So many kinds, how do you choose?

In this section you will learn the differences between all of the Pills on the market and why it is important to pay attention to the benefit profiles and chemical make-ups.

Vive la difference

While all birth control pills may work in the same way, they are not all the same.  

Run that by me again, you might say.  OK, here's the scoop.  All birth control pills contain hormones that stop the ovaries from releasing eggs, or as your healthcare professional might put it, they “suppress ovulation.”  That's how they work to prevent pregnancy.  No ovulation = no pregnancy.

But – and here comes the other important but – different birth control pills may contain different types, as well as amounts, of hormones.  Out of more than 40 brands of birth control pills that are available today, very few are exactly alike.  There is a “mini-pill” that contains progestin only – it's for women who should not take estrogen – but most birth control pills contain both estrogen and progestin, so let's take a closer look at these 2 hormones.

Those hormones

Estrogen: Probably the better known of the 2 types of hormones in the Pill.  When most of us think of estrogen, we recognize it as the predominant “female” hormone – what helps make us a woman and controls our reproductive cycles.  The estrogen found in the Pill is a synthetic version made from plants that's very similar to the estrogen our bodies naturally produce.  Its chemical name is ethinyl estradiol.  It's used in all combination birth control pills, but in different amounts.  When you hear that a particular birth control pill is “low-dose,” it primarily means that the amount of estrogen is low, usually less than 35 micrograms.

Progestin: The female hormone that gets much less attention – but the reality is, it's a close and vital partner to estrogen in regulating reproduction.  While estrogen mostly stimulates the ovaries and eggs, progestin mainly affects the endometrium, or lining of the uterus.  In contrast to the one type of estrogen found in the Pill, there are many different types of progestin used in different birth control pills, and at different doses.  Some of the most widely used include: norgestimate (the #1-prescribed progestin in combination with estrogen), norethindrone, desogestrel, drosperinone, and levonorgestrel.  Important fact: The type of progestin used doesn't affect the Pill's ability to prevent pregnancy, but it may result in a different “pill experience” – it depends on the woman. 

To phase or not to phase

Now that we've got the hormone thing down, we need to add a final dimension about dosing. 

Most birth control pills come in monthly packs that include a number of “active” pills containing hormones, and “inactive” pills or placebos, which serve as reminders to take the Pill every day. Most of the monthly regimens give you a 28-day cycle, at the end of which you'll have a short “period” while you're taking the inactive pills (you'll take either 21 or 24 days of active pills followed by seven or four days of inactive pills).  Other regimens skip the placebos periodically (for example, 84 active pills followed by seven placebos – giving you a “period” every 3 months) or skip the placebos altogether (365 active pills, with no “period”).

The level of hormones in the active pills can be the same – a monophasic pill – or they can vary – a multiphasic pill.  Further, multiphase pills can have 2 dose levels (biphasic) or 3 dose levels (triphasic) with the highest level delivered during the time of the month when protection is most critical, usually between days 14 to 21 in a 28-day cycle.  Multiphasic pills were developed to more closely mimic the body's natural cycle. 

Based on these factors – types of hormones and dosing – you can pretty much get a good lay of the land as to the different pills available, but if you want to know more, these resources can help.

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