Types of Birth Control Pills (Oral Contraceptives)
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on May 4, 2020.
How Effective is the Birth Control Pill?
The birth control pill is a popular and highly effective method of birth control if taken correctly. The pill has a less than a 1 percent (1%) failure rate - meaning less than 1 out of 100 women unintentionally become pregnant - when the pill is used correctly. However, for women who miss taking their pills, the failure rate goes up to roughly 8%, or 8 out of 100 women become pregnant unintentionally.
Roughly 85% of women who do not use birth control and are trying to get pregnant will conceive within one year. If you do not want to become pregnant, and if you are not likely to remember to take a pill each day, you probably should consider a longer-acting form of birth control, such as the injection, patch, implant, vaginal ring or IUD.
What Are Birth Control Pills?
Birth control pills are an oral pill that a woman can take every day to prevent pregnancy.
- Birth control pills stop the ovaries from releasing eggs and thickens the cervical mucus, which keeps sperm from fertilizing the egg.
- Birth control pills come in two forms: combination pills contain two hormones, progestin and estrogen, while the “mini-pills” contain only progestin.
- Generally, combination birth control pills are slightly more effective than progestin-only birth control pills. All birth control pills require a prescription from a healthcare provider.
Combination birth control pills are available in 21-day packs, with 21 active tablets, or 28-day packs with 21 active tablets, and 7 inactive tablets. Extended-cycle pills such as Seasonique contain 84 active tablets and 7 inactive tablets. The inactive pills are included to help the woman remember when she should start a new pack of pills. The menstrual cycle occurs during the time period when the inactive pills are taken. If the inactive pills are missed, there is no chance this would result in a pregnancy. However, it is important to start the new pack and active pills on the correct day.
Are Birth Control Pills Free?
Birth control pills are typically free for women under the Affordable Care Act (ACA). However, birth control pills are often affordable, depending upon health insurance coverage and generic availability. In general, you should be able to get birth control pills from $10 to $50 per month if you pay cash, although there are many more expensive options.
Many birth control pills are available generically and have a lower price. Check with your insurance company before getting a prescription to determine which birth control pills are on their medication formulary. Again, if you have prescription drug insurance, your birth control (all types) may be free under the Affordable Care Act.
What Are the Advantages to the Birth Control Pill?
- Lighter periods, less frequent periods, or possibly no periods at all depending upon the type of pill taken and dosing schedule
- If the birth control pill is taken correctly, it has a high level of effectiveness to prevent pregnancy.
- The birth control pill can lessen heavy bleeding, pain and severity of endometriosis and fibroid tumors
- Acne or premenstrual dysphoric disorder (PMDD) may improve with some birth control pills
- The use of the birth control pill can lower the risk of pelvic inflammatory disease, uterine cancer and ovarian cancer
- The progestin-only forms may be used by women who are breast-feeding or cannot use estrogen for other reasons
What Are Some Common Names of Birth Control Pills?
Examples of combination birth control pills include:
- Loestrin 24 Fe
See a full list of combination birth control pills here.
A monthly period still occurs with the traditional, combination birth control pills. Women may also choose the extended or continuous dosing birth control pill, in which a period only occurs 4 times a years (e.g., Seasonique) or is completely eliminated (e.g., Amethyst). It is also possible to completely eliminate periods by taking only the active pills continuously (every day) from a combination birth control pill package, and skipping the inactive pills. Ask your healthcare provider if this would be a good option for you.
What is the Mini-Pill or Progestin-Only Birth Control Pill?
The progestin-only or “mini-pills” contain only norethindrone and each pill is active (there are no placebo, inactive pills). When you finish one pack of progestin-only pills, you start another pack the next day. With progestin-only pills you will either get your period in the fourth week, get no periods, or have spotting during the month. Your periods may be heavier or lighter. Do not stop taking your progestin-only pills.
Examples of progestin-only pills include:
See other progestin-only birth control options
What Should I Do if I Miss My Birth Control Pill?
Any time you miss a birth control pill it is best to use a back-up method of birth control, such as a condom or diaphragm with a spermicide, or a contraceptive sponge. Your chances for getting pregnant increase depending upon when you missed your pill during your cycle.
If you miss one pill
In general, per CDC guidelines, if you miss or are late with one combination pill (< 48 hours since a pill should have been taken), take it as soon as you remember.
- Continue taking the rest of your pills at the usual time (even if it means taking two pills on the same day). No additional contraceptive protection needed.
- Emergency contraception is not usually needed but you might consider it (with the exception of ulipristal [Ella]) if the pills were missed earlier in your cycle or in the last week of the previous cycle.
- Always follow the specific directions in your package insert for missed pills. Call your doctor if you have questions.
If you miss two pills
In general, if you miss two or more combination pills (> 48 hours since you took a pill), take the most recent pill as soon as you remember. Discard any other missed pills.
- Continue taking your remaining pills at the same time (even if you have to take 2 pills on the same day to get back on track). Taking two pills at once may make you feel a little sick to your stomach, but that will not last long. Use back-up contraception (such as condoms) or avoid sexual intercourse until you have taken your hormonal pills for 7 days in a row.
- If the pills you missed were in the last week of hormonal pills (e.g., days 15–21 for 28-day pill packs), you should omit the hormone-free interval by finishing the hormone pills in the current pack and starting a new pack the next day. If you are unable to start a new pack immediately, use back-up contraception (such as condoms) or avoid sexual intercourse until hormonal pills from a new pack have been taken for 7 consecutive days.
- Emergency contraception (with the exception of ulipristal [Ella]) should be considered if hormonal pills were missed during the first week and unprotected sexual intercourse occurred in the previous 5 days. It may also be considered at other times, if appropriate.
- Always follow the specific directions in your package insert for missed pills. Call your doctor if you have questions.
The combination (estrogen and progestin) pills works best if taken every day at the about the same time. The progestin-only pills (mini-pills) MUST be taken at the same time each day (no more than 3 hours late). If you miss a pill, you will increase your chances of releasing an egg that could be fertilized, and getting pregnant.
If you miss three combination pills in a row, call your healthcare provider. You may need to stop using your current birth control pack and start a new pack while using a back up method of birth control.
What Should I Do If I Miss My Progestin-Only Birth Control Pill?
You could become pregnant if you miss taking your progestin-only pill (mini-pill) by more than 3 hours.
- If you miss taking one mini-pill, take it as soon as you remember, and take the next pill at the regular time.
- Continue to take your mini-pills daily on your regular schedule at the same time, even if you have to take 2 pills at the same time.
- Use a back-up method of birth control, such as a condom, or avoid sexual intercourse until your pills have been taken correctly, on time, for 2 consecutive days. Emergency contraception should be considered (with the exception of ulipristal [Ella]) if you have had unprotected sexual intercourse.
If you are still confused about what to do if you have missed any birth control pills, use a back-up method of birth control each time you have vaginal intercourse, and take a birth control pill each day until you can talk to your health care provider.
Is the Birth Control Pill Safe?
Birth control pills should not be used by women who have a history of:
- breast cancer
- endometrial cancer
- undiagnosed vaginal bleeding
- uncontrolled high blood pressure or heart disease
- chest pain
- severe headaches
- uncontrolled diabetes
- liver tumors or liver disease
- increased blood clotting or stroke risk
- or if currently pregnant
Smoking increases the risk of serious heart side effects when using a combined estrogen and progestin birth control, including the ring or the patch. Combination estrogen and progestin birth control should NOT be used in women over 35 years of age who smoke due to an increased risk of rare but serious side effects, such as heart attack, blood clots, and stroke.
Women should talk to their healthcare professional about their individual risk profile before deciding which birth control method to use. Heart risks linked with the pill increase with:
- family history of heart disease
- number of cigarettes smoked per day.
Let your physician know if you have migraine headaches when discussing birth control options.
The birth control pill does not protect against any form of sexually transmitted disease (STD), including HIV / AIDS. A male latex or female condom should be used in combination with any other form of birth control if protection against STDs is needed.
Can I Take the Pill If I'm Breastfeeding?
Breastfeeding mothers should avoid the estrogen in combined hormonal birth control as it may reduce milk supply. Birth control options for breastfeeding women include:
- progestin only pills (“mini-pills”)
- the implant
- the birth control shot
Common Side Effects with Birth Control Pills
- Spotting between periods
- Possible weight gain
- Breast swelling or tenderness
- Nausea or upset stomach
- Mood changes
Serious Side Effects with Birth Control Pills
- Blurred vision
- Severe stomach pain
- Severe headache
- Swelling or pain in the legs
- Chest pain, heart attack, blood clots, stroke
Other warnings and side effects exist for birth control pills. It is important to review the specific consumer information for the birth control of your choice and discuss any questions or concerns with your healthcare provider. Generic options of birth control pills may be available; check with your pharmacist for cost-savings.
Tell your healthcare provider about all other medications you take, including prescription, over-the-counter, vitamin and herbal supplements. Certain medications may make your birth control less effective. Be sure you have complete drug interaction review each time you start a new medication.
Table 1: Common Birth Control Pills
|Generic Name||Example Proprietary Name(s)||Description|
|desogestrel and ethinyl estradiol||
Apri, Azurette, Bekyree, Caziant, Cesia, Cyclessa, Cyred, Desogen, Emoquette, Enskyce, Isibloom, Juleber, Kalliga, Kariva, Kimidess, Pimtrea, Reclipsen, Simliya, Velivet, Viorele, Volnea
|Combination progestin and estrogen pill; some packs may be triphasic|
|dienogest and estradiol valerate||Natazia||Quadraphasic progestin and estrogen pill|
|drospirenone and ethinyl estradiol||
Gianvi, Jasmiel, Lo-Zumandimine, Loryna, Nikki, Ocella, Syeda, Yasmin, Yaz, Zarah, Zumandimine
|Drospirenone-containing birth control pills may be associated with a higher risk for rare but serious blood clots (DVT, PE) compared to other progestin-containing pills.|
|drospirenone and ethinyl estradiol and levomefolate||Beyaz, Safyral, Tydemy||Drospirenone-containing birth control pills may be associated with a higher risk for rare but serious blood clots (DVT, PE) than other progestin-containing pills. Contains a daily dose of folate to lower rare neural tube defect risk.|
|ethynodiol and ethinyl estradiol||
|Monophasic combination progestin and estrogen pill.|
|levonorgestrel and ethinyl estradiol||
Afirmelle, Altavera, Amethia, Amethyst, Ashlyna, Aubra, Aviane, Ayuna, Balcoltra, Camrese, Camrese, Chateal, Daysee, Delyla, Enpresse, FaLessa, Falmina, Fayosim, Introvale, Jaimiess, Jolessa, Kurvelo, Larissia, Lessina, Levonest, Levora, Lillow, LoJaimiess, LoSeasonique, Lutera, Marlissa, Myzilra, Orsythia, Portia, Quartette, Quasense, Rivelsa, Seasonique, Setlakin, Simpesse, Sronyx, Trivora-28, Vienva
|Combination progestin and estrogen pill; some examples are triphasic, extended-cycle pills, or continuous-cycle pill.|
Aygestin, Camila, Deblitane, Errin, Heather, Incassia, Jencycla, Jolivette, Lyza, Nor-QD, Nora-BE, Norlyda, Norlyroc, Ortho Micronor, Sharobel, Tulana
|Progestin-only birth control pills (“mini-pills”); for use in breast-feeding or high risk for blood clots.|
|norethindrone and ethinyl estradiol||
Alyacen, Aranelle, Balziva, Blisovi 24 FE, Brevicon, Briellyn, Cyclafem, Dasetta, Estrostep Fe, Femcon Fe, Generess Fe, Gildagia, Gildess, Junel, Kaitlib FE, Leena, Loestrin, Lo Loestrin, Lo Minastrin Fe, Microgestin, Minastrin 24 Fe, Necon, Norinyl 1+35, Nortrel, Ortho-Novum, Philith, Taytulla, Tilia Fe, Tri-Legest Fe, Wera, Wymzya Fe, Zenchent Fe
|Combination progestin and estrogen pill; some are biphasic or triphasic.
|norgestimate and ethinyl estradiol||
Estarylla, Femynor, Mili, Mono-Linyah, Previfem, Sprintec, Tri Femynor, Tri-Estarylla, Tri-Linyah, Tri-Lo-Estarylla, Tri-Lo-Marzia, Tri-Lo-Sprintec, Tri-Lo-Mili, Tri-Lo-Sprintec, Tri-Mili, Tri-Previfem, Tri-Sprintec, Tri-VyLibra, Tri-VyLibra Lo, VyLibra
|Combination progestin and estrogen pill; some options are triphasic.|
|norgestrel and ethinyl estradiol||Cryselle 28, Low-Ogestrel, Ogestrel-28, Low-Ogestrel, Elinest||Combination progestin and estrogen pill.|
For other options, generic and proprietary names, also see: Oral Contraceptives
- Birth Control Pills - Periods
- Birth Control Pills and Breakthrough Bleeding
- Birth Control Pills: Benefits, Risks and Side Effects
- Emergency Contraception
- Emergency Contraceptives Available in the U.S.
- Grapefruit and Birth Control Pills: Your Questions Answered
- Hormonal Birth Control (Non-Pill Options)
- Missed taking your birth control pill? Here's what to do next
- Non-hormonal Birth Control
- Permanent Birth Control
- U.S. Selected Practice Recommendations for Contraceptive Use, 2016. CDC. https://www.cdc.gov/mmwr/volumes/65/rr/rr6504a1.htm#F-1-2_down
- Kaunitz A, et al. Patient education: Birth control; which method is right for me? (Beyond the Basics). Up to Date. Accessed May 4, 2020 at https://www.uptodate.com/contents/birth-control-which-method-is-right-for-me-beyond-the-basics
- FDA. Drugs@FDA: FDA Approved Drug Products. Accessed May 4, 2020 at https://www.accessdata.fda.gov/scripts/cder/daf/
- Planned Parenthood. Website. Birth Control Pills. Accessed May 4, 2020 at https://www.plannedparenthood.org/health-info/birth-control/birth-control-pill
- American College of Obstetrics and Gynecology (ACOG): Birth Control (Contraception): Resource Overview. Accessed May 3, 2020 at https://www.acog.org/Womens-Health/Birth-Control-Contraception#Patient
- U.S. Food and Drug Administration (FDA). Birth Control. Accessed May 3, 2020 at https://www.fda.gov/consumers/free-publications/birth-control.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.