Birth control pills are medications that help prevent pregnancy. They contain synthetic hormones. Some pills contain estrogen and progestin, others only progestin.

Several types of birth control pills are available. Everyone has different needs, so it is important to speak with a healthcare professional about the different options.

Birth control pills typically contain progestin, estrogen, or a combination.

Keep reading to learn about the different birth control pill options and their advantages and disadvantages.

Combined birth control pills contain both progestin and estrogen. Different pills can help a person avoid pregnancy by preventing ovulation, thickening the cervical mucus, and thinning the uterus lining called the endometrium.

Progestin-only pills prevent pregnancy by thickening the cervical mucus, making it difficult for sperm to enter the uterus. They also thin the endometrium. About 40% of people who use progestin-only pills continue to ovulate.

Most commercially available oral birth control pills contain a combination of estrogen and progestin.

Each birth control pill brand may contain different dosages of estrogen and different types of progestin. A doctor can help a person decide which option is best for them.

According to a 2015 journal article, most combination birth control pills contain ethinylestradiol, and dosages vary between 20–35 micrograms (mcg).

Types of progestin in combination pills

Combination birth control pills contain different types of progestin. Manufacturers list the dosage in milligrams (mg) or mcg.

Progestin can cause increased water and salt retention, leading to bloating.

Some progestins act as androgens. High levels of androgens can play a role in acne and excess hair growth. This may concern someone who wants to use a birth control pill to help reduce acne or excess hair growth. However, not all birth control pills cause these side effects.

Currently, no data indicate that any pill is more effective than another at reducing acne or excess hair growth.

Desogestrel

Some people may prefer a birth control pill containing the progestin desogestrel. It may help reduce excess hair growth and acne somewhat better than other pills.

Combination birth control pills that contain desogestrel include:

  • Apri (150 mcg desogestrel, 30 mcg ethinylestradiol)
  • Azurette (150 mcg desogestrel, 20 mcg ethinylestradiol)
  • Kariva (150 mcg desogestrel, 20 mcg ethinylestradiol)
  • Mircette (150 mcg desogestrel, 20 mcg ethinylestradiol)
  • Reclipsen (150 mcg desogestrel, 30 mcg ethinylestradiol)

Some birth control pills contain the same drugs in the same dosages but have different names. For example, a doctor may prescribe Azurette and Kariva or Reclipsen and Apri interchangeably because they contain the same active ingredients.

Desogestrel birth control may cause symptoms associated with hormonal birth control, such as a headache, upset stomach, mood changes, weight gain, high blood pressure, and an increased risk of blood clots.

The medication a doctor recommends may depend on insurance coverage and drug availability.

Drospirenone

Some people prefer birth control pills containing progestin drospirenone because they have diuretic properties, which help prevent bloating.

According to the Food and Drug Administration (FDA), drospirenone may increase the risk of blood clots. However, according to The American College of Obstetricians and Gynecologists (ACOG), this risk is low.

A 2012 study found that drospirenone may also help treat premenstrual dysphoric disorder (PMDD), a severe type of premenstrual syndrome.

Birth control brands that contain drospirenone include:

  • Gianvi (3 mg drospirenone, 20 mcg ethinylestradiol)
  • Loryna (3 mg drospirenone, 20 mcg ethinylestradiol)
  • Ocella (3 mg drospirenone, 30 mcg ethinylestradiol)
  • Syeda (3 mg drospirenone, 30 mcg ethinylestradiol)
  • Yasmin (3 mg drospirenone, 30 mcg ethinylestradiol)
  • Yaz (3 mg drospirenone, 20 mcg ethinylestradiol)
  • Zarah (3 mg drospirenone, 30 mcg ethinylestradiol)

Levonorgestrel

Birth control pills containing levonorgestrel appear to have a lower risk of side effects, such as blood clots, than pills containing other types of progestin.

However, there is always the risk of some side effects with hormonal birth control.

Doctors consider pills containing levonorgestrel and ethinylestradiol to be an effective first-line treatment.

Pills that contain levonorgestrel include:

  • Aviane (100 mcg levonorgestrel, 20 mcg ethinylestradiol)
  • Lessina (100 mcg levonorgestrel, 20 mcg ethinylestradiol)
  • Levora (150 mcg levonorgestrel, 30 mcg ethinylestradiol)
  • Lutera (100 mcg levonorgestrel, 20 mcg ethinylestradiol)
  • Portia (150 mcg levonorgestrel, 30 mcg ethinylestradiol)
  • Sronyx (100 mcg levonorgestrel, 20 mcg ethinylestradiol)

Norethindrone

Norethindrone is a progestin that comes from testosterone.

People who take birth control pills containing norethindrone may experience side effects such as excess hair growth and acne. If this occurs, a doctor may recommend a different birth control pill.

Birth control pills that contain norethindrone include:

  • Balziva (400 mcg norethindrone, 35 mcg ethinylestradiol)
  • Junel 1/20 (1 mg norethindrone, 20 mcg ethinylestradiol)
  • Junel 1.5/30 (1.5 mg norethindrone, 30 mcg ethinylestradiol)
  • Loestrin 1/20 (1 mg norethindrone, 20 mcg ethinylestradiol)
  • Loestrin 1.5/30 (1.5 mg norethindrone, 30 mcg ethinylestradiol)
  • Microgestin 1/20 (1 mg norethindrone, 20 mcg ethinylestradiol)
  • Necon (500 mcg norethindrone, 35 mcg ethinylestradiol)
  • Nortrel 0.5/35 (500 mcg norethindrone, 35 mcg ethinylestradiol)
  • Nortrel 1/35 (1 mg norethindrone, 35 mcg ethinylestradiol)
  • Ortho-Novum 1/35 (1 mg norethindrone, 35 mcg ethinylestradiol)

Norgestimate and norgestrel

People who use birth control pills containing norgestimate or norgestrel may also experience androgenic side effects, such as excess hair growth and acne.

Some brands containing these hormones include:

  • Cryselle (300 mcg norgestrel, 30 mcg ethinylestradiol)
  • Ortho-Cyclen (250 mcg norgestimate, 35 mcg ethinylestradiol)
  • Previfem (250 mcg norgestimate, 35 mcg ethinylestradiol)
  • Sprintec (250 mcg norgestimate, 35 mcg ethinylestradiol)

Each packet of extended cycle pills, such as Seasonique, contains 12 weeks of combined hormonal birth control. Packets also contain 1 week of placebo or low-dose ethinylestradiol.

Some people prefer this approach because it means they only get a period every 3 months. People wishing to delay their period longer using this method can do so safely for up to 12 months.

As with other birth control pills, extended cycle pills also come with a risk of side effects.

Each packet of triphasic birth control contains 21 days of pills containing different dosages of estrogen and progestin each week.

An example of a triphasic pill is Ortho-Tri-Cyclen. Each pill contains 35 mcg of ethinylestradiol. The dosage of norgestimate increases each week, imitating the natural changes of hormones throughout the menstrual cycle.

Triphasic birth control aims to reduce side effects by mimicking the natural fluctuation of hormones throughout the menstrual cycle.

However, there is limited research on whether triphasic pills cause fewer side effects than monophasic pills.

Healthcare professionals tend not to prescribe triphasic types of birth control. According to an older 2011 study, they do not appear to be more effective than standard monophasic birth control pills.

Monophasic pills provide the same amounts of hormones for 21 days, followed by 1 week of placebo.

A person can learn more about monophasic birth control here.

Anyone who cannot tolerate estrogen may consider taking progestin-only pills.

Micronor, which contains norethindrone, and Slynd, which contains drospirenone, are two brand-name examples.

Micronor may suit people who experience side effects on combination birth control pills.

However, Micronor contains norethindrone, which may cause side effects that include excess hair growth and acne.

The table below compares some of the most common types of birth control pills:

Medication NameTypeDose and hormonesGeneric name
Apri
Combination150 mcg desogestrel,
30 mcg ethinylestradiol		desogestrel and
ethinylestradiol tablets
Yaz
Combination3 mg drospirenone,
20 mcg ethinylestradiol		drospirenone/ethinylestradiol
tablets
AvianeCombination100 mcg levonorgestrel,
20 mcg ethinylestradiol		levonorgestrel and
ethinylestradiol tablets
Junel 1/20Combination1 mg norethindrone,
20 mcg ethinylestradiol		norethindrone and
ethinylestradiol tablets
SprintecCombination250 mcg norgestimate,
35 mcg ethinylestradiol		norgestimate and
ethinylestradiol tablets
SeasoniqueExtended cycle84 light blue tablets containing:
0.15 mg levonorgestrel,
0.03 mg ethinylestradiol.
7 yellow tablets containing:
0.01 mg ethinylestradiol
levonorgestrel/ethinylestradiol tablets
and ethinylestradiol tablets
MicronorProgestin-only0.35 mg norethindronenorethindrone

Birth control pills carry varying risks and side effects. It is important to discuss any underlying health issues and concerns with a medical professional before deciding on a birth control option.

Some factors to consider when picking a birth control pill include:

  • The types of hormones. Estrogen is not safe for everyone, as it may increase the risk of blood clots. Additionally, some forms of progestin in high doses may increase the risk of blood clots and worsen acne.
  • Underlying health conditions. People with health issues, such as high blood pressure or diabetes, should speak with a doctor about the safest birth control option.
  • Insurance coverage. Though most plans must cover birth control pills, they may only cover certain options. “Religious exempt” plans do not need to cover birth control methods.

A person may try several different birth control methods before finding one that works best for them.

Doctors may prescribe pills with lower dosages of ethinylestradiol to prevent side effects.

According to the Office of Women’s Health (OWH), possible side effects of hormonal birth control pills include:

Taking a pill containing estrogen can increase the risk of developing blood clots, though this risk is typically low. However, smoking can increase this risk.

Doctors recommend that people who smoke and are at least 35 years old avoid birth control pills because of an increased risk of heart attack and stroke.

Another risk concerns pregnancy. It can be easy to forget to take the pill every day. Forgetting to take birth control can increase a person’s chances of getting pregnant.

Birth control pills cannot prevent the spread of HIV or other sexually transmitted infections. Barrier methods, such as a condom or dental dam, can prevent these infections.

Learn more about the side effects of birth control pills here.

A person may want to avoid taking a pill every day.

Some birth control options that do not involve taking pills include:

Some people prefer to use more than one birth control option.

The Affordable Care Act typically provides free birth control for women. Most insurance also covers the majority of birth control costs.

Prices vary depending on coverage and the availability of generic options. Prices typically range from $10 to $50 per month.

Learn how to access free or low cost birth control here.

Below are answers to some common questions about birth control pills.

What is the most common birth control pill?

The most common type of pill is the combination pill.

What is the cheapest birth control pill brand?

The Affordable Care Act requires all insurance and Medicaid plans to cover the total cost of birth control, such as the pill. However, some plans can opt-out of this coverage for religious reasons.

If a person does not have insurance, they may be able to acquire free or lower-cost pills from local clinics.

Where can I get birth control pills?

A person needs a prescription from a doctor. They can get the pills:

  • Online. Several retailers offer birth control pills online with valid prescriptions. Some companies have doctors on staff who provide consultations and prescriptions.
  • At pharmacies. Most pharmacies have common types of birth control pills in stock. Learn about the best OTC birth control here.
  • Clinics. Several low- or no-cost clinics offer birth control pills to people without insurance or with insufficient coverage.

Do I need to see a doctor to get birth control?

A person needs a prescription for birth control pills. People in good health may consider an online consultation to get a prescription.

People with medical conditions, allergies to medications, and other concerns should speak with a doctor about the various birth control options available.

What are mini pills?

Mini pills are progestin-only birth control pills. They contain progestin in the form of norethindrone or drospirenone. A pack of minipills contains no inactive pills or placebos.

Some people taking the mini pill experience spotting throughout the month or do not get their period. Others get their period after starting a new pack of minipills each month.

What is the difference between minipills and combination pills?

Combination pills contain a combination of estrogen and progestin. Minipills contain only progestin.

There are many types of birth control pills. Doctors most commonly prescribe combination birth control pills.

Birth control pills can cause side effects and increase some health risks.

Some people prefer birth control options that do not contain hormones, such as a copper IUD. People can discuss their options with a healthcare professional and find the right choice for their needs.