Comparing Birth Control Pill Types

Birth control effectiveness can be an important part in your decision to choose a certain contraceptive method. Yet, birth control effectiveness greatly depends on whether or not you use your contraceptive reliably and correctly. If you want high levels of birth control effectiveness, you can’t allow yourself to become careless with your chosen method - this means use it always and use it the right way! Even though no birth control method is fool-proof, believe it or not, there are certain steps that you can take to increase your birth control effectiveness:

Are you taking, or considering taking, a birth control pill? Nearly 12 million U.S. women do. And though you may simply call it “the pill,” there are many different types of birth control pills.

Each type of pill has pros and cons. But first, make sure that this form of contraception is right for you.

Here’s what to consider.

2 Questions to Ask Yourself First

- Will you still use a condom to protect against STDs? Male condoms offer the best protection against STDs. With all other methods of contraception, you should also use a condom.
- How likely are you to forget pills now and then? The answer matters, because it affects how well the pill works. “You should swallow a pill at the same time every day, whether or not you have sex,” the FDA’s web site states.

When taken correctly, the pill is highly effective at preventing pregnancy. But that phrase “when taken correctly” is key.

About 8% of women who take the pill become pregnant unintentionally each year. In most of those cases, the women forgot to take pills. Yet when used perfectly - every day at the same time of day - only 1 in 100 women have an unintended pregnancy during the first year of using the pill.

So yes, the pill works. But it’s not ideal for women wanting a contraception method that they don’t need to think about.

How Does Hormonal Contraception Work?

Normally a woman becomes pregnant when an egg released from her ovary (the organ that holds her eggs) is fertilized by a man’s sperm. The fertilized egg attaches to the woman’s womb (uterus), where it receives nourishment and develops into a baby. Hormones in the woman’s body control the release of the egg from the ovary and prepare the body to accept the fertilized egg.

Hormonal contraceptives (the pill, the patch, and the vaginal ring) all contain a small amount of synthetic estrogen and progestin hormones. These hormones work to inhibit the body’s natural cyclical hormones to prevent pregnancy. Pregnancy is prevented by a combination of factors. The hormonal contraceptive usually stops the body from releasing an egg from the ovary. Hormonal contraceptives also change the cervical mucus to make it difficult for the sperm to find an egg. Hormonal contraceptives can also prevent pregnancy by making the lining of the womb inhospitable for implantation.

A new option for hormonal contraceptives is extended-cycle pill use; the first one approved is called Seasonale. Seasonale contains the same hormones as in other birth control pills, but they are taken in a longer cycle to reduce the number of yearly menstrual periods from 13 periods a year to only four periods a year. Therefore, women menstruate only once each season.

Seasonale contains the same combination of two hormones commonly used in other hormonal contraceptives, and are in low doses taken continuously for 12 weeks followed by one week of inactive pills which causes a menstrual cycle.

What Are Mini Pills?

These are pills that contain only one hormone (progestin). They do not contain estrogen and may be prescribed in women who are breastfeeding or in women who experience nausea with estrogen.

How Do Mini Pills Work?

Mini pills work by thickening the cervical mucus so the sperm cannot reach the egg. The hormone in the pills also changes the lining of the uterus, so that implantation of a fertilized egg is much less likely to occur. In some cases, mini pills stop ovulation (the release of an egg). A pill is taken every day.

How Effective Are Mini Pills?

If mini pills are used consistently and correctly, they are about 95% effective - somewhat less effective than standard birth control pills.

“It’s a very effective method for women who remember to take their pill each and every day at around the same,” says Elizabeth Micks, MD, an instructor and fellow in family planning at Oregon Health and Science University.

Birth control methods that don’t require daily action on the woman’s part, such as intrauterine devices (IUD) and contraceptive implants, have significantly lower failure rates.

If you’ve answered those questions and decided that you want birth control pills as your form of contraception, here are the options.

Types of Pills

There are two main types of birth control pills: combination pills and progestin-only pills. Most pills are available in both a 21-day or a 28-day pack. They are often classified on the amount of estrogen and/or the amount and type of progestin.

Breastfeeding as Birth Control
Breastfeeding as Birth Control at a Glance

- Sometimes called LAM (Lactational Amenorrhea Method)
- A natural way to prevent pregnancy after giving birth
- Effective, safe, convenient, and free
- Lasts for up to six months after giving birth

Is Breastfeeding as Birth Control Right for Me?
All of us who need birth control want to find the method that is best for us. Use My Method to find out which birth control methods may be right for you.

Women who have just given birth may use continuous breastfeeding as a method of birth control. Here are some of the most common questions we hear women ask about using breastfeeding as birth control. We hope you find the answers helpful.

Combination pills. These contain the hormones estrogen and progestin. Most birth control pills are combination pills. They’re equally effective at preventing pregnancy - again, when taken correctly. They may also have other benefits, including:

- Shorter, lighter, more regular, and less painful periods
- May reduce the severity or frequency of menstrual migraines
- Can improve bleeding and pain associated with endometriosis and fibroids
- May improve acne
- Can lower risk of ovarian and uterine cancer
- Can lower risk of pelvic inflammatory disease
- May improve bone density in the years just before menopause

All combination pills slightly raise the risk of heart attacks, stroke, and blood clots that start in a leg vein but could travel to other parts of the body - including the lungs, which could be fatal. That risk rises if you’re a smoker older than 35.

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