woman holding birth control pills

Birth Control Pills: What You Need to Know

August 5, 2022

There are a lot of birth control pills on the market these days, and it can be tough to figure out which one is right for you. In this blog post, we will discuss the different types of birth control pills available and help you decide which one is best for you. It is important to understand the various types of pills and how they work, so that you can make an informed decision about which one is right for you when meeting with a provider.

Types of Birth Control Pills

There are 2 types of birth control pills available:

1 Estrogen/progestin combinations

Available as a pill, patch, and vaginal ring.

Combined oral contraceptives (COCs): estrogen/progestin combination oral pills

COCs are primarily for women who have menstrual cramps, premenstrual syndrome (PMS), acne, anemia (decreases blood loss), and perimenopause symptoms, such as hot flashes and night sweats.

COCs are also considered first-line treatment options for those who have polycystic ovary syndrome (PCOS), a hormonal disorder that causes infrequent, irregular, or prolonged menstrual periods, as well as endometriosis, where tissue grows outside of the uterus.

Most COCs involve 28 days (4 weeks) of pills, with 21–24 pills containing active hormone and the remaining pills containing no hormone. During week 4 (the inactive pill), bleeding occurs for 3-7 days.

Common side effects of COCs, due to estrogen, include:

  • Nausea
  • Breast tenderness
  • Bloating
  • Weight gain, which is due to fluid retention
  • Increased blood pressure
  • Bleeding between periods

2 Progestin-only options

Available as a pill, injectable, implant, and IUD.

Progestin-only pills (POPs) also known as 'mini-pills' do not contain any estrogen, and have 28 days of active pills in each pack.

POPs are primarily for women

who are lactating (breastfeeding), have a history of blood clots and/or strokes, or have migraines with aura. POPs must be taken at the same time each day to maximize effectiveness.

Common side effects of POP, due to progestin, include:

  • Breast tenderness
  • Headache
  • Fatigue
  • Mood changes
  • Bleeding between periods
  • Weight gain

It may be useful to have an idea of which kind of birth control pill would seem appropriate for you before going to the doctor.

All FDA-approved generic medicines contain the same active components and dosage as the brand name versions, and they are interchangeable (they function in the same manner). All interchangeable medications may be substituted at the pharmacy without consulting your doctor.

Birth Control Pills: Combined Oral Contraceptives

We can break these down into 3 categories: monophasic, continuous use, and multiphasic

Monophasic birth control pills have the same amount of synthetic estrogen and progestin in each active pill. 28 days of active pills are followed by either no placebo pills or four to seven days of placebo pills, depending on the brand. Some of these end in "Fe" which means they include iron supplements.

Some popular Monophasic pills are: Ortho-Cyclen, Microgestin, Yasmin, Yaz and Lo Loestrin Fe.

Continuous Birth Controls are used to decrease dysmenorrhea and the number of periods or to prevent menstrual migraines. These birth controls include 84 days of active hormone pills followed by 7 days of inactive pills, which are taken for a total of 91 days. Bleeding happens every three months instead of monthly with this schedule.

Some popular Continuous birth control pills are: Jolessa, Amenthia, Seasonal, and Seasonique

Multiphasic birth control bills can be biphasic, triphasic, or quadriphasic. These are designed to mimic fluctuations in hormones during the menstrual cycle. The estrogen and progestin combination varies as the month progresses. There is no significant difference in efficacy between the different combinations.

Some popular Biphasic birth control pills are: Azurette and Kariva

Some popular Triphasic pills are: Ortho Tri-Cyclen, Tri-Sprintec, Tri-Lo-Estarylla

Natazia is the Quadriphasic pill option on the market currently.

As you can see, there are many different types of birth control pills on the market today. It is important to discuss with your doctor which one would be best for you, based on your individual medical history and health concerns.

The type of pill you choose is a personal decision, and your doctor or prescriber can help you decide which one is right for you.

At Person Street Pharmacy, we offer free or low cost birth control options. Depending on your insurance, your pills will be at no or little cost to you. No insurance or high deductible plan? We offer a low-cost generic drugs program that covers most types of birth control. We can ship anywhere in North Carolina, South Carolina or Georgia.

As of August, 2022, we also have two pharmacists on staff who are licensed to write birth control prescriptions. So, if you are in the Raleigh area and need a prescription, schedule a consultation with one of our pharmacists. Save yourself the hassle of going to the doctor, and get your prescription, and pills, in one spot.