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Birth control pills – Types

Modern contraception include three most common types of birth control pills:
1. Combined birth control pills – so called “PILLS”
2. Progestin-Only birth control pills (POP)
3. Emergency Contraceptive Pills (ECP) – so called Morning After Pills or called Plan B

Combined Birth Control Pills

Combined birth control pills contain two components – estrogen and progestin. Each pill in the pack contains a combination of these two hormones. Combined birth control pills could be monophasic, where each of the active pills contains the same amount of estrogen and progestin, or multiphasic where the active pills contain varied amounts of hormones designed to be taken at specific times throughout the menstrual cycle and pill-taking schedule.

There are different ways you can use combined birth control pills – packages for 21 days, packages for 28 days and even possible for 91 days.

Birth control pills

Birth control pills

21-day pills. If your birth control pack contains 21 pills, you will take one pill at the same time each day for 21 days (preferably every evening before going to bed) and then wait seven days to start a new pack. During these seven days, you will get your period. You start next package after period.
Discover 3 possible ways – How to start Birth Control Pills

28-day pills. With 28-day pills, you take a pill at the same time each day for 28 days (preferably every evening before going to bed). Usually, the first 21 pills contain combined hormones, and the last seven pills are placebo pills (empty – without hormones). During the week when you take the last seven pills, you will get your period. Once you’ve finished all the pills in your pack, you’ll start a new pack of 28 pills.

91-day pills. This type of contraception called extended cycles or extended-use pills – they are marketed under the brand names Seasonale, Seasonique, LoSeasonique and Quasense. This dose regimen calls for taking a pill at the same time every day for 91 days (preferably every evening before going to bed). The first 84 pills contain hormones, and the last seven are placebo (sugar) pills or a very low dose of estrogen to help control some period symptoms. You get your period when you take the sugar pills. With this method of contraception you only get your period four times a year. But you may have some light brown bleeding or spotting of blood as your body adjusts to the extended-use pills.

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.

In order to skip their periods some women take their birth control pills continuously or refrain from taking the sugar pills in the 28-day pack so they are only ever taking pills that contain hormones. This may work best for women using monophasic pills. If you’re considering this option, discuss it first with your doctor.

Combined pills’ advantages include following positive actions:

  • reversible type of contraception,
  • reduce risk of ovarian cancer and endometrial cancer,
  • reduce the frequency of ectopic pregnancy,
  • decrease the volume of menstrual blood,
  • could be effective for menstrual cramps,
  • make premenstrual symptoms less severe,
  • help regulate menstrual cycles,
  • could be effective for acne treatment,
  • prevent bone density loss in women over 30,
  • decrease the risk of ovarian cysts,
  • could be effective for hirsutism treatment,
  • can improve endometriosis.

Combined pills’ disadvantages include the following – nausea, vomiting, headaches and/or spotting, particularly during first few cycles; high blood pressure; blood clots in very specific group of users; stroke risk; gallstones and rare benign liver tumors.

Birth Control Pills possible side effects include – nausea and vomiting, headaches, irregular bleeding, weight gain, breast tenderness, increased breast size. Mentioned side-effects should not be a reason for discontinue the method – they are common during the first 3 cycles and then usually disappear.

Before you start Birth Control Pills, you need to know more about:

Progestine-only Birth Control Pills (POP)

This type of pills do not contain estrogen component and usually called progestin-only pills or “mini-pills”. This type of contraception is very convenient for breastfeeding women (because estrogens usually reduce milk production). It’s also ideal for women who cannot take estrogen (especially for smoking women over 35). Progestin-only pills primarily work by preventing ovulation, thinning the endometrium and thickening the cervical mucus and thereby preventing sperm from entering the uterus. However, with progestin-only birth control pills, ovulation isn’t consistently suppressed, so the actions on cervical mucus and the endometrium are the critical factors. To work effectively, they must be taken at a certain time every 24 hours.

Progestin-only birth control pills advantages:

  • reversible type of contraception,
  • decreased volume of menstrual blood loss,
  • decreased frequency of menstrual cramps,
  • can be used by breastfeeding women immediately after delivery,
  • good choice for women who cannot use estrogen (especially for smoking women over 35).

Progestin-only birth control pills’ disadvantages include irregular bleeding, brown spotting, brown discharge and/or breakthrough bleeding, do not protect against sexually transmitted diseases (STDs), increased risk of follicular cysts on the ovaries, may be slightly less effective than combination oral contraceptives.

Progestin-only birth control pills’ possible side effects include amenorrhea (absence of a monthly period), irregular bleeding, tender breasts, nausea, headaches.

Discover more about MINI-PILLS on next page

Emergency contraception or Morning after pills or Plan B

Emergency Contraception is not intended to be used regularly as a contraception method. This type of contraception is designed to prevent pregnancy after unexpected accidentally unprotected sex – when no contraceptive has been used; when no contraceptive method was available; when contraceptive methods failed (missed pills, condom rupture, diaphragm dislodgement, etc.); when girl or woman has been a victim of the sexual attack (abuse).

Emergency contraception can be used during 72 hours after unprotected sex.
Emergency contraceptive pills can contain progestogen-only or combined hormones (oestrogen and progestogen components).
In addition, certain regular oral birth control pills can be used for emergency contraception – see detailed instructions on next page.

Emergency Contraception Mode of Action

Hormonal emergency contraception achieves its contraceptive effect by several mechanisms depending on the time in a woman’s cycle it is taken. It can inhibit or delay ovulation and may also interact with ovum and sperm transport, and fertilization. Studies differ on whether hormonal emergency contraception can cause changes in the endometrium that would be sufficient to interfere with implantation. There is no evidence that hormonal emergency contraception dislodges the embryo after implantation has occurred.

Emergency Contraception Advantages:

  • reduces the chance of unwanted and unplanned pregnancy,
  • can be used during 72 hours after unprotected sex,
  • can be obtained in advance and kept handy in case of an emergency such as condom breakage, missed oral contraceptives, late contraceptive injections or forced sex.

Emergency Contraception Disadvantages: Time limitation – It should be taken during 72 hours after unprotected sex. Earlier taken – better effect can be expected and Possibility of menstrual cycle dysfunctions – Sometimes normal menstrual cycle rhythm can be changed.

Emergency Contraception Possible Side Effects include nausea and vomiting, dizziness and fatigue, headache, menstrual cycle dysfunctions (early period, late period, bleeding, etc.), breast tenderness, menstrual cramps and/or pain.


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One Comment

  1. Very helpful information about birth control pills…….Thanks for the post…

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