Your Guide to Birth Control Pills: Types, Effectiveness, Safety

There are many options available. If you’re a sexually active person who menstruates, you may want to consider birth control pills.

Oral contraceptives (also known as birth control pills) are medications you take to prevent pregnancy. According to the Food and Drug Administration (FDA), they’re an effective method of birth control with a success rate of about 91 percent (or a failure rate of 9 percent).

Learn about how they work, side effects and other factors that can help you decide if birth control pills are right for you.

Birth control pills are an oral contraceptive that contains small amounts of hormones. Birth control pills prevent pregnancy by stopping ovulation (or the release of an egg). Some birth control pills also temporarily change the lining of the uterus so it’s less likely a fertilized egg will implant.

Birth control pills come in a package, usually with a 28-day period. Each day is given one pill. Depending on which pill you choose, you will take a birthcontrol pill every day. This keeps certain hormones elevated, so you’re less likely to get pregnant.

Combination pills

Combination pills contain synthetic hormones of estrogen and progesterone (also known as progestin in its synthetic version). The menstrual cycle is controlled by estrogen.

Your period is when your estrogen levels are at their lowest. Progesterone prepares your uterus for pregnancy by thickening your endometrium. Ovulation can also be prevented by high progesterone levels.

Combination pills are available in a 28-pack. The majority of the pills in each cycle contain hormones and are therefore active. The remaining pills are inactive, which means they don’t contain hormones. There are many combinations of pills:

  • Monophasic tabletsThese are taken in 1-month cycles. Each active pill provides the same amount of hormone. You can take the inactive pills during the last week.
  • Multiphasic pillsThese pills are used in 1-month cycles. They provide different levels hormones throughout the cycle. You can still have your period by taking the inactive pills or skipping them during the last week.
  • Extended-cycle pills.These pills are usually used in 13-week cycles. The 12 week cycle includes 12 weeks of taking active pills. During the last week, you have the option to take the inactive or skip the pills, and then you will have your period. You will have your period three to four times a year.

Here are some examples of brand-name combinations pills:

  • Azurette
  • Beyaz
  • Encourage
  • Estrostep Fe
  • Kariva
  • Levora
  • Loestrin
  • Natazia
  • Ocella
  • Low-Ogestrel
  • Ortho-Novum
  • Ortho Tri-Cyclen
  • Seasonale
  • Seasonique
  • Velivet
  • Yasmin
  • Yaz

Only progestin-only tablets

Progestin-only tablets contain synthetic progesterone (progestin) and no estrogen. This pill is also known as the minipill.

People who have heavy periods may benefit from progestin-only tablets to reduce their bleeding. They may be a good choice for people who can’t take estrogen for health or other reasons, like a history of stroke, heart disease, peripheral vascular disease, and/or deep vein thrombosis.

You should also avoid estrogen if you’re over 35 and smoke, as this combination can increase your risk of developing a blood clot.

All active pills in a progestin-only pill cycle are active. There are no inactive tablets, so you may have a period while taking progestin only pills.

These are examples of brand-name progestin pills that are only available in the form of:

  • Camila
  • Errin
  • Heather
  • Jencycla
  • Nor-QD
  • Ortho Micronor

Deciding on the type of birth control pill

Some types of pills may not be right for everyone. Talk to your doctor about the best pill option for you. There are many factors that could influence your decision.

  • Your menstrual symptoms.You may be able to get a progestin-only pill if you have heavy bleeding.
  • It doesn’t matter if you’re breastfeeding. If you’re breastfeeding, your doctor may recommend avoiding birth control pills that contain estrogen.
  • Your cardiovascular health.Your doctor may recommend a progestin only birth control pill for those who have had strokes, blood clots or deep vein thrombosis.
  • You might also have chronic health conditions.You may not be a candidate for oral contraceptives if you have chronic conditions like active breast or endometrial carcinoma, migraine with aura, or heart disease. Talk to your doctor about your health history.
  • You might also be taking other medications. If you’re taking antibiotics or herbal remedies, such as St. John’s Wort, combination birth controls may not be a good fit for you. Some antiviral medications and epilepsy medications can also interact with birth control pills and vice versa.

Combination pills work in two different ways.

They prevent your body’s ability to ovulate. This means your ovaries won’t release an egg each month.

Second, these pills cause the body to thicken cervical mucus. This fluid is what helps sperm travel from your uterus to fertilize eggs. Sperm can’t reach the uterus because of thickened mucus.

There are a few ways that progestin-only tablets work. They thicken your cervical mucus, and thin your endometrium.

Your endometrium is the lining of your uterus, where an egg implants after it’s fertilized. If this lining is thinner, it’s harder for an egg to implant in it, which will prevent a pregnancy from growing.

Progestin-only drugs may also prevent ovulation.

There are many options for combination pills. Monthly packs can be used to follow 21-, 24- or 28-day cycles. Extended regimens can be followed for up to 91 days. You take one pill every day with all these formats.

If you start taking your combination pill within 5 days after your period starts, you’ll be protected against pregnancy right away. If you start at any other time, you’ll need to take the pills for 7 consecutive days before you’re protected. You should use an external condom as a barrier method to birth control during this time.

Progestin only pills come in 28 packs. You can only take one pill every day, just like combination pills.

Progestin-only pills tend to work more quickly than combination pills, which means you’ll be protected against pregnancy after taking 2 consecutive pills within 48 hours. If you don’t want to wait the 48 hours to have sex, you should use a barrier method of birth control.

Birth control pills are very effective in preventing pregnancy when taken correctly. Both the combination pill, and the progestin alone pill have a 9 percent failure rate with regular use. This means that 9 out of 100 women who use the pill would become pregnant.

Progestin pills must all be taken within the same time frame every day for maximum effectiveness. If you miss this time frame, you should take your progestin pill within the same 3-hour period every day.

Combination pills offer a little more flexibility. Combination pills offer a little more flexibility. You don’t have to take them all at once, but you can still take them within the same 12-hour period and still have pregnancy protection.

Some medications can make one type of pill less effective than the other, such as:

  • Rifampin (an antibiotic).
  • Certain antiretroviral or HIV medications, such efavirenz
  • Certain antiseizure medication such as levonorgestrel and carbamazepine are available, along with oral norethindrone and the subdermal Etonogestrel Implant.
  • St. John’s wort

You may experience vomiting or diarrhea, which can make the pill less effective. If you’ve had a stomach illness, check with your doctor to see whether you’re at risk of pregnancy. If that happens, you should consider using a condom as a backup method of contraception.

Depending on which pill you’re taking, there are different routes to take when you’ve missed one or more doses.

Although birth control pills are generally safe for most people they can cause side effects and even death. Every person reacts differently with birth control pills. Some people experience side effects such:

  • Sex drive is decreasing
  • nausea
  • Headaches
  • Between periods, bleeding or spotting
  • Breast tenderness
  • Abdominal cramping
  • Increase in vaginal discharge

These side effects will usually improve over time if you continue to take the pill. If they don’t improve, you should talk with your doctor. Your doctor may recommend that you switch to another type of birth control pill.


There is a greater risk of blood clots if you use birth control pills, particularly combination pills. This can lead:

The risk of getting a bloodclot from any kind of birthcontrol pill is very low.

According to the American College of Obstetricians and Gnecologists, 10% of those who use birth control pills will develop a clot within a year. This risk is still less than the risk of developing an immediate blood clot after giving birth or during pregnancy.

Certain groups have a higher risk of getting clots from the pill. This includes:

  • live in larger bodies
  • High blood pressure
  • are in bed rest for extended periods

If any of these factors are true, consult your doctor about the potential risks of using a contraceptive pill.


There are many birth prevention options today, but the birth control pills is an excellent choice. There are many factors that go into choosing the best birth control option for you. Talk to your doctor about the best options for you. Ask any questions that you may have. These could include:

  • Which type of birthcontrol pill is best for me?
  • Are there any medications I’m taking that could interfere with my birth control pill?
  • Are I at greater risk of blood clots due to the pill?
  • What should I do if I forget a pill?
  • What other birth-control options should I consider

Access to birth control pills is easier than ever because of the growing demand for contraceptive options.

You can choose to go the traditional route and book an in-person appointment with a doctor. After discussing your medical history with your doctor, and your family planning goals with him/her, the doctor will issue a prescription which you can fill at your local pharmacy.

You can also get birth control pills online and avoid an in-person visit with a doctor.

Telehealth services, like Nurx, Lemonaid, SimpleHealth and The Pill Club offer an online consultation, some via video and others through messaging or a questionnaire. These consultations are conducted by licensed doctors and healthcare professionals who will review your medical history and provide a prescription for the recommended birth control.

Once your prescription is filled, the birthcontrol pills are shipped directly from the pharmacy to your home.

Birth control pills can be used to prevent pregnancy. Each pill contains small amounts (in their synthetic form, progesterone) of the hormones estrogen or progesterone. They have a 91 per cent success rate if taken correctly.

There are two types: progestin-only and combination. Combination pills are more common, but progestin-only pills, which don’t contain any estrogen, may be a better fit for certain groups of people, such as those who have a history of blood clots or have heavy periods.

Talk with your doctor before taking birth control pills.

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