Combination birth control pills, or the pill for short, are oral contraceptives that prevent pregnancy. If you’re considering your birth control options, the pill is one of the most common and most effective.
The combination pill is a type of birth control pill that contains both estrogen and progestin, which are two hormones used to prevent pregnancy.
Many brands of combination pills are available, and they are usually divided into three categories, including:
- Monophasic 21-day pills. This is the most common type of combination pill, which provides the same amount of hormones in each pill. It is usually taken daily for 21 days, followed by 7 days without taking any pills.
- Phasic 21-day pills. This type has two to three different colored pills per pack, each of which contains varying levels of hormones and must be taken in order. Like monophasic pills, phasic pills should be taken daily for 21 days, followed by 7 days without taking any pills.
- Every day pills. This type of birth control contains 21 active pills and 7 placebo pills per pack. Each pill should be taken in order once per day, without any breaks between packs.
Birth control pill prescriptions are relatively easy to get and are typically covered by health insurance. Many online birth control services will deliver the pill straight to your doorstep each month.
The pill contains a combination of synthetic hormones — that’s why it’s called the combination pill. These hormones work in two main ways.
First, the pill stops the ovaries from releasing an egg each month, a process known as ovulation. The pill also thins the lining of the uterus and thickens cervical mucus, both of which work to make implantation less likely.
Estrogen and progestin are the two main hormones in the combination pill. The estrogen in birth control pills may result in better control over your period, though it’s also associated with some risks.
“Taking estrogen continuously throughout the active pills suppresses the ovarian formation of a mature follicle (the sac within which the egg grows), thereby suppressing ovulation,” explains Rashmi Kudesia, MD, a fertility doctor in Houston.
The amount of estrogen in combination pills may vary. Low dose pills are available and quite common.
If taken perfectly, the combination pill is 99 percent effective at preventing pregnancy, according to Planned Parenthood.
However, many people forget to take pills at the right time or may occasionally miss a dose. Because of this, it’s estimated that the combination pill is around 91 percent effective for most users.
This means that for every 100 people who use the combination pill, approximately 9 will get pregnant each year.
The combination pill can be used by people who want to prevent pregnancy.
It may also be prescribed to treat other conditions like acne, unwanted hair growth, endometriosis, and polycystic ovary syndrome.
However, combination birth control pills may not be suitable for people who have any of the following health conditions:
- breast cancer
- high blood pressure or vascular disease
- heart disease
- migraine headaches with aura
- certain liver diseases
According to the
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Pros
- 99 percent effective when taken perfectly
- can be used to improve gynecological conditions, like polycystic ovary syndrome and endometriosis
- may be prescribed to treat acne and unwanted hair growth
- lighter, predictable periods or no periods at all
- may lower the risk of ovarian, colorectal, and endometrial cancers
Cons
- must be taken daily, around the same time for maximum effectiveness
- side effects may happen, including nausea and irregular bleeding
- may pose a risk of blood clots, high blood pressure, and more
- prescription is required
- slightly increases risk of breast cancer
Birth control pills are taken orally every day. For maximum effectiveness, you should take the pill around the same time every day.
There is no specific time of day that you have to take your pill. However, taking the pill in the evening or with a meal may decrease nausea.
As long as you meet the medical eligibility, there is no limit on how long you can be on the pill. If you want to become pregnant, you can stop taking the pill.
The chance of becoming pregnant while taking the pill is low. Planned Parenthood estimates that 9 percent of birth control pill users get pregnant. When taken perfectly, the chance of pregnancy while on the pill is 1 percent or less.
Aside from pregnancy, there are other combination pill side effects and risks to consider.
“The most common side effect… is irregular bleeding in the first few months of use,” says Katharine White, MD, a gynecologist and associate professor of OB-GYN at the Boston University School of Medicine.
“Your bleeding patterns will regulate with time — but if irregular bleeding doesn’t improve by your fourth pack, talk with your doctor about changing which pill you’re taking. A different combination of hormones may work better for you.”
If you want to switch birth control pills, chat with a medical professional about how to switch without having gaps in your birth control plan.
According to White, the risks of the combination pill are much lower than the risks of pregnancy. Pregnancy risks include blood clots, high blood pressure, heart attack, stroke, and liver tumors.
Do combination pills work right away?
You can start taking combination pills at any time if you meet medical criteria.
According to Planned Parenthood, starting within 5 days of your period offers immediate protection. If you start at any other time in your menstrual cycle, the pill is effective after 7 days of daily use.
Do you get your period on a combination pill?
Skipping your period is only possible with combination birth control pills. You can skip your period by continually taking the birth control pills and skipping the hormone-free placebo pills.
According to the CDC, birth control pills are the most common form of female contraception after sterilization. Of the birth control options out there, the combination pill is an effective one.
Online birth control services are accessible and affordable resources for people interested in the pill.
However, birth control is not one-size-fits-all. Many people who menstruate are great candidates for the pill, but there are risks, side effects, and contraindications. To determine if the combination pill is right for you, consider talking with a doctor.