Combination Birth Control Pills Procedure
Overview
Combination birth control pills, often called “the pill,” are medicines taken by mouth to help prevent pregnancy. These pills contain two main hormones: estrogen and progestin. They work by stopping the ovaries from releasing eggs, so there is no egg for sperm to fertilize. Besides stopping ovulation, these pills also change two things:
- The mucus at the cervix gets thicker, making it harder for sperm to swim into the uterus.
- The lining of the uterus becomes thinner, so a fertilized egg cannot easily attach.
Different types of combination pills exist. Some let users have fewer periods each year by using extended or continuous dosing. Another kind of birth control pill, called the mini-pill, only has progestin and works a bit differently.
| Term | Description |
|---|---|
| Sperm | Male cell that can fertilize an egg |
| Uterus | Organ where a baby can grow during pregnancy |
| Birth control pills | Oral medicine for preventing pregnancy |
| Mini-pill | Progestin-only pill used as another option |
Reasons for Use
People use combination birth control pills for more than just preventing pregnancy. Many choose this method of contraception because it is reversible, and most people can return to their usual fertility quickly if they stop using them. It is a preferred method compared to others like condoms, barrier methods, IUDs, implants, or emergency contraception.
Key Benefits
- Reliable Contraception: Oral contraceptives decrease the risk of pregnancy when used correctly.
- Cycle Control: Many people use these pills to help regulate their monthly periods. Pills can make periods more regular, lighter, and less painful, helping with conditions like dysmenorrhea and premenstrual syndrome.
- Health Protection: These pills may lower the risk of ovarian cancer, endometrial (uterine) cancer, noncancerous breast disease, and ovarian cysts. They can also help prevent ectopic pregnancy and decrease heavy menstrual bleeding, reducing the risk of iron deficiency anemia.
- Skin Improvement: Some people experience clearer skin with fewer acne breakouts when using combination birth control.
- Treatment for Other Conditions: For those with polycystic ovary syndrome (PCOS), the pills can lower androgen levels, which helps with both acne and excessive hair growth. They may also ease symptoms of uterine fibroids and endometriosis.
- Support During Life Changes: These pills can help manage hot flashes and cycle changes around menopause (perimenopause).
Types of Combination Pills
| Type | Active Pills | Inactive Pills | Bleeding Pattern |
|---|---|---|---|
| Conventional pack | 21–24 | 2–7 | Monthly |
| Extended-cycle pack | 84 | 7 | Four times a year |
| Continuous-dosing pack | 365 | 0 | Few to no periods |
Extended or continuous dosing can help prevent migraines related to menstruation and relieve conditions like seizures or endometriosis. These options offer more control over cycles.
Comparison with Other Methods
- Condoms protect against both pregnancy and sexually transmitted infections (STIs), but users must use them every time and can experience failure if not used correctly.
- Barrier Methods (such as diaphragms) block sperm but are less convenient and can be less effective.
- IUDs and Implants offer long-term protection without daily pills, but procedures are needed to place and remove them.
- Emergency contraceptive pills are for occasional use and not a main method of birth control.
Who Should Be Cautious
Combination oral contraceptives do not suit everyone. People who smoke and are older than 35, or those with certain health problems (like uncontrolled high blood pressure, a history of blood clots, stroke, some cancers, migraine with aura, or serious liver or gallbladder issues), may need to avoid these pills. Those who recently gave birth or are breastfeeding may also need a different option.
Summary Table: Benefits and Considerations
| Benefit | Additional Details |
|---|---|
| Pregnancy prevention | Effective when used daily |
| Quick return to fertility | Usually returns after stopping the pills |
| Menstrual symptom relief | Cramps, bleeding, migraine |
| Lower risk of certain cancers | Ovarian, uterine |
| Improved skin | Less acne, less extra hair |
| Not for everyone | See above for health conditions |
Dangers and Concerns
Accidental Pregnancy
Combination birth control pills do not provide 100% effectiveness. With regular use, about 9 out of 100 users may experience an unplanned pregnancy within the first year. Those who follow instructions exactly have a lower chance—fewer than 1 in 100 each year. If someone suspects they might be pregnant, they should stop taking the pills right away.
Protection Against Infections
These birth control pills do not guard against sexually transmitted infections (STIs), including HIV. People may need to use condoms or other methods to lower the risk of getting STIs.
Unwanted Reactions
Some users experience mild to moderate side effects, which may include:
- Nausea
- Headaches
- Breast soreness
- Bloating
- Spotting or irregular vaginal bleeding
- Mood changes
- Dizziness
- Weight gain
- High blood pressure
Other side effects, such as skin changes or breast tenderness, often improve with time.
Possible Health Hazards
Birth control pills can increase the risk of more serious medical issues. These include:
| Condition | Description |
|---|---|
| Blood clots | Clots can develop in the legs or lungs (venous thromboembolism). |
| Stroke or heart attack | Risk is higher for those who smoke or have other risk factors. |
| Liver problems | Rare liver disease or tumors may occur. |
| Breast cancer | There may be a small increase in risk for some users. |
| High blood pressure | Pills can cause elevated blood pressure in certain people. |
When to Get Medical Advice
Individuals should call their health care provider if they notice:
- Severe stomach pain, vomiting, or leg swelling
- Chest pain, coughing, or trouble breathing
- Sudden severe headaches, problems with vision, confusion, or trouble speaking
- Signs of depression or mood swings
- Yellow skin or eyes (jaundice)
- Missing two periods in a row or signs of pregnancy
Quick action helps prevent complications from becoming serious.
Getting Ready
A healthcare provider must prescribe combination birth control pills before use. The provider usually checks blood pressure and measures weight to make sure it is safe. They will also review current medications, supplements, and health history.
Pregnancy and breastfeeding status should also be discussed, as these may affect the choice of pill. Routine exams may be done, though a full pelvic exam is not always necessary.
Combination pills come in several types. Monophasic pills have the same amount of hormones in each active pill. Biphasic and triphasic pills have changing hormone levels during the month. Estrogen doses usually range from 20 to 35 micrograms, but some pills have as little as 10.
| Preparation Step | Why It Matters |
|---|---|
| Blood pressure check | Ensures safety |
| Medicine/supplement review | Avoids interactions |
| Discuss health history | Finds best pill option |
| Rule out pregnancy | Safe use of pills |
What You Can Expect
When choosing combination birth control pills, users need to learn how to use them for best results. Take them daily at a consistent time, such as with breakfast or before bed. Starting methods vary:
| Method | When to Start | Backup Contraception Needed? |
|---|---|---|
| Quick-start | Any time | Use backup for the first 7 days. |
| Sunday-start | First Sunday after period | Use backup for the first 7 days. |
| First-day-start | First day of next period | Not required. |
Follow provider instructions for your specific pill type and dosing. If a pill is missed, take it as soon as possible. For one missed pill, this could mean taking two in one day.
If more than one is missed, take the last missed pill and resume the routine. Use backup birth control for the next seven days. Consider emergency contraception if unprotected sex occurs.
Effectiveness and Safety
When used as directed, combination birth control pills provide reliable contraception. Perfect use prevents pregnancy about 99% of the time; typical use has about an 8% failure rate.
They can make periods lighter, reduce cramps, and help clear acne. They also thicken cervical mucus to block sperm. Both brand-name and generic pills are effective. Generics are often more affordable and covered by insurance.
Availability and Affordability
Most pharmacies carry these pills, and a prescription is needed. Insurance often covers generics fully. For those without insurance, lower-cost generics or assistance programs may help.
Combination pills are safe for many, but not all. Some health conditions or medications may make them less suitable. Talk to a provider about risks, side effects, and alternatives.
Combination birth control options
Combination birth control pills contain estrogen and a progestin. They stop ovulation, which prevents pregnancy. Most come in 21- or 28-day packs. The 28-day packs include inactive pills.
| Formulation | Key Hormones |
|---|---|
| Monophasic | Same dose all month. |
| Biphasic/Triphasic | Varying hormone doses weekly. |
| Extended Cycle | Fewer periods per year. |
