Sofie Wise

Jillian Stenzel

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About Author — A Nevada-bred traveler & food nerd who dances & eats spinach, sometimes simultaneously. She writes from wherever her curiosity demands, and is passionate about spreading the wisdom of better health.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog.

What are estrogens?

Estrogens are hormones that drive sexual and reproductive development in women. Aside from being responsible for female characteristics, menstruation and reproductive function, some forms of estrogen are used for medical purposes, especially the type in birth control pills, which send feedback to the brain to prevent ovulation and thwart the production of certain hormones.

What is low estrogen birth control?

Most birth control pills contain a combination of estrogen and progestin. While effective at preventing pregnancy, high levels of estrogen in birth control pills often come with a host of undesirable side effects.

Women on the pill can suffer from any of the following symptoms:

  • Headache
  • Nausea
  • Decreased libido
  • Spotting
  • Weight gain
  • Missed periods
  • Mood swings
  • Breast tenderness

The higher dose of estrogen, the worse these symptoms tend to be.

If you like the idea of taking a pill for birth control, but want to avoid estrogen and its side effects altogether, you might consider the minipill– a progestin-only birth control pill. On top of being estrogen-free, the minipill actually has less progestin than combination oral contraceptives which contain both estrogen and progestin.

The mini birth control pill works by thinning the lining of the uterus and thickening the cervical mucus. This prevents sperm from reaching an egg and helps to suppress ovulation. You may still have periods while taking the mini birth control pill and it is important to take the pill at the same time every day.

The mini birth control pill may be right for you if you have any of the following:

  • Concern about estrogen: You don’t want to take birth control that takes estrogen because you are concerned about the side effects.

  • You are breastfeeding: You are breastfeeding your baby and are concerned about the possibility of inhibited milk production.

  • You have health issues: If you have an increased risk or a history of blood clots in your legs or lungs, you doctor may recommend the mini pill as an alternative form of contraceptive.

Why use birth control with estrogen?

So, if estrogen causes all of these symptoms, why consider anything but the minipill? Combination pills– those which contain estrogen and progestin– are more effective at preventing pregnancy than the minipill. If your concern is efficacy, but you would like to minimize the side effects of estrogen, the best compromise is to try a low dose, or low estrogen, combination birth control pill.

Brands of low-dose estrogen pills

The following are all low-dose estrogen birth control brands:

  • Alesse
  • Apri
  • Aviane
  • Levlen 21
  • Levora
  • Lo Loestrin Fe
  • Mircette
  • Ortho-Novum
  • Yasmin
  • Yaz

In the early days of birth control, the pill contained 150 mg of estrogen. Today, even the highest doses contain 50mg, and are rarely prescribed. Most birth control pills nowadays contain 35mg or less of estrogen. If you want even less than 35 mg estrogen, you may look into what is referred to as either low or ultra low-dose pills, which contain 20 mg or less of estrogen.

Are ultra low-dose pills effective?

So far, ultra low-dose pills have been just as effective as higher estrogen pills in preventing pregnancy, and come with fewer symptoms. They aren’t entirely without side effects, however. Many women on low dose pills experience breakthrough bleeding or spotting, to the point that they stop taking them. Vaginal dryness and pelvic pain are two other common symptoms that can make sex uncomfortable, and therefore deter women from low-dose pills.

The lowest hormone option, of course, is to not use hormones at all. The most effective estrogen and hormone-free form of birht control is the copper IUD, which is inserted once and is 99.9% effective at preventing pregnancy for up to 10 years. While effective and easy to maintain, the copper IUD comes at a hefty price tag. For this reason, other low estrogen or forms of birth control may be a more practical option for most women.

If your symptoms from higher dose pills are too much to bear, speak to a doctor online to learn more about what low-dose birth control options are best for you. PlushCare doctors are available online or by phone to discuss your symptoms and prescribe, refill or change your birth control prescription as needed.

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