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Types of Birth Control Pills (Oral Contraceptives)

Medically reviewed on Mar 19, 2018 by L. Anderson, PharmD.

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 1 percent (%) 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 can be 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 formulary. Again, if you have prescription drug insurance, your birth control 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 Names of Birth Control Pills?

Examples of combination birth control pills include:

  • Apri
  • Aviane
  • Azurette
  • Balcoltra
  • Beyaz
  • Caziant
  • Cryselle
  • Gianvi
  • Junel
  • Kariva
  • Kelnor
  • Levora
  • Loestrin 24 Fe
  • Low-Ogestrel
  • Microgestin
  • MonoNessa
  • Natazia
  • Necon
  • Nortrel
  • Ocella
  • Ogestrel
  • Ortho-Novum
  • Portia
  • Previfem
  • Safyral
  • TriNessa
  • Trivora
  • Velivet
  • Yasmin
  • Yaz
  • Zarah
  • Zovia 1/35
  • Zovia 1/50

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:

  • Camila
  • Errin
  • Heather
  • Jolivette
  • Nora-BE

Learn More: 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 or two combination (estrogen and progestin) pills, take them as soon as you remember. Take your next pill at the regular time. This means if you miss two pills, you would take both missed pills at the same time, and then take your next pill whenever it is due. Taking two pills at once may make you feel a little sick to your stomach, but that will not last long. Use a back up method of birth control, such as a condom, sponge or spermicide until you finish the pack, unless your healthcare provider advises otherwise.

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 the remainder of the mini-pills on the regular schedule. Use a back-up method of birth control, such as a condom, sponge or spermicide for the next 48-hours.

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:

  • age
  • weight
  • 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:

  • IUDs
  • 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 Proprietary Name(s) Description
desogestrel and ethinyl estradiol

Apri, Azurette, Caziant, Cyclessa, Desogen, Emoquette, Enskyce, Isibloom, Juleber, Kariva, Kimidess, Mircette, Ortho-Cept, Reclipsen, Velivet, Viorele, Solia, Cesia, Cyred

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, Loryna, Nikki, Ocella, Syeda, Vestura, Yasmin, Yaz, Zarah

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.
drospirenone and ethinyl estradiol and levomefolate Beyaz, Rajani, Safyral 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

Kelnor, Zovia 1/35, Zovia 1/50

Monophasic combination progestin and estrogen pill.
levonorgestrel and ethinyl estradiol

Altavera, Amethia Lo, Amethyst, Ashlyna, Aubra, Aviane, Camrese, Camrese Lo, Chateal, Daysee, Delyla, Enpresse, FaLessa Kit, Falmina, Fayosim, Introvale, Jolessa, Kurvelo, Larissia, Lessina, Levlen, Levonest, Levora, Lillow, LoSeasonique, Lutera, Marlissa, Myzilra, Orsythia, Portia, Quartette, Quasense, Rivelsa, Seasonale, Seasonique, Setlakin, Sronyx, Trivora-28, Vienva

Combination progestin and estrogen pill; some are triphasic,  extended-cycle pills, or continuous-cycle pill.
mestranol and norethindrone Necon 1/50, Norinyl 1+50 Combination progestin and estrogen monophasic pill
norethindrone

Aygestin, Camila, Deblitane, Errin, Heather, Jencycla, Jolivette, Lyza, Nor-QD, Nora-BE, Norlyda, Norlyroc, Ortho Micronor, Sharobel

Progestin-only birth control pills (“mini-pills”); for use in breast-feeding or high risk for blood clots.
norethindrone and ethinyl estradiol

Alyacen 1/35, Alyacen 7/7/7, Aranelle, Balziva, Brevicon, Briellyn,  Cyclafem 1/35, Cyclafem 7/7/7, Dasetta 1/35, Estrostep Fe, Femcon Fe, Generess Fe, Gildagia, Gildess, Gildess FE 1.5/30, Junel 1.5/30, Junel 1/20, Junel Fe 1.5/30, Junel Fe 1/20, Leena, Lo Loestrin Fe, Loestrin 21 1.5/30, Loestrin 21 1/20, Loestrin 24 Fe, Loestrin Fe 1.5/30, Loestrin Fe 1/20, Microgestin 1.5/30, Microgestin 1/20, Microgestin FE 1.5/30, Microgestin FE 1/20, Minastrin 24 Fe, Modicon, Necon 0.5/35, Necon 1/35, Necon 10/11, Necon 7/7/7, Norinyl 1+35, Nortrel 0.5/35, Nortrel 1/35, Nortrel 7/7/7, Ortho-Novum 1/35, Ortho-Novum 7/7/7, Ovcon 35, Ovcon 35 Fe, Philith, Tilia Fe, Tri-Legest Fe, Tri-Norinyl, Wera, Wymzya Fe, Zenchent Fe, Zeosa

Combination progestin and estrogen pill; some are biphasic or triphasic.
 
norgestimate and ethinyl estradiol

Estarylla, Femynor, Mono-Linyah, MonoNessa, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Ortho-Cyclen, Previfem, Sprintec, Tri Femynor, Tri-Estarylla, Tri-Linyah, Tri-Lo-Estarylla, Tri-Lo-Marzia, Tri-Lo-Sprintec, Tri-Previfem, Tri-Sprintec, TriNessa, TriNessa Lo, TriVyLibra, VyLibra

Combination progestin and estrogen pill; some options are triphasic.
norgestrel and ethinyl estradiol Cryselle 28, Low-Ogestrel, Ogestrel-28, Lo/Ovral-21, Lo/Ovral-28, Ovral, Ovral-28, Low-Ogestrel-21, Ovral-21, Elinest Combination progestin and estrogen pill.

For other options, generic and proprietary names, also see: Oral Contraceptives

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