risk of blood clots, high blood pressure, cardiovascular concerns, or if you suffer from migraines
- Can be used if you are sensitive to estrogen
- Can be used immediately after giving birth if you are breastfeeding
- Shorter return to fertility
Cons of the progestin-only pill may include the following:
- Must be taken at the same time daily in order to be effective
- Slightly higher failure rate than the combination pill
- Like the combination pill, minipills can cost up to $50 a month. Consider looking into how much you could save on your minipill with SingleCare.
Popular progestin-only birth control pills
Consider these common minipill brands as birth control options when comparing pills for pricing and side effects:
Low-dose birth control pills are a type of combination pill that have, as the name suggests, lower hormone levels. Specifically, low-dose pills have 35 micrograms or less of estrogen, while ultra-low-dose pills have 20 micrograms or less of estrogen. The decreased levels of estrogen prevent common side effects like headache, nausea, and tender breasts while maintaining effectiveness.
They work the same way as regular combination pills by preventing ovulation, sperm reaching an egg, and the inability for a fertilized egg to implant due to thinning of the uterus’ endometrial lining.
One of the reasons low-dose pills have become so popular over the last 20 years is because they are just as effective at preventing pregnancy and regulating menstrual cycles as their high-dose counterparts. With typical use, low-dose pills are 91% effective. When used perfectly, they can be more than 99% effective in preventing pregnancy.
Why would the low-dose birth control be prescribed?
Due to their effectiveness and reduced side effects, the majority of birth control pills prescribed today are considered low dose. As the low-dose pill contains lower levels of estrogen, your doctor may prescribe it if you have an estrogen sensitivity.
If you think you’ll struggle to take the pill at the exact same time each day, as required with the progestin-only minipill, a low-dose birth control pill may be recommended as an alternative, as there is a slightly larger window for when you take it daily.
If your doctor does recommend you try a low-dose pill, here are some pros:
- Reduced estrogen-related side effects
- Less side effects than higher-dose pills
- Less severe menstrual cramping and PMS
- Reduction of acne
- Reduced risk of ovarian cancer
- Period regulation
As with most medications, there are some potential side effects and cons to using a low-dose birth control pill:
- Slight risk of increased blood pressure
- Rare potential for blood clots and deep vein thrombosis
- Spotting between periods
Popular low-dose pills
Many of the pills available today are low-dose. Here are some of the most common and popular brand names, with many generic versions also available:
- Levlen 21
Emergency Contraception Pill
Emergency contraception pills, otherwise known as the morning after pill, are used by women after having unprotected sex, or if a condom breaks. In the U.S. the most common morning after pills, available to purchase over-the-counter at pharmacies without I.D., are levonorgestrel pills. Levonorgestrel is a type of progestin hormone. Although many brands are available, they work in the same way: they prevent the release of an egg from the ovary or preventing fertilization of the egg by sperm. Morning after pills should not be used on a regular basis to prevent pregnancy, but instead as an emergency contraceptive or backup in case regular birth control fails or is used incorrectly.
When should emergency contraception be used?
Emergency contraception should be used after unprotected sex, or when another birth control method, like condoms, failed or were used incorrectly. It’s generally advised to take a morning after pill as soon as you can after sex. You can take a levonorgestrel (Plan B, My Way, AfterPill, Take Action) up to five days after unprotected sex, however the longer you wait, the less effective it becomes.
Although levonorgestrel morning after pills are the most common in America, if you’re over 155 pounds, you may be advised to try another option like ella (30 mg of ulipristal acetate). This is a prescription only option however, and may make your hormonal birth control ineffective. In some cases, your doctor may recommend a copper IUD, which can then also be used going forward (up to ten years) as an effective birth control method.
Effectiveness of emergency contraception?
The effectiveness of the morning after pill varies depending on how quickly you take it after having unprotected sex. For example, if you take Plan B One-Step within 24 hours, it is about 95% effective, however if taken within three days of unprotected sex, the morning after pill can reduce the chance of pregnancy by 75-89%
Advantages of emergency contraception
- Available over the counter
- No I.D. required
- Can be purchased by persons of any gender
- Highly effective
- Little to no side effects
- Single dose
Disadvantages of emergency contraception
- No serious side effects have been reported
- Vomiting within two hours of taking the pill will render it ineffective
- May not be suitable for women taking medication for liver problems, epilepsy, or severe asthma
Popular emergency contraception
There are a number of emergency contraception options available, including:
Frequently asked questions about birth control pills
What is the safest contraception pill?
Generally, low-dose birth control pills, be it combination or progestin-only minipill, are considered safest as they are associated with the lowest risk of causing blood clots.
What is the difference between 21- and 28-day birth control?
The only difference between the 21- and 28-day birth control pill is that the 28-day includes either seven inactive “sugar” pills or seven iron pills.
Which birth control pill does not cause weight gain?
Although some women report weight gain from various types of hormonal contraception, studies, including this one, indicate no sign of weight can when using a low-dose birth control pill.
What is the best birth control pill for acne?
Only three types of contraceptive pill have been approved by the FDA to treat acne. These are all combination pills: Ortho Tri-Cyclen, Yaz, and Estrostep.
When should I take birth control pills?
For birth control pills to be most effective, you should take one pill at the same time each day.
Who shouldn’t take birth control?
If the following risk factors resonate with you, it is not recommended that you take any birth control that contains estrogen as it can increase the risk of clots, strokes, and heart attack.
- You are over 35 years of age and smoke.
- You are scheduled to have surgery that will reduce your mobility for extended periods.
- You have a history of heart disease, deep vein thrombosis, or pulmonary embolism.
Which birth control method is most effective?
The most effective birth control method is abstinence; however, this may not be the preferred method for many. Alternatively, the most effective birth control options are the implant (Nexplanon coupons | Nexplanon details) and IUDs (intrauterine device), especially when paired with a condom.
The implant is a small device that is inserted into your arm and slowly releases the hormone progestin into your body. It lasts for up to four years.
Non-hormonal and hormonal IUDs are available as small devices. The IUD is placed into your uterus, lasting up to 12 years.
Implants and IUDs are considered more effective than the pill as there is no human error in remembering to take your medication. If taken perfectly, the contraceptive pill (combination birth control pill or the minipill), shot (Depo-Provera coupons | Depo-Provera details), vaginal ring (NuvaRing coupons| NuvaRing details), and patch (Xulane coupons | Xulane details) can all be highly effective. Speak to your doctor about which method will work with your medical history and lifestyle.
Remember that birth control pills only protect from pregnancy. They do not protect against sexually transmitted infections or diseases. That’s why it’s always recommended to use them in conjunction with condoms.
Birth control mild
Low-dose birth control: Everything you need to know
Low-dose birth control is a type of hormonal birth control that contains lower amounts of hormones than some older, traditional pills.
For some people, low-dose pills may cause fewer side effects and offer more health benefits than higher-dose pills. Some low-dose pills contain both estrogen and progestin, while others contain only progestin.
In this article, learn about the oral types of low-dose birth control. We also cover the risks and side effects of this type of medication.
Most birth control pills contain a combination of estrogen and progestin.
Progestin is a synthetic form of the natural hormone progesterone. Together, the two hormones regulate the menstrual cycle and prevent pregnancy.
Low-dose birth control pills come in two forms. Combination pills use both estrogen and progestin, but provide lower doses of estrogen than traditional pills. Progestin-only pills only contain synthetic progesterone.
Combination low-dose birth control
Combination pills contain 10–35 micrograms (mcg) of estrogen, while higher-dose pills contain 50 mcg or more.
Doctors rarely prescribe high-dose combination pills because the low-dose pills work just as well and cause fewer side effects. Numerous brands and generic forms of combination pills are available.
Some combination pill brand names include:
People usually take 21 active pills followed by either a 7-day break or 7 pills without hormones. They will usually get their period during the week without hormones.
Progestin-only low-dose birth control
A pack of progestin-only pills, or minipills, contains 28 active pills. It is critical to take the pill at the same time each day. When people take minipills according to this schedule, they are as effective as combination pills.
A doctor may recommend progestin-only pills for people who are breast-feeding or approaching menopause. People who cannot tolerate estrogen may also wish to use a minipill.
About 40 percent of people who use progestin-only pills continue to ovulate. This means that these pills affect the body in other ways to prevent pregnancy.
The minipill is also available in both generic and brand-name form. Some progestin-only pill brand names include:
Low-dose birth control may be a better option for people who experience intolerable side effects from high doses of estrogen.
Low-dose birth control also offers some health benefits, including:
The minipill can also be beneficial for people who cannot take traditional pills containing estrogen.
Low-dose combination birth control should be just as effective as birth control containing higher estrogen levels.
It is essential to take birth control pills at the same time each day and not miss a dose. Failing to take the pills at the same time can increase the risk of pregnancy. This risk is higher with minipills.
Low-dose birth control poses fewer health risks than birth control that uses high levels of estrogen. This is because high doses of estrogen are more likely to cause side effects.
Estrogen slightly increases the risk of heart health issues and may raise blood pressure. Very rarely, it can cause a blood clot to form in a vein, usually in the leg, which is called deep vein thrombosis (DVT).
The blood clot can break loose and travel to other areas of the body, potentially causing a life-threatening embolism.
The risk of estrogen-related cardiovascular health problems is higher in people who:
People who use low-dose birth control are less likely than those using high-estrogen pills to experience heart health issues.
The long-term use of hormonal birth control may a person’s risk of certain cancers, including breast and cervical.
However, some research shows that the risk of cervical cancer in people who use birth control drops after 10 years of use. It is also worth noting that the in people who have used birth control.
Some other risks of low-dose birth control include:
The risk of developing these issues depends on many factors, including lifestyle and family medical history. So it is important to discuss the risks and benefits of oral contraceptives with a healthcare provider.
Side effects are common with all hormonal birth control pills, although some people report fewer side effects with progestin-only pills.
The most common side effects include:
- changes in sleep
- bleeding between periods, especially initially
- sore breasts
- changes in libido
Many people find that the side effects disappear after a few months as the body adjusts to the new hormones.
When to switch birth control methods
Finding the right form of birth control is a process of trial and error. Many people find that hormonal birth control reduces the pain of period cramps and regulates the menstrual cycle.
However, it is common to have to try several different types or brands of pill before finding one with manageable side effects. Some people find that they are not able to tolerate hormonal birth control in any form.
Many non-hormonal options are available, including the copper intrauterine device (IUD), condoms, a diaphragm, and spermicidal lubricants. If people are interested in permanent contraception, they can discuss surgical options with a doctor.
People can also speak to a doctor about switching birth control types whenever the side effects feel intolerable, or the risks seem too large.
Switching birth control type might be beneficial for people who are:
- continuing to experience side effects that are no better after 2–3 months
- having side effects that are unbearable or interfere with daily functioning
- living with a medical condition, such as lupus, liver disease, or cardiovascular disease, that may worsen the side effects of birth control
- smoking while using hormonal birth control
- having migraines while using birth control, especially those with aura
Numerous safe and effective options can prevent pregnancy. Hormonal contraceptives are about 91 percent effective with typical use, which is imperfect. With perfect use, they are more than 99 percent effective.
People who want to avoid pregnancy may wish to consider adding a backup method of contraception, such as condoms.
The most suitable birth control method may vary as a person ages or experiences changes to their health or hormonal levels. Monitoring side effects is especially vital for people who use birth control for reasons other than preventing pregnancy.
It is best to talk to a doctor about all birth control options. It is essential to be clear about any side effects and to raise any queries or concerns.
Birth Control Pill
What Is It?
The birth control pill (also called "the Pill") is a daily pill that contains hormones to change the way the body works and prevent pregnancy. Hormones are chemical substances that control the functioning of the body's organs. In this case, the hormones in the Pill control the ovaries and the uterus.
How Does It Work?
Most birth control pills are "combination pills" containing a mix of the hormones estrogen and progesterone to prevent ovulation (the release of an egg during the monthly cycle). A woman cannot get pregnant if she doesn't ovulate because there is no egg to be fertilized.
The Pill also works by thickening the mucus around the cervix, which makes it difficult for sperm to enter the uterus and reach any eggs that may have been released. The hormones in the Pill can also sometimes affect the lining of the uterus, making it difficult for an egg to attach to the wall of the uterus.
How Is the Pill Taken?
Most combination pills come in either a 21-day pack or a 28-day pack. One hormone pill is taken each day at about the same time for 21 days. Depending on your pack, you will either stop taking birth control pills for 7 days (as in the 21-day pack) or you will take a pill that contains no hormones for 7 days (the 28-day pack). A woman has her period when she stops taking the pills that contain hormones. Some women prefer the 28-day pack because it helps them stay in the habit of taking a pill every day.
There is also a type of combination pill that decreases the frequency of a woman's period by supplying a hormone pill for 12 weeks and then inactive pills for 7 days. This decreases the number of periods to one every 3 months instead of one every month.
Another kind of pill that may change the number of monthly periods is the low-dose progesterone pill, sometimes called the mini-pill. This type of birth control pill differs from the other pills in that it only contains one type of hormone — progesterone — rather than a combination of estrogen and progesterone. It works by changing the cervical mucus and the lining of the uterus, and sometimes by affecting ovulation as well. The mini-pill may be slightly less effective at preventing pregnancy than combination pills.
The mini-pill is taken every day without a break. A girl who is taking it might have no period at all or she may have irregular periods. For the minipill to work, it must be taken at the same time every day, without missing any doses.
Any type of birth control pill works best when it is taken every single day at the same time of day, regardless of whether a girl is going to have sex. This is especially important with progesterone-only pills.
For the first 7 days of taking the Pill, a girl should use an additional form of contraception, such as condoms, to prevent pregnancy. After 7 days, the Pill should work alone to prevent pregnancy. This timing can vary based on the type of Pill and when you start taking it — so be sure to talk about it with your doctor. Also, it's important to continue using condoms to protect against sexually transmitted diseases (STDs).
If pills are skipped or forgotten, a girl is not protected against pregnancy and she will need a backup form of birth control, such as condoms. Or she will need to stop having sex for a while. Do not take a friend's or relative's pills.
How Well Does It Work?
Over the course of 1 year, about 9 out of 100 typical couples who rely on the Pill to prevent pregnancy will have an accidental pregnancy. Of course, this is an average figure and the chance of getting pregnant depends on whether you take your birth control pills every day. The Pill is an effective form of birth control, but even missing 1 day increases the chance of getting pregnant.
In general, how well each type of birth control method works depends on a lot of things. These include whether a person has any health conditions or is taking any medicines or herbal supplements that might interfere with its use (for example, an herb like St. John's wort can affect how well the Pill works). Talk to your doctor to check if anything you take could affect how the Pill works for you.
How well a particular method of birth control works also depends on whether the method chosen is convenient — and whether the person remembers to use it correctly all the time.
Protection Against STDs
The birth control pill does not protect against STDs. Couples having sex (or any intimate sexual contact) must always use condoms along with the Pill to protect against STDs.
Abstinence (the decision to not have sex or any intimate sexual contact) is the only method that always prevents pregnancy and STDs.
Possible Side Effects
The birth control pill is a safe and effective method of birth control. Most young women who take the Pill have none to very few side effects. The side effects that some women have while on the Pill include:
- irregular menstrual bleeding (more common with the mini-pill)
- nausea, headaches, dizziness, and breast tenderness
- mood changes
- blood clots (rare in women under 35 who do not smoke)
Some of these side effects improve over the first 3 months on the Pill. When a girl has side effects, a doctor will sometimes prescribe a different brand of the Pill.
The Pill also has some side effects that most girls are happy about. It usually makes periods lighter, reduces cramps, and is often prescribed for women who have menstrual problems. Taking the combination Pill often improves acne, and some doctors prescribe it for this purpose. Combination birth control pills have also been found to protect against some forms of breast disease, anemia, ovarian cysts, and ovarian and endometrial cancers.
Who Uses It?
Young women who can remember to take a pill each day and who want excellent protection from pregnancy use birth control pills.
Not all women can — or should — use the Pill. In some cases, medical or other conditions make the use of the Pill less effective or more risky. For example, it is not recommended for women who have had blood clots, certain types of cancers, or some migraine headaches. It also might not be recommended for girls who have had unexplained vaginal bleeding (bleeding that is not during their periods) or who think they might be pregnant.
Girls who are interested in learning more about different types of birth control, including the Pill, should talk to their doctors or other health professionals.
How Do You Get It?
A doctor or a nurse practitioner (NP) must prescribe the Pill. He or she will ask about a girl's health and family medical history, and do a complete physical exam, which might include a pelvic exam. If the doctor or NP prescribes birth control pills, he or she will explain when to begin taking the Pill and what to do if pills are missed.
The doctor or NP will usually ask the girl to come back in a few months to have her blood pressure checked and to see if she is having any problems.
After that, girls who are having sex should get routine exams every 6 months to a year, or as recommended.
How Much Does It Cost?
The Pill usually costs between $0 and $50 a month, depending on the type. Many health and family planning clinics (such as Planned Parenthood) sell birth control pills for less. In addition, birth control pills and doctor visits are covered by many health insurance plans.
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Low Dose Birth Control Might Be the Wonder Pill You’ve Been Searching For
Birth control pills are hands down our fave invention of the 20th century. (Yeah, we’re including TV and the Internet in that statement.)
Not only do they prevent unwanted pregnancy, but they regulate your menstrual cycle, ease cramps, slow a heavy flow, and help clear up acne. Damn.
However, not all birth control pills work well for everyone. Some people get gnarly side effects, especially when the hormones are at higher doses. For that reason, your healthcare provider may prescribe you what’s called low-dose birth control.
Intrigued? Let’s take a close look at low-dose birth control, what it does, and how you can decide what’s right for you.
Diet BC: What is it and how does it work?
Birth control pills contain hormones that stop ovulation (aka prevent eggs from being released every month) and thicken cervical mucus, making it more difficult for sperm to reach an egg.
Let’s quickly recap how the menstrual cycle works:
- The hormones estrogen and progesterone regulate your menstrual cycle. They’re busy all month getting an egg ready to be fertilized.
- The lining of your uterus preps itself in the possibility an egg will implant there.
- The egg is released from your ovaries.
- When the released egg is not fertilized by sperm, your uterine lining sheds. That’s called your period.
Any type of hormonal birth control will affect your menstrual cycle. But since we’re focusing on low-dose birth control here, let’s zero in on the two main types: combination and the “minipill.”
- Combination low-dose birth control has small amounts of synthetic estrogen and progesterone.
- The minipill contains only synthetic progesterone. It may be prescribed if you have risk factors that prevent you from taking estrogen (such as smoking).
In order for any low-dose birth control to work effectively, you must take each dose daily at the same time to prevent pregnancy.
What does “low dose” actually mean, though?
As the name implies, low-dose birth control contains lower doses of hormones than traditional BC pills. Most fall between 10 and 30 micrograms of estrogen and around 35 micrograms of progesterone.
The minipill contains 35 micrograms of progesterone and no estrogen.
When birth control pills first came onto the scene in 1960, they had what we could consider today to be super high levels of hormones. The first version had 150 micrograms of estrogen and 9.85 milligrams of progesterone.
In newer versions of the pill, estrogen levels are between 20 and 50 micrograms, and progesterone levels are between .01 and 3.0 milligrams.
Those early birth control pills gave women more control of their bodies. It was a societal game changer for sure. But that freedom came with some serious side effects: heart attacks, blood clots, and stroke.
Since then, researchers have found you don’t need big doses of hormones to prevent pregnancy, leading to today’s version of the pill.
Is low-dose birth control less effective than traditional BC pills?
Low-dose birth control is very effective. When it’s taken correctly — that is, every single day — it has a 91 percent success rate, according to Planned Parenthood. Just set an alarm on your phone and you’re set!
To explain how, let’s go back to your menstrual cycle. Pregnancy happens when your ovaries release an egg, which is called ovulation. That egg gets fertilized by sperm and implanted in your uterus. Low-dose birth control interrupts this process in a couple of ways.
- The hormones in birth control pills tell your pituitary gland (which controls your hormones) not to release the hormones that trigger ovulation. No egg = no pregnancy.
- They also thicken the mucus on the cervix, so sperm have a harder time fighting their way through. Sorry, little buddies!
The exception to the above is the minipill, which rather than preventing ovulation, works by thinning the lining of your uterus and thickening cervical mucus to keep sperm out and prevent implantation.
And voila. That’s how you prevent pregnancy.
Is low-dose BC right for you?
Reasons why low-dose birth control rocks
One of the best perks? Your chance of serious side effects is low, because of the low dose of hormones. This is especially true of the progesterone-only minipill, since estrogen is the culprit for most of the risks and side effects.
What else can low-dose birth control do for you?
- It can help reduce acne, cystic breasts and ovaries, and iron deficiency (anemia).
- It reduces PMS symptoms, likely meaning lighter cramps. (Hell yeah!)
- It can regulate irregular periods and make periods lighter.
- If you want to get pregnant, you can just stop taking the pill.
- Helps people who deal with PMDD or menstrual migraines.
- Can help those with endometriosis.
- Helps decrease risk of ovarian and endometrial cancer.
Reasons to stay clear of low-dose birth control
Alas, there are downsides to low-dose birth control, too. The biggest one is that you must take it every day for it to effectively prevent pregnancy. There’s no wiggle room on this one.
Other downsides include:
- Some people have side effects like decreased libido, headaches, bloating, nausea, or breast tenderness. The good news is these may lessen over time.
- All birth control pills come with a risk of heart attack, blood clots, or strokes. People who smoke or have certain medical conditions are more likely to have these side effects.
- The minipill can cause spotting (bleeding a bit between periods).
Additionally, certain medications decrease the effectiveness and make you vulnerable to an unwanted pregnancy. These include:
If you take any of these above medications, your healthcare provider might suggest another way for you to prevent pregnancy.
Different types of low-dose birth control pills
You can take your low-dose birth control in different dosages. There are two types of dosing: conventional and continuous/extended cycle.
Conventional dosing most closely follows your typical 28-day menstrual cycle. You take pills that contain hormones (“active” pills) for 3 weeks, and then pills without hormones (“inactive” pills) for 1 week.
You’ll get your period during that week of inactive pills. Taking inactive pills during the week of your period keeps you in the habit of taking a pill every single day.
Continuous dosing, or extended cycle dosing, stretches out the time between periods. For some brands, like Seasonale, you take active pills for 12 weeks and then inactive pills for 1 week. That means you only get a period every 3 months!
Other brands have 365 pills, so you take one every day for a year and do not have a period.
Extended cycle dosing can be especially good for people who get unusually heavy periods or experience severe PMS. We have to admit, fewer periods sounds really great.
What are some brands of low-dose birth control?
There are oh so many options to consider! Here’s a list of low-dose birth control pills that your healthcare provider may consider:
- Levlen 21
- Lo Loestrin Fe
OK, so what’s the fine print?
We’re glad you asked! Here’s a few questions to ask yourself.
Is low-dose birth control safe for someone with my health history?
Hormone based birth control isn’t for everyone. Some risk factors are blood clots, breast cancer or other cancers, high blood pressure, a heart condition or diabetes.
Make sure you share your entire health history with your healthcare provider, so they can determine the best contraception for you.
What if I smoke? Or I’m not so reliable about taking pills?
Smoking while on birth control pills that contain estrogen is a big no-no, because it increases the risk of having a heart attack. The risk is especially high if you’re 35 or older. Taking oral contraception and smoking also increases your risk for having a stroke.
Taking a daily pill might not be a good lifestyle fit if you’re forgetful (it happens!) or your lifestyle is chaotic. Be honest with yourself: Will you really take the pill every single day at about the same time every day?
It’s totally OK if taking birth control wouldn’t work for you. There are plenty of other contraceptive options out there.
Do I want to get pregnant soon?
You can get down to baby-making quickly after stopping low-dose birth control pills. You simply stop taking the pills! Birth control pills are easier to stop taking than getting implants (Nexplanon) and IUDs (Kyleena, Liletta, Mirena, Skyla) removed.
How to talk with your doctor about going on the pill
Maybe you’re looking for reliable birth control. Or maybe you have irregular or very heavy periods, bad PMS, or acne. No matter your reason for wanting to go on low-dose birth control, here’s what to share with your doctor:
- your age
- a list of medications you currently take
- your health history, including whether you smoke
- your ability to take a pill at the same time every day
- any plans to get pregnant
If your healthcare provider says the pill isn’t right for you, don’t fret. There are many other options.