How Do Birth Control Pills Work?
The birth control pill is the most popular contraception method today. 28% of women (10.6 million) in the United States use the pill according to the CDC.
Birth control pills work by emitting naturally-occurring hormones estrogen and progestin to prevent pregnancy. These hormones stop sperm from fertilizing an egg by stopping ovulation. Ovulation occurs when an ovary releases an egg, making it available for sperm to fertilize. The hormones in the pill also thicken cervix mucus, meaning it is more difficult for the sperm to get to the egg.
Different Types of Birth Control Pills
Birth control pills come in a variety of shapes and sizes, but there are two main types:
- Combination pills and progestin-only pills. Combination pills get their name as they combine two hormones, estrogen and progestin, in order to prevent pregnancy. The amount of each hormone and the balance varies from brand to brand.
- Progestin-only pills, meaning they contain no estrogen, are sometimes called the mini pill birth control. They also prevent pregnancy and for some women with estrogen sensitivity, they can be helpful in reducing certain side effects.
Birth control pills also work with different cycle lengths. The main types are 21-day packs, 28-day packs, and 91-day packs. The days in the cycle determine when you will get your period.
For the 21-day pack, you take pills for 21 days (three weeks), and get your period during the fourth week. There are still pills to take in the fourth week, but they are hormone-free and are just used to keep your habit of taking the pill every day.
The pills may contain iron or other supplements that help keep you healthy and are often referred to as reminder pills or “placebo” pills. 28-day packs work the same except you take pills for 28 days (four weeks) and get your period during the week after. 91-day packs means you will only get your period every three months or 12 weeks.
Some common birth control pill brands include Yaz, Yasmin, and Ortho Tri-Cyclen. A medical provider can prescribe these pills based on what’s best for the patient and their needs, but no matter the brand or hormone level, all help prevent pregnancy.
Combination Pills: Options and Reviews
The pill, patch and the ring are all combination birth control treatments — meaning they contain estrogen and progestin. There are more combination birth control pill options than progestin-only. The side effects for these drugs include acne, breast tenderness and nausea/vomiting.
These are your choices of combination birth control pills:
- Azurette: an oral contraceptive regimen of 21 white, round tablets. Azurette has a 6.9/10 rating on drugs.com.
- Beyaz: 24 pink tablets. drugs.com users rates this drug a 6.8/10.
- Enpresse: 28 tablets. drugs.com users rate Enpresse a 5.8/10.
- Kariva: 28 tablets. drugs.com users rate drugs a 6.2/10.
- Levora: Levora 28 comes with 7 reminder pills (also called sugar pills). These pills contain no medicine, but will help you remember to take the pills at the same time every day. Levora 21 contains no reminder pills. Levora has a 6.1/10 average customer review according to drugs.com.
- Loestrin: Each pill pack has 24 active blue pills and 2 active white pills. Each pack has 2 "reminder" brown pills. Loestrin has a 6.6/10 rating on drugs.com.
- Natazia: The pill pack contains 26 active pills and 2 reminder pills. According to drugs.com reviews, Natazia has a 6.8/10 rating.
- Ocella: 28 tablets per pack. In each pack, 21 tablets contain hormones, and the rest do not. Drugs.com reviewers give Ocella a 6.6/10.
- Ortho-Novum: 21 pills with active medication. It may also contain 7 reminder pills with no medication. 8.3/10 rating according to drugs.com.
- Seasonale: 3 months of active medication followed by one week of inactive pills. 5.9/10.
- Seasonique: 3 months of active medication followed by one week of inactive pills. Rating of 5.5/10.
- Velivet: 28 tablets per pack. In each pack, 21 tablets contain hormones, and the rest do not. Rating of 5.8/10.
- Yasmin: 28 tablets per pack. In each pack, 21 tablets contain hormones, and the rest do not. Yasmin has a 6.2/10 rating.
- Yaz: Contains 28 tablets — 24 active tabs and 4 inactive. 6.4/10.
Progestin-Only Pills: Options and Reviews
Progestin-only pills are available because for some women, the side effects of combination pills are too severe.
Progestin-only pills are also recommended for women over 35 and smoke and women with a history of blood clots or high blood pressure.
In general progestin-only pills have lower ratings than combination pills.
- Camila: 28 tablets per pack. 4.4/10 rating.
- Errin: 4.7/10
- Heather: 6.8/10, which makes Heather tied for the highest rated progestin-only pill.
- Jencycla: 6.8/10, which makes Jencycla tied for the highest rated progestin-only pill.
- Nor-QD: 28 pills. No review available.
- Ortho Micronor: 28 pills. 6.0/10 review according to drugs.com.
Does Birth Control Stop Periods?
Taking birth control pills does not mean you automatically stop your period, but it does make it so your period happens only during the time you are taking the reminder pills.
You can use birth control pills to skip your period once or stop getting your period all together by skipping the reminder pills and jumping to the next pack of birth control. This is completely safe and will not be harmful to you or change the effectiveness of the pill.
Some women report using this method to make sure they don’t get their period during a vacation or at an inconvenient time. Other women use this method to become period free. If you do this, it is still possible to have some spotting or bleeding. If you always skip the reminder pills, then this spotting usually goes away after six months.
Birth Control Pills Side Effects
Birth control pills combine two hormones that work to prevent pregnancy (or only one in the case of progestin-only pills), but also provide other positive benefits. These include making your period regular, easing menstrual cramps, helping protect against pelvic inflammatory disease, and lighten bleeding.
Additionally, it can help prevent or reduce: acne, anemia, PMS, serious infections in your reproductive organs, bone thinning, ectopic pregnancy, cysts in ovaries or breasts, and ovarian, endometrial cancers.
But it’s important to note that birth control pills can have negative side effects as well as well. Commonly reported side effects are sore breasts, bleeding between periods, nausea, and headaches.
While these side effects are common, they usually go away in 2 to 3 months.
While exceptionally rare, there are very serious risks with this method including complications as a result of the increased estrogen levels, such as liver tumor, blood clots, heart attack and stroke. See a doctor immediately if you have any of the following warning signs: chest pain, trouble breathing, severe pain in stomach, headaches that are sudden and worse than usual, sudden back or jaw pain, seeing flashing lines, or yellowing on the eyes or skin.
According to several studies, contrary to popular belief, birth control pills do not cause weight gain.
How Effective are Birth Control Pills?
The effectiveness of birth control pills depends on how well it is used. If used perfectly, the pill can be 99% effective. In reality, the average effectiveness is 91%, meaning 9 of every 100 people each year will get pregnant even while using the pill. People can forget to take the pill on time or even for days at a time. Taking the pill on time every day means that you get the proper balance of hormones to prevent pregnancy. Finally, taking some medication can decrease the effectiveness of the pill:
- Certain HIV medicines
- Certain medicines to prevent seizures
- Certain antibiotics and antifungals
It is best to consult a doctor if you are planning to go on the patch and worry about other medication interring with its effectiveness.
What to Do About a Missed Birth Control Pill
As much as you may try to always take your birth control every day at the same time, sometimes you may forget. Here’s what to do:
- As soon as you remember, take your most recent pill. If you missed multiple pills, throw the previous ones in your current cycle away.
- Resume your normal time. Taking two pills in one day is fine. For example if you forgot to take your pill yesterday at 5 PM, and remember at 8 AM the next day, you can take the missed birth control pill at 8 AM and the regular one for the day at 5 PM.
- If you have had sex since the missed pill, consider taking emergency contraception, such as Plan B. Plan B can be purchased from a drugstore without a prescription.
- Use condoms during sex for the next week. This is especially important if it has been more than 48 hours since you missed your pill. You will not be fully protected by the pill until one week later.
How to Get Birth Control Online
You can procure prescriptions for birth control pills, the birth control patch, and the birth control vaginal ring online.
Instead of going to your gynecologist, you may opt to book an appointment and speak to a doctor via your phone or desktop.
If you would like to book an appointment to speak with a doctor about birth control, please do so below.
PlushCare is a licensed provider, easy to use, and allows you to interact using video chat or over the phone with a doctor directly to discuss birth control options and any other questions you have. You can then have the birth control prescribed to you and sent to your local pharmacy for pick up.
If you’re interested in understanding other birth control options, read the rest of our series: