Best Birth Control Pill
Types of Oral Contraceptive Pills
There are two main types of birth control pills:
- Combined Pills: These contain both estrogen and progestin. Many brands and formulas are available, so people can choose based on how often they want periods, their hormone needs, or preferences for benefits like lighter bleeding.
- Progestin-Only Pills: Also called the minipill, this type has only progestin. All the pills in each pack have the same amount and are active.
Combined pills come in several forms:
- Standard packs provide 21 days of hormone pills (active) followed by 7 days of no-hormone (inactive) pills, or 24 active pills and 4 inactive.
- Extended or continuous-use packs often contain 84 active pills and 7 inactive, reducing the number of periods to four per year. Some have only active pills, so periods may not occur unless someone chooses to take a break.
Combined pills can also differ in how hormones are given:
- Monophasic: Each active pill has the same hormone dose.
- Multiphasic: The hormone levels change during the cycle.
Most have 10โ35 micrograms of ethinyl estradiol, a type of estrogen. Pills with less estrogen may help those sensitive to hormones but can cause more spotting between periods.
Is a Prescription Needed for Birth Control Pills?
Most birth control pills require a prescription from a healthcare provider. This includes most combination pills and several types of progestin-only pills. One progestin-only option is available without a prescription, making it easier for some people to get birth control pills from a pharmacy or online.
How Do Birth Control Pills Work?
Combination pills help prevent pregnancy by:
- Stopping the ovaries from releasing eggs.
- Making cervical mucus thicker so it’s harder for sperm to reach an egg.
- Thinning the uterine lining, so it’s harder for a fertilized egg to attach.
Progestin-only pills:
- Usually thicken cervical mucus and thin the uterine lining.
- Sometimes stop ovulation, depending on the type of progestin and the brand.
These actions lower the chance of sperm reaching an egg or a fertilized egg attaching inside the uterus.
Are All Birth Control Pills Safe for Everyone?
Birth control pill safety depends on health and personal risk factors. Combined pills with estrogen may not be suitable for people with certain health problems, including:
- Recent childbirth
- Smokers older than 35
- High blood pressure
- Blood clotting disorders or history of deep vein thrombosis
- Breast cancer (current or past)
- History of stroke or heart disease
- Serious diabetes or related complications
- Liver or gallbladder disease
- Lupus
- Unexplained uterine bleeding
- Extended bed rest or limited movement after major surgery
- Use of certain medicines, herbal supplements, or after gastric bypass
Progestin-only pills may not be recommended for those with:
- Breast cancer (present or previous)
- Certain liver diseases
- Unexplained uterine bleeding
- Some anti-seizure or tuberculosis medicines
- After gastric bypass
- Some types of lupus
Discuss your current medications and medical history with a healthcare provider to find the safest option.
Combination Birth Control Pills
Benefits
- Easy to Stop: Fertility returns quickly after stopping.
- Eases Premenstrual Symptoms: Less PMS.
- Less Painful Periods: Reduces cramps and pain.
- Helps with Acne: Certain brands can improve skin.
- Predictable or Lighter Bleeding: Shorter, lighter, or even fewer periods.
- Reduces heavy periods: Less bleeding means less risk for anemia.
- Relief for Endometriosis: Lessens symptoms.
- Cancer Protection: Can lower the risk for cancers like ovarian, endometrial, and colorectal.
- Supports Bone Strength: May help keep bones healthier.
- Improves Unwanted Hair: Helps with hair growth from polycystic ovary syndrome.
Table: Possible Health Benefits of Combined Pills
| Benefit | Details |
|---|---|
| Quick return to fertility | Pregnancy possible soon after stopping |
| Less heavy periods | Lower risk of anemia |
| Decreased endometriosis pain | Fewer symptoms |
| Acne improvement | Some brands target acne |
| Lower certain cancer risks | Ovarian, endometrial, colorectal |
| Bone health | May help support bone density |
| Hirsutism reduction | Reduces unwanted hair from PCOS |
Drawbacks
- Timing Matters: Missing pills or late doses may lower effectiveness.
- No STI Protection: Does not prevent sexually transmitted infections.
- Higher Certain Health Risks: Slight increase in blood clots, heart attack, or stroke, especially for smokers over 35, or those with certain medical conditions.
- Cancer Risks: May slightly raise the risk of breast and cervical cancer while taking the pills, but risk decreases after stopping.
- Side Effects: Some people get headaches, nausea, sore breasts, mood changes, spotting, bloating, or weight changes.
List of Possible Side Effects
- Headache
- Nausea
- Irregular or breakthrough bleeding
- Bloating
- Breast tenderness
- Weight gain
- Mood changes
Progestin-Only Birth Control Pills
Advantages
- Can Stop Anytime: Fertility returns quickly.
- Safe After Childbirth or Miscarriage: No pause needed before starting.
- Fewer Risks for Some Health Issues: Safer for people with blood clot risks, migraines, high blood pressure, or breastfeeding.
- Supports Breastfeeding: Less likely to lower milk supply.
- Endometrial Cancer: Can reduce the risk.
| Positive Points | Details |
|---|---|
| Quick return of fertility | Pregnancy possible after stopping |
| Post-pregnancy use | Safe to start right away |
| Fits some health needs | Suitable for blood clot risk, migraines |
| Breastfeeding friendly | Less likely to reduce milk supply |
| Cancer protection | Helps lower endometrial cancer risk |
Disadvantages
- Must Stick to Strict Schedule: A late or missed pill means backup contraception is needed for at least 2 days.
- No Protection Against Infections: Does not prevent STIs.
- Side Effects May Appear: Includes irregular periods, ovarian cysts, headache, acne, lower sex drive, weight change, and hair growth.
- Ectopic Pregnancy Risk: Slightly increased chance the pregnancy could develop outside the uterus if a pill fails.
Common Side Effects of Progestin-Only Pills
- Irregular or skipped periods
- Ovarian cysts
- Lower interest in sex
- Headache
- Acne or skin changes
- Breast soreness
- Mild weight gain or mood changes
- Unwanted hair growth (hirsutism)
How to Choose the Right Birth Control Pill
Choosing a birth control pill depends on health, lifestyle, and personal needs. Important steps include:
- Talk to a Healthcare Professional: Share your health history and other medicines or supplements you take.
- Think About Your Needs: Consider if you prefer fewer periods, lighter bleeding, help with acne, or fewer cramps.
- Consider Health Risks: If you have higher risk for blood clots, heart disease, or certain cancers, ask about progestin-only pills.
- Decide How Consistent You Can Be: If taking a pill at the same time every day is hard, combined pills might be easier than the minipill.
- Breastfeeding: If you are breastfeeding, progestin-only pills are often a safer choice.
- Personal Preference: Consider what side effects you can tolerate and how you feel about predicting your periods.
Table: Factors to Consider When Choosing a Pill
| Consideration | Best Pill Type | Notes |
|---|---|---|
| Wants fewer periods | Combined or extended-use | Longer cycles or continuous options |
| Blood clot risk | Progestin-only | No estrogen; safer for clot risks |
| Acne concerns | Some combined pills | Ask for a brand that can help with acne |
| Breastfeeding | Progestin-only | Less impact on milk supply |
| Predictable cycle | Combined, monophasic | More regular periods |
| Schedule flexibility | Combined, monophasic | More forgiving with missed pills |
Talk to a healthcare provider to review your personal health, needs, and preferences. You may need to try a few types before finding the best match. If problems or side effects occur, switching formulas or hormone types may help.
