Birth control pills are medications that help to prevent pregnancy. These medications can contain estrogen and progestin or just progestin.
Several different types of birth control pills are available. Everyone will have different birth control requirements, so it is best to consult a doctor or healthcare professional to discuss options.
Different products have advantages and disadvantages. Keep reading to learn about the different birth control pill options.
According to the National Health Service (NHS) in the United Kingdom, combined birth control pills contain both progestin and estrogen. They prevent ovulation, thin the endometrium, which is the lining of the womb, and thicken cervical mucus.
The American College of Obstetricians and Gynecologists (ACOG) state that progestin-only pills prevent pregnancy by thickening the cervical mucus, making it difficult for sperm to enter the uterus. They also thin the uterus lining.
Although they can suppress ovulation, ACOG indicate that roughly 40% of females who use progesterone-only pills will 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 doses of estrogen and different types of progestin. A doctor can help a person decide which one is best.
According to a 2015 article, most combination birth control pills contain ethinyl estradiol, which is an estrogen component, although the doses among brands will vary. Ethinyl estradiol doses may vary between 20–35 micrograms (mcg).
Types of progestin in combination pills
Combination birth control pills may contain different types of progestin.
Manufacturers express the dose of progestin in milligrams (mg) or mcg.
Some progestins can cause increased water and salt retention, which leads to bloating.
Some progestins also act like androgens, which are a group of hormones that play a role in a person’s sexual health. According to ACOG, high levels of androgens can also play a role in acne and excess hair growth.
Some people may want to use the birth control pill to help treat these conditions. Different types of progestin vary in how androgenic they are.
Other progestins do not act in this way and may help those who experience acne or excess hair growth. However, at present, there is no data to support one particular birth control pill being more effective than others at treating acne or excess hair growth.
People might consider talking to a doctor or healthcare professional about which type of progestin will suit them best.
Some people may prefer to use a birth control pill that contains the progestin desogestrel. According to a 2015 article, it may help those with hair growth and acne. However, the article also indicates that there is limited evidence to confirm that it is better than other options is limited.
Birth control pill brands that contain desogestrel include:
- Apri (150 mcg desogestrel, 30 mcg ethinyl estradiol)
- Azurette (150 mcg desogestrel, 20 mcg ethinyl estradiol)
- Kariva (150 mcg desogestrel, 20 mcg ethinyl estradiol)
- Mircette (150 mcg desogestrel, 20 mcg ethinyl estradiol)
- Reclipsen (150 mcg desogestrel, 30 mcg ethinyl estradiol)
Some of these birth control pills contain the same drugs in identical dosages but have different names. For example, a doctor may prescribe Azurette and Kariva, or Reclipsen and Apri interchangeably because they have the same contents.
Which drug a person gets may depend on a variety of factors, such as their insurance policy or availability of a specific brand.
Some people prefer birth control pills that contain the progestin drospirenone because it has diuretic properties, which helps prevent bloating.
Birth control brands that contain drospirenone include:
- Gianvi (3 mg drospirenone, 20 mcg ethinyl estradiol)
- Loryna (3 mg drospirenone, 20 mcg ethinyl estradiol)
- Ocella (3 mg drospirenone, 30 mcg ethinyl estradiol)
- Syeda (3 mg drospirenone, 30 mcg ethinyl estradiol)
- Yasmin (3 mg drospirenone, 30 mcg ethinyl estradiol)
- Yaz (3 mg drospirenone, 20 mcg ethinyl estradiol)
- Zarah (3 mg drospirenone, 30 mcg ethinyl estradiol)
As before, it is important to note that a doctor may prescribe some brands interchangeably when they contain the same dosages, such as with Loryna and Yaz.
The birth control pills that contain levonorgestrel appear to have lower risks of side effects, such as venous thrombosis, than some of the other progestin options.
Doctors consider pills containing levonorgestrel and ethinyl estradiol as first-line, and they are effective as long as a person takes them correctly.
Pills that contain levonorgestrel include:
- Aviane (100 mcg levonorgestrel, 20 mcg ethinyl estradiol)
- Lessina (100 mcg levonorgestrel, 20 mcg ethinyl estradiol)
- Levora (150 mcg levonorgestrel, 30 mcg ethinyl estradiol)
- Lutera (100 mcg levonorgestrel, 20 mcg ethinyl estradiol)
- Portia (150 mcg levonorgestrel, 30 mcg ethinyl estradiol)
- Sronyx (100 mcg levonorgestrel, 20 mcg ethinyl estradiol)
A doctor may prescribe these brands interchangeably, providing they contain the same ingredients and dosages, as in the case of Aviane, Lessina, and Sronyx.
Norethindrone is a progestin that derives from testosterone.
Those who take birth control pills containing norethindrone may experience androgenic side effects.
If this occurs, doctors may switch to a birth control pill with less androgenic activity.
Birth control pills that contain norethindrone include
- Balziva (400 mcg norethindrone, 35 mcg ethinyl estradiol)
- Junel 1/20 (1 mg norethindrone, 20 mcg ethinyl estradiol)
- Junel 1.5/30 (1.5 mg norethindrone, 30 mcg ethinyl estradiol)
- Loestrin 1/20 (1 mg norethindrone, 20 mcg ethinyl estradiol)
- Loestrin 1.5/30 (1.5 mg norethindrone, 30 mcg ethinyl estradiol)
- Microgestin 1/20 (1 mg norethindrone, 20 mcg ethinyl estradiol)
- Necon (500 mcg norethindrone, 35 mcg ethinyl estradiol)
- Nortrel 0.5/35 (500 mcg norethindrone, 35 mcg ethinyl estradiol)
- Nortrel 1/35 (1 mg norethindrone, 35 mcg ethinyl estradiol)
- Ortho-Novum 1/35 (1 mg norethindrone, 35 mcg ethinyl estradiol)
Norgestimate and norgestrel
People who use birth control pills containing norgestimate or norgestrel may also experience androgenic side effects, such as hair growth and acne.
Some brands containing these hormones include:
There are also extended-cycle birth control pills, such as Seasonique, which contain 12 weeks of combined hormones (ethinyl estradiol and levonorgestrel) and one week of placebo or low dose ethinyl estradiol.
Some people prefer extended cycles because they only bleed once every 3 months. Studies show that continuous use is safe for up to 12 months.
According to DailyMed, triphasic birth control pills contain 21 days of active hormonal pills with different doses of estrogen and progestin each week. An example of a triphasic birth control pill is Ortho Tri Cyclen.
Each pill contains 35 mcg of ethinyl estradiol, but the dose of norgestimate increases each week.
Manufacturers of triphasic birth control attempted to reduce side effects by mimicking the natural fluctuation in hormones throughout the menstrual cycle.
However, healthcare professionals are leaning away from triphasic birth control as, according to a 2011 study, they do not appear to be any more effective than monophasic birth control.
Many healthcare professionals prefer to prescribe monophasic birth control pills. These are birth control pills that provide the same level of hormones for 21 days, followed by 1 week of placebo.
This method of birth control is appropriate for those who cannot tolerate estrogen or who cannot take estrogen.
Doctors may prescribe lower doses of ethinyl estradiol to reduce the side effects of estrogen.
The Office of Women’s Health (OWH) indicate that possible side effects of birth control pills include the following:
- a headache
- an upset stomach
- sore breasts
- changes in menstruation
- changes in mood
- weight gain
- high blood pressure
- spotting or bleeding between periods
- decreased libido
According to a 2015 review article, one side effect of taking estrogen is an increased risk of developing blood clots. However, the chance is typically low.
The OWH also state that cigarette smoking can increase a person’s chance of developing a blood clot while taking combined oral contraceptive pills.
Forgetting to take a birth control pill may increase the chance of pregnancy. If a person misses a pill, they should speak with a doctor or pharmacist.
According to the Centers for Disease Control and Prevention (CDC), barrier methods, such as a condom or dental dam, are more effective in preventing infections.
Some people prefer birth control methods that do not require remembering to take a pill every day.
Others may not be able to use estrogen or progestin pills for a variety of reasons.
The OWH list the following birth control options:
- copper intrauterine device (IUD)
- hormonal IUD
- hormonal implants
- medroxyprogesterone injection
- hormonal patch
- hormonal vaginal ring
- cervical cap
- permanent sterilization surgery for females (tubal ligation)
Some people may use a combination of contraception methods to avoid pregnancy.
People have many different options when choosing a birth control pill. Depending on their desires, they can choose a combination pill that prevents pregnancy and minimizes side effects.
A doctor will be able to help a person decide which type of birth control pill is most appropriate for them.
If a person experiences side effects from one pill, it does not mean they will have the same experience with another birth control pill.
If side effects occur, a doctor can help a person choose another effective birth control pill that will have fewer side effects.
Those who do not want to take hormonal birth control can speak with a doctor about alternatives.