Very low-dose pills
This is not a complete list of all brand-name birth control
Birth control pills
Very low-dose and low-dose pills generally have less estrogen than other pills.
Phasic pills have changing levels of estrogen and progestin.
For information on progestin-only pills, see
progestin-only hormonal methods.
birth control packets have pills without hormones for certain days of the
month. Other brands of birth control, such as LoEstrin, may add an iron
supplement to the nonhormonal pills.
Birth control hormones in
pills, skin patches, or vaginal rings give you a regular dose of
progestin. This controls your body's
menstrual cycles and prevents pregnancy. It also helps
relieve heavy menstrual bleeding, pain, and sometimes premenstrual mood
problems and bloating.
perimenopausal years before menopause, hormone levels
go up and down a lot. Using birth control hormones may help relieve some of the symptoms women have in the years before menopause.
Birth control pills, also
called oral contraceptives, come in packs. The most common type has 3 weeks of
hormone pills. Some packs have pills without hormones (sugar pills) for the fourth week, and some do
not. During that fourth no-hormone week, you have your menstrual period. After
the fourth week (28 days), you start a new pack.
For some kinds of pills, such as Seasonique
and Seasonale, you take 12 weeks of hormone pills followed by 1 week of
low-estrogen or no-hormone pills. On this schedule, you have four periods a
year. If your doctor prescribes an
unlabeled use for other birth control pills, you can
also have four periods a year. You take the active hormone pills continuously
for 12 weeks, followed by 1 week of sugar pills. You then start a new pack of
pills. If you have breakthrough bleeding during the 3 months, your doctor will
prescribe extra estrogen.
Another kind of pill, such as Lybrel, comes in 4-week packs of hormone
pills, which you take every day of the year. On this schedule, you have no
For more information, see
how to take birth control pills.
birth control patch is a patch [about
1.75 in. (4.5 cm) square] that
sticks firmly on your skin. You can wear it on your lower abdomen, buttocks, or
upper arm. Each patch releases estrogen and progestin through your skin for 7
days. Over a 4-week period, you use one patch each week for 3 weeks, and then
no patch for 1 week. During this week, you have your menstrual period.
For more information, see
how to use the patch.
The vaginal ring
is small [about 2 in. (5 cm) in
diameter], flexible, and colorless. It releases a continuous low dose of
hormones into the vagina to prevent pregnancy for that month.
You insert the vaginal ring yourself and leave it in place for 3 weeks. This
gives you continuous birth control for the month. On the first day of the
fourth week, you remove the ring and usually have a menstrual period. The exact
position of the ring in the vagina is not critical for it to work.
For more information, see
how to use a vaginal ring.
Birth control hormones are commonly
Do not use birth control hormones
containing estrogen if you have any of the following conditions:
If you are older than age 35, do not
use birth control pills if you:
Estrogen-progestin pills, skin
patches, or vaginal rings are effective methods of birth control when they are
used exactly as directed. Since some women do not use their birth control as
directed, pregnancy does happen in a certain number of women. This has been
shown by studies of actual users.
The pill and the patch may not work as well if you are
overweight. Talk with your doctor about the type of birth control that will
work best for you.
Low-dose pills are as
highly effective as higher-dose pills when you take them as directed. But your
risk of pregnancy is higher after missing low-dose pills than after missing
Estrogen-progestin pills, skin patches,
and vaginal rings have similar possible side effects. The pill causes hormone
levels to peak and drop each day. Each weekly patch takes 3 days after
application to reach a steady hormone level. The ring releases a steady dose
every day throughout the day. This may explain why the ring is less likely to
cause headaches and nausea than the pill or patch.
The most common side effects are changes in menstrual periods,
The contraceptive skin patch may
cause skin irritation at the site.
The contraceptive vaginal ring may cause:
Less common side effects include:
The following symptoms are rare but serious and should be reported to your
If you have kidney, liver, or
adrenal gland disease, you cannot use YAZ or Yasmin.
This is because the progestin in these pills can increase your potassium
levels. This can be dangerous for people who have kidney, liver, or adrenal
Some types of progestin used in certain birth control pills may cause a greater risk of blood clots than other types of progestin in birth control pills. Talk to your doctor about your risk of blood clots when deciding which pill is best for you.
Patch warnings. The patch
delivers more estrogen than the low-dose birth control pills do. The U.S. Food
and Drug Administration (FDA) warns that women using the patch are slightly
more likely to get dangerous blood clots in the legs and lungs than women using
birth control pills. So talk to your doctor about your risks before using the
Direct sunlight or high heat can increase, then lower, the
amount of hormone released from a patch. This can give you a big dose at the
time and leave less hormone for the patch to release later in the week. This
increases your risk of pregnancy. Avoid direct sunlight
on the hormone patch. Also avoid using a tanning bed, heating pad, electric
blanket, hot tub, or sauna while you are using a hormone patch.
See Drug Reference for a full list of side effects. (Drug Reference is
not available in all systems.)
Other factors to consider include
Be sure to use a backup birth control method during the
first 7 days of starting hormonal birth control.
is available if any birth
control method fails and you are concerned about unprotected sex.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Abramowicz M (2010). Choice of contraceptives. Treatment Guidelines From the Medical Letter, 8(100): 89–96.
Fraser IS, Kovacs GT (2003). The efficacy of
non-contraceptive uses of hormonal contraceptives. Medical Journal of Australia, 178(12): 621–623.
Nelson A (2007). Combined oral
contraceptives. In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 193–270. New York:
Trussell J (2007). Choosing a contraceptive:
Efficacy, safety, and personal considerations. In RA Hatcher et al., eds.,
Contraceptive Technology, 19th ed., pp. 19–47. New
York: Ardent Media.
May 3, 2012
Sarah Marshall, MD - Family Medicine
& Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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