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Types of Birth Control Pills

It’s important for any sexually active woman who does not want to become pregnant to know about birth control options and their effectiveness. One frequently used method of birth control is the birth control pill. Did you know there are different types of birth control pills? We hope the information in this article will be helpful for you if you are considering or currently using an oral contraceptive.

Avenue Women’s Center offers needed services for women in DuPage County and surrounding communities who are confronting an unplanned pregnancy. Our free medical grade pregnancy test can confirm (or unconfirm!) a suspected pregnancy just, ten days past the time when conception may have occurred. A no-obligation pregnancy options consultation with a caring client advocate is another of our free services. If you, or someone you know, believe you may be pregnant and are facing the challenging decisions that follow, we hope you will contact us for an appointment at one of our five convenient offices in Elmhurst, Glen Ellyn / Lombard, Naperville, West Chicago and Wood Dale, Illinois.

There are a number of reasons for the popularity of the birth control pill as a contraceptive. The pill is convenient, relatively uncomplicated, easy to use, and one of the more effective means of birth control. When used correctly, the pill provides consistent, on-going protection from unwanted pregnancy with no additional preparations needed at the time of intimacy. Because it regulates the menstrual cycle, women who have irregular or heavy periods may benefit from this as well. It is a non-permanent, reversible type of birth control; when discontinued, the menstrual cycle typically returns to normal, making it possible for a couple to pursue pregnancy at a time when it is desired.

How do birth control pills work?

The birth control pill is an oral hormonal contraceptive. It utilizes varying amounts of synthetic estrogen and/or progestin; these work to inhibit a woman’s regular hormonal cycle and prevent pregnancy in a number of ways. It may stop ovulation, meaning that the woman’s body does not produce an egg that might be fertilized by a male sperm. The woman’s cervical mucus may change, making it difficult for the sperm to enter the woman’s reproductive tract to find an egg. It may also alter the lining of the uterus, hindering the implantation of a fertilized egg.

What are the types of birth control pills and the differences between them?

Basically, there are two different types of birth control pills: The combination pill and progestin-only pills. Today, we are going to discuss combination pills.

Combination pills include both estrogen and progestin, and are generally used in one-month cycles. They come in either 21 or 28-day packs, depending on the type and brand of the pill. In both the 21 and 28-day packs, there are 21 “active” pills containing the hormones. In the 28-day pack, the seven pills for the last week of the cycle are “inactive,” without hormones. It is in this last week, with either inactive or no pills taken, that the woman has her period. A benefit of the 28-day pack is that taking one pill every day can help establish the habit of a daily pill, making it less likely for a pill to be missed. The pills should be taken at the same time each day. A new pack is started after 28 days to begin a new cycle.

Combination pills may contain different doses of the hormones. The dosage of estrogen in most combination pills is about 35 mcg, although low-dose pills may be as low as 10 mcg. With the low-dose pills, there may be more break-through bleeding that with a higher level of estrogen. Not every woman has the same experience. Some women may have spotting throughout the month; some may get no period at all.

There are categories of combination pills, based on the amount of the hormones that are present in each type.

  • In Monophasic pills, the dosage of the hormones is the same in all the active pills.
  • Multiphasic pills provide different levels of estrogen and progestin throughout the cycle of active pills.

With “perfect” use of combination pills the pregnancy rate is less than 1 in 100 women in the first year of use. That means a pill is taken at the same time every day without a miss. In “typical” use, acknowledging less than perfect adherence to the regimen, 9 out of 100 women will get pregnant in a year. In the case of missed pills, there is a higher risk of unintended pregnancy; a backup form of contraception (for example, a condom) may be a wise accommodation to prevent this.

What are the potential side effects of combination pills?

Studies have suggested there is an increased risk of blood clots with the use of birth control pills, especially the combination pills.

The following conditions may cause a health care provider to discourage use of combination birth control pills:

  • History of breast cancer, stroke or heart disease
  • Complications of diabetes
  • Liver disease
  • History of or a current pulmonary embolism or deep vein thrombosis
  • Unexplained uterine bleeding
  • Poorly controlled high blood pressure
  • Taking St. John’s Wort, anti-convulsant or anti-tuberculous medications
  • Breast-feeding

Extended Cycle or Continuous Dosing is another type of combination pill. With this regimen, active hormone pills are taken at the same time every day for three months (84 days). One week of inactive or low-dose estrogen pills follows, and it is in this week that there is a menstrual period. With this type of pill, there will be just three or four periods in the year. Some women find it convenient or preferable to limit menstrual bleeding In this way. For those who experience heavy bleeding with their periods, there is a reduced likelihood of iron deficiency. It may also reduce cramping, headaches, and other discomforts of a menstrual cycle. There may be unscheduled bleeding and spotting in the first few months of extended cycle pills. For most women this will end over time; however, in some it may continue even after using the pills.

There are newer extended-cycle regimens in which the use of active pills for an entire year can result in significantly lighter periods or stop all menstrual bleeding. A doctor may also advise you as to how to get more “extended-cycle” type performance through adjustments to the use of regular combination pills.

If you are looking into birth control pills or have taken them in the past and think you might be pregnant, contact Avenue Women’s Center today. We offer free pregnancy tests & information on your next steps. Our caring client advocates have assisted many women throughout the past thirty seven years. Contact us today for a complimentary appointment at one of our five DuPage County locations. We look forward to serving you.


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Reviewed by Patricia Kuenzi, APN-CNP, MSN, ANP, PNP.

The information provided here is general in nature.  It is not a substitute for a consultation with a medical professional. Before any medical procedure, it is imperative that you discuss your personal medical history, risks, and concerns with your doctor. If you have questions during or after a procedure, your doctor should be immediately contacted. Avenue Women’s Center is not an emergency center.  If you are experiencing severe symptoms, such as bleeding and/or pain, seek immediate medical attention.  Contact your physician, go to an emergency room, or call 911.