Choosing the right birth control pill is a pivotal decision for many individuals, one that can profoundly impact their reproductive health and overall well-being. Birth control pills, also known as oral contraceptives, come in various formulations, each with its own hormone contents and potential side effects. There are mainly two types of birth control pills to choose from: combination pills and progestin-only or the minipill. Selecting the appropriate pill involves considering factors such as hormonal balance, medical history, lifestyle, and individual preferences.

Making an informed choice ensures not only effective contraception but also minimizes the risk of adverse effects and maximizes the pill's benefits especially when done under the guidance of a licensed OBGYN. Thus, the importance of careful consideration when choosing a birth control pill cannot be overstated, as it directly influences an individual's reproductive choices and health outcomes.

Read on to learn more about the different types of birth control pills at Kindred to help you feel more empowered in making a decision.

Glossary of important terms

Before we get started, here’s a short glossary of important terms that you will be encountering throughout the article. 

Estrogen-free pill

Progestin-only pill that is also known as the “minipill” 

Hyperandrogenism

Having high male hormones manifesting as excessive unwanted body and facial hair, hair loss most pronounced at the temples, acne, irregular menstruation, and the coarsening of body features

Monophasic

Contains the same amount of estrogen and progesterone in all active pills

Biphasic

Contains a lower ratio of estrogen and progestin in the first half of the cycle, with an increased dose during the second half of the cycle

Triphasic

Contains three different doses of progestin and estrogen that change around every seven days

Quadriphasic

Contains different doses of progestin/estrogen during a 28-day cycle

Progestin

Progestins are synthetic forms of the body’s naturally-occurring hormone progesterone. The most commonly used progestins in birth control include levonorgestrel (LNG), cyproterone acetate (CPA), norethisterone, norgestrel, desogestrel, gestodene, drospirenone, and dienogest.

Ethinylestradiol (EE)

A form of synthetic estrogen that decreases the luteinizing hormone 

Combination pills

Combination pills (COCs) are the most common type of birth control pills, containing both estrogen and progestin. In the body, progesterone is a precursor to three hormones that may affect blood sugar and stress/sugar hormone levels (glucocorticoids), salt concentrations, blood pressure (mineralocorticoids), and androgens (male hormones). Therefore, the progestins found in COCs may have the potential to produce these hormone effects to different extents.

Aside from their contraceptive properties, these can also help relieve symptoms of premenstrual syndrome (PMS), dysmenorrhea and heavy menstrual bleeding, and address irregular periods due to polycystic ovarian syndrome (PCOS) and other causes. Because of their estrogen content, combination pills may increase the risk of developing certain medical conditions and are best taken after consulting with your OBGYN. Each pack of pills will need a hormone-free period to start your next menstruation, which may be produced either through placebo pills included in the pack, or pill-free days.

(Source:  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2021.958)

  • The rightmost boxes containing metabolic side effects and androgenic effects, indicate how likely progestins will cause weight gain, hypertension, high blood sugar (metabolic), or how likely they are to exacerbate acne and other male hormone characteristics.
  • The first generation COCs mentioned above are phased out because the high estrogen content (50mcg or higher) has been linked to abnormal blood clot formation (thromboembolism) and increased risk of breast cancer, and because their progestins tend to produce a lot of undesired effects. 
  • Most commercially available COCs now belong to the second, third, or fourth generation. 

According to MIMS PH, these are the locally available brands of oral contraceptive pills:

Second generation combined oral contraceptives (COCs)

Ethinylestradiol + Levonorgestrel (EE + LNG)

COCs containing EE + LNG are highly effective as birth control, and may be used as well in the treatment of PMS, dysmenorrhea, irregular menses, and heavy menstrual bleeding. Since this is also an older formulation, COCs with these components may be less expensive than newer formulations. However, due to Levonorgestrel’s propensity to produce both metabolic and androgenic side effects, COCs with these components might not be a good fit for women who are overweight or have difficulty losing weight, with blood sugar issues, or with PCOS.

  • Charlize (EE 30mcg + LNG 150mcg x 21 then Ferrous Fumarate x 7)
  • Lady (EE 30mcg + LNG 150mcg x 21 then placebo x 7)
  • Trust Pill (EE 30mcg + LNG 125mcg x 21 and 7 Ferrous Fumarate tablets)

Fourth generation combined oral contraceptives

Ethinylestradiol + Cyproterone acetate (CPA)

Some of the most well-known oral contraceptives contain EE + CPA, and the notoriety is because of its high anti-androgenic activity, that is it is able to effectively combat excessive male hormone symptoms such as acne, hirsutism, hair loss, and coarse facial features. Aside from its use as a contraceptive, it is also widely used in the management of hormonal acne, dysmenorrhea, PMS, heavy menstrual bleeding, and irregular periods

However, it should be used with caution in women who are overweight or have difficulty losing weight and those who have blood sugar issues because it can produce weight gain due to its ability to bring about metabolic side effects.

Ethinylestradiol + Drospirenone

Recently, EE + Drospirenone-containing COCs have been prescribed more frequently by many gynecologists due to Drospirenone’s low likelihood of producing metabolic side effects and its anti-androgenic activity. Aside from its contraceptive effect, it is also used in the treatment of PMS, dysmenorrhea, irregular periods, heavy menstrual bleeding, and hormonal acne. Due to its lower weight gain-producing properties, it is also commonly used in managing women with PCOS. However, since it is a newer formulation, EE + Drospirenone-containing COCs are typically more expensive than others.

  • Lizelle (EE 30mcg + Drospirenone 3mg x 24 and 4 inert tablets)

  • Yaz (EE 30mcg + Drospirenone 3mg x 24 and 4 inert tablets)

  • Liza (EE 20mcg + Drospirenone 3mg x 21)

  • Yasmin (EE 20mcg + Drospirenone 3mg x 21)

Progestin-only pills

Progestin-only pills (POPs), also known as the minipill, only contain progestin. Aside from one formulation, all pills in every pack of POPs are active. These pills may be recommended if you have certain health conditions, are heavy smokers, or are actively breastfeeding. There are less variations and brands of progestin-only pills available in the market compared to combination pills. 

According to MIMS PH, these are the locally available brands of progestin-only pills:

  • Cerazette (Desogestrel)

    • Desogestrel is a third generation progestin, and as such it may have both metabolic and androgenic side effects. As a contraceptive, Cerazette is used by breastfeeding women, women who smoke, women above the age of 35, and women with health problems preventing them from using COCs. As with Daphne, Cerazette may help in the management of dysmenorrhea and heavy menstrual bleeding, but may also cause your periods to stop. Therefore, it is best used after consulting with your gynecologist. It also contains 28 active Desogestrel tablets, with no pill-free period.

  • Daphne (Lynestrenol 500mcg x 28)

    • Daphne contains Lynestrenol, which is a progestin typically used as a contraceptive. It is usually prescribed to breastfeeding women or women with high likelihood of developing complications with the use of COCs but who would still prefer an oral contraceptive. Aside from its contraceptive properties, Lynestrenol may help in the management of dysmenorrhea and heavy menstrual bleeding. However, it may also cause your periods to stop, so it is best to consult with your gynecologist before starting its use. One pack of Daphne contains 28 active Lynestrenol tablets, with no pill-free period.

Why do I need a prescription for birth control pills?

It’s extremely important that you get an OBGYN’s clearance before deciding to get on the pill. OBGYNs can help prescribe the right pill for your body, and these require prescriptions for a reason. Birth control pills are regulated by the FDA, and taking them without supervision can put you at greater risk for side effects. Your OBGYN can help you by conducting sexual and fertility health checks to determine the best contraceptive for you. In addition, controlled access is more effective in long-term care for consistency in taking the pill. 

Through thorough discussions, medical history reviews, and possibly even hormonal testing, an OBGYN can help navigate the array of birth control options available, ensuring that the chosen pill aligns with the individual's health goals and preferences.

Additionally, ongoing communication with an OBGYN facilitates monitoring for any potential side effects or adjustments needed, fostering a partnership in maintaining reproductive health and overall well-being. By collaborating with an OBGYN, individuals can confidently make informed decisions about their birth control pill, empowering them to take control of their reproductive health journey.

Book OBGYN consults and purchase your birth control pills today on mykindred.co!



Last medically reviewed on May 16, 2024.