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What is the best birth control pill for you?

This contraception guide can help you find the pill that’s right for your body’s needs


Since it was first legalized in the U.S. in the 1960s, the birth control pill has become one of the most popular forms of female contraception. Sixty-five percent of all women of childbearing age use some type of birth control to avoid pregnancy, according to the CDC. And as many as 99% of women who have had sex have used some form of birth control in the past. Many women opt to use birth control pills thanks to their ease of use, availability, safety, limited side effects, additional health benefits, and effectiveness. 

RELATED: List of contraceptives | How much does birth control cost yearly (and how to save)

What is the best birth control pill?

It’s no secret, everyone is different. That’s why, in order to determine the right birth control pill for you, you’ll need to have an open conversation with your doctor. There are many factors to consider when choosing a birth control pill, including your age, body mass index (BMI), health history, how you respond to treatment, and your lifestyle and preferences. The journey to finding the best birth control pill for you can often take some trial and error, patience, and honesty with your physician.

Birth control pill comparison chart
Best birth control pill for … Type of birth control pill  Popular brands  Birth control coupons
Weight loss Combination pills (containing drospirenone) Loryna, Ocella, Syeda, Yaz, Yasmin Loryna coupons
Ocella coupons
Syeda coupons
Yaz coupons
Yasmin coupons
Acne Combination pills  Estrostep Fe, Beyaz, and Yaz Beyaz coupons
Yaz coupons
PCOS Combination pills Aranelle, Lessina, Natazia Aranelle coupons
Lessina coupons
Natazia coupons
Endometriosis Progestin-only pills Camila, Errin, Jolivette Camila coupons
Errin coupons
Migraine with aura Progestin-only pills Camila, Errin Camila coupons
Errin coupons
Heavy periods Combination pills, progestin-only pills Camrese

Camila

Camrese coupons
Menopause or women age 50 and older Progestin-only pills Ortho Micronor, Camila, Errin, Nor-QD, Ovrette Camila coupons
Errin coupons
Teens Combination pills Enpresse, Apri, Sprintec  Enpresse coupons
Apri coupons
Sprintec coupons
Over 35 Combination pills Lutera, Viorele Lutera coupons
Viorele copupons
Over 40 Progestin-only, Combination pills for women with no risk factors Ortho Micronor, Camila, Errin, Ovrette Camila coupons
Errin coupons

The recommendations above are based on the advantages of each type of birth control pill. You should always seek professional medical advice from your healthcare provider before starting a new medication.

Types of birth control pills

Birth control pills contain man-made versions of hormones, estrogen and one of a dozen different types of progestin. Women naturally produce varying amounts of estrogen and progesterone during their monthly cycle. There are three main kinds of birth control pills: combined estrogen-progesterone, progestin-only, and continuous or extended cycle pills. There are many varieties of each type of pill, from brand names to generic, with dosing available in 28, 90, or 365-day active pill cycles. Different brands contain the same hormones, they are just given different names by different manufacturers. Which specific pill is best for you depends on your body’s needs, plus the recommendation of your healthcare provider. 

Here’s a brief explanation of the various types of pills on the market and how they work:

  • Combination pills: Taken orally at the same time each day, combination pills regulate your menstrual cycle with a blend of the two hormones: estrogen and a type of progestin.
  • Extended cycle pills: A combination pill that contains both estrogen and progestin, these pills are designed to allow for more time between menstrual bleeding. For example, instead of having twelve periods per year, a female on an extended cycle pill will have her period every twelve weeks, so only four periods a year. Women may opt to skip the placebo pills of the extended cycle pills and have a menstrual period once a year, or never.  
  • Progestin-only pills: Also called the minipill, this birth control pill only contains the hormone progestin (a synthetic version of the natural hormone, progesterone). Like all birth control pills, it is taken orally daily.
  • Low-dose pills: Available as both combination or progestin-only, low-dose pills contain a lower dose of hormones. Just as effective as high-dose pills, low-dose pills may cause fewer side effects in some women.
  • Emergency contraception: Unlike other pills, these are used after sexual intercourse to prevent pregnancy, usually in the case of missed birth control pill, unprotected sex, or a broken condom. There are various types, including combination, progestin-only, and antiprogestin pills.

Combination birth control pills

Combination pills are a blend of two hormones, estrogen and progestin, taken once a day at the same time each day. The combination birth control pill prevents pregnancy in three ways:

  1. Preventing sperm from reaching the egg and fertilizing it. Sperm is stopped because the pill thickens the cervical mucus and does not allow the sperm to pass into the uterus. 
  2. Suppressing ovulation. When eggs are not released from the ovaries, they cannot be fertilized by sperm.
  3. Thinning the uterus’ endometrial lining so after the rare occasion an egg is fertilized, the fertilized egg has difficulty implanting

There are four types of combination pills currently on the market in the U.S.: conventional combination pills, extended cycle combination pills, monophasic combination pills, and multiphasic combination pills. The conventional combination pill contains the two hormones estrogen and progestin, and follows a standard dosing schedule. This generally includes 21 days of active pills followed by seven inactive pills. The body withdrawal bleeds during the week on the inactive pills. When a combination pill contains the same dose of estrogen and progestin throughout the first 21 days of each package. This is called monophasic. Multiphasic pills contain differing amounts of estrogen and progestin depending on which week of your pill pack you are taking. 

Effectiveness

Combination birth control pills are 99% effective at preventing pregnancy when used correctly. However, typical-use effectiveness is reduced to 93% in the combination birth control pill. For maximum pregnancy prevention, take your pill at the same time daily and start new pill packs on time. To be extra careful, use condoms as an additional method of contraception. 

Advantages

Pros of the combination pill include the following:

  • Shorter, lighter, and more regular periods
  • Less severe menstrual cramps
  • Improved acne
  • Less severe PMS 
  • Preventing period-related anemia (due to less vaginal bleeding)
  • Reducing risk of endometrial and ovarian cancer

Disadvantages

Cons of the combination pill may include the following: 

  • Breast tenderness 
  • Breakthrough bleeding or irregular menstruation
  • Bloating
  • Nausea and weight gain
  • Slight increased risk for heart attack, stroke, and blood clots
  • Combination birth control pills can cost anywhere from $5 to $50 a pack, depending on your script, if it is generic or name brand, and insurance coverage. Fortunately, SingleCare can help you save on your birth control prescription. Try searching for the lowest priced options available in your area.

Popular combination birth control pills

Consider these common combination birth control brands as options when comparing pills for pricing and side effects:

  • Alesse
  • Apri
  • Aranelle
  • Aviane
  • Enpresse
  • Estrostep FE
  • Lessina
  • Levlen
  • Levlite
  • Levora 
  • Loestrin
  • Mircette
  • Natazia
  • Nordette
  • Lo Ovral
  • Ortho-Novum
  • Ortho Tri-Cyclen
  • Yaz
  • Yasmin

RELATED: Yaz vs. Yasmin

Extended cycle pills

Extended cycle pills are also combination pills, however, they create longer cycles and are designed to be taken over longer periods of time. Unlike the standard combination birth control pill, extended cycle combination pills are typically prescribed for 12 to 13 continuous weeks of active pills followed by a full week of an inactive pill. This extended cycle pill still allows you to have your period, just less often. 

Depending on your body and dosing schedule, you may only get your period three or four times a year on this pill. If you want to skip your period altogether, continuous dosing may be prescribed at the discretion of your healthcare provider. Some women experience vaginal spotting, which usually decreases the longer continuous pills are taken. A continuous dosing schedule includes taking a combination pill every day without taking any breaks from the hormones. Continuous pills and no menstrual period are safe for most women.

Effectiveness

As a combination pill, the effectiveness of extended cycle pills are considered 99% effective at preventing pregnancy if used correctly. However, effectiveness drops to 91% upon routine use. One way to help ensure maximum pregnancy protection is to set a daily alarm on your phone that reminds you to take your pill at the same time each day, and set an alert for when you need to start your new pill pack. Some women use a backup method of contraception, like condoms, for additional protection against pregnancy. 

Advantages

The advantages of extended cycle pills are much the same as for conventional combination pills, with the addition of:

  • Fewer periods
  • Potentially lighter, shorter periods

Disadvantages

As a type of combination pill, cons of extended cycle pills are also similar to conventional combination pills, with the addition of:

  • Potential spotting between periods
  • Possibility of heavier periods (although this is rare)

Popular extended cycle birth control pills

There are a few extended cycle birth control pills available, including:

  • Seasonale
  • Seasonique
  • Lybrel

Progestin-only birth control pills (minipills)

The minipill is a birth control pill that only contains a type of progestin, which is a synthesized version of the naturally occurring hormone, progesterone. Unlike the combination birth control pill, the minipill does not contain estrogen.

Minipills prevent pregnancy in a similar way: it stops sperm from reaching a female egg by thickening cervical mucus blocking the sperm’s pathway into the uterus to find the egg. On the off chance sperm does reach and fertilize an egg, the minipill also thins the uterus’ endometrial lining so the fertilized egg cannot implant. Minipills, however, do not prevent eggs from being released from the ovary as consistently as a combination pill. 

Progestin-only birth control pills are oral contraceptives that are taken every day, and must be taken at the same time each day to maximize effectiveness. 

Effectiveness

The minipill is just as effective at preventing pregnancy as the combination pill (about 99%) if taken perfectly. However, because the minipill must be taken at the same time each day, it has a higher failure rate than the combination pill. If it is not taken at the same time, for example 9 a.m. Monday, then 11 a.m. on Tuesday, your risk of pregnancy is increased for about 48 hours. About 13 females in every 100 get pregnant when on the minipill, in comparison to nine in 100 women on the combination pill. 

If you miss taking your scheduled dose on any day, consider abstaining from sexual activity, taking an emergency contraceptive pill (Plan B or Ella), or use additional protection, such as a condom, over the next 48 hours or more. This added precaution can help to prevent unplanned pregnancies during the interruption of doses.

Why would the minipill be used? 

There are a few reasons why your doctor may recommend a progestin-only pill instead of the more-common combination pill. For starters, the minipill contains no estrogen, so this could be a perk if you are sensitive to estrogen. Your physician may prescribe a progestin-only pill for you if you notice that you are sensitive to the estrogen in a combination pill. You may also be prescribed the minipill if you have a family or personal history of blood clots. If you have a medical condition that puts you in the CDC Medical Eligibility Class (MEC) 3 or 4, estrogen-containing pills are contraindicated. Examples of MEC 3 or 4 conditions are hypertension, smoking, and diabetes with retinopathy. Lastly, your physician may prescribe the minipill if you are currently breastfeeding, as it is safe to use immediately after giving birth and does not decrease breast milk supply. As always, consult your doctor if you are breastfeeding and looking for the best birth control option for you. When you stop breastfeeding, let your physician know because this is a good time to change to the combination pill. 

Advantages

Pros of the progestin-only pill may include the following: 

  • Safer option if you are at increased risk of blood clots, high blood pressure, cardiovascular concerns, or if you have migraines with aura.
  • Can be used if you are sensitive to estrogen
  • Can be used immediately after giving birth if you are breastfeeding
  • Shorter return to fertility

Disadvantages

Cons of the progestin-only pill may include the following: 

  • Must be taken at the same time daily in order to be maximally effective
  • Slightly higher failure rate than the combination pill
  • Like the combination pill, minipills can cost up to $50 a month. Consider looking into how much you could save on your minipill with SingleCare. 

Popular progestin-only birth control pills

Consider these common minipill brands as birth control options when comparing pills for pricing and side effects: 

  • Ortho Micronor
  • Nor Q D
  • Ovrette

Low-dose pills

Most pills prescribed are considered low-dose birth control pills. They are a type of combination pill that have, as the name suggests, lower hormone levels. Specifically, low-dose pills have 35 micrograms or less of estrogen, while ultra-low-dose pills have 20 micrograms or less of estrogen. The decreased levels of estrogen prevent common side effects like headache, nausea, and tender breasts while maintaining effectiveness. 

They work the same way as regular combination pills by preventing ovulation, sperm reaching an egg, and the inability for a fertilized egg to implant due to thinning of the uterus’ endometrial lining. 

Effectiveness

One of the reasons low-dose pills have become so popular over the last 20 years is because they are just as effective at preventing pregnancy and regulating menstrual cycles as their higher dose counterparts. With typical use, low-dose pills are 91% effective. When used perfectly, they are more than 99% effective in preventing pregnancy. 

Why would low-dose birth control be prescribed?

Low-dose birth control is effective and well-tolerated even in women who are sensitive to estrogen. 

If you think you’ll struggle to take the pill at the exact same time each day, as required with the progestin-only minipill, a low-dose birth control pill may be recommended as an alternative, as there is a slightly longer window for when you take it daily.

Advantages

If your doctor recommends a low-dose pill, here are some pros:

  • Reduced estrogen-related side effects
  • Less side effects than higher-dose pills
  • Less severe menstrual cramping and PMS
  • Decreases acne
  • Reduced risk of ovarian cancer
  • Regulates period

Disadvantages

As with most medications, there are some potential side effects and cons to using a low-dose birth control pill:

  • Slight risk of increased blood pressure
  • Rare potential for blood clots and deep vein thrombosis
  • Spotting between periods
  • Headache
  • Nausea

Popular low-dose pills

Many of the pills available today are low-dose. Here are some of the most common and popular brand names, with many generic versions also available:

  • Yasmin
  • Levora
  • Ortho-Novum
  • Apri
  • Aviane
  • Yaz
  • Lo/Ovral
  • Levlen 21

Emergency contraception pills

Emergency contraception pills, otherwise known as the morning-after pill, are used by women after having unprotected sex, if a condom breaks, or if they have missed their birth control pill. In the U.S. the most common morning-after pills, available to purchase over-the-counter at pharmacies without I.D., are levonorgestrel pills. Levonorgestrel is a type of progestin hormone. Although many different brands are available, they work in the same way: they prevent the release of an egg from the ovary or prevent fertilization of the egg by sperm. Morning-after pills should not be used on a regular basis to prevent pregnancy, but instead as an emergency contraceptive or backup in case regular birth control fails or is used incorrectly.

When should emergency contraception be used?

Emergency contraception should be used after unprotected sex, when another birth control method, like condoms, failed, or if pills were used incorrectly. It’s generally advised to take a morning-after pill as soon as you can after sex. You can take levonorgestrel (Plan B, My Way, AfterPill, Take Action) up to five days after unprotected sex, however the longer you wait, the less effective it becomes. 

Although levonorgestrel morning-after pills are the most common in America, if you’re over 155 pounds, you may be advised to try another option like Ella (ulipristal acetate 30 mg). Ella is a prescription-only option and may make your hormonal birth control ineffective. In some cases, your doctor may insert a copper IUD, which is also considered an emergency contraceptive method. The Copper IUD can be then left in up to 10 years as an effective birth control method.

Effectiveness

The effectiveness of the morning-after pill varies depending on how quickly you take it after having unprotected sex. For example, if you take Plan B One-Step within 24 hours, it is about 95% effective. However, if taken within three days of unprotected sex, the morning-after pill can reduce the chance of pregnancy by 75-89%. 

Advantages

  • Available over the counter
  • No I.D. required
  • Can be purchased by persons of any gender
  • Inexpensive
  • Highly effective
  • Little to no side effects
  • Single dose

Disadvantages

  • No serious side effects have been reported
  • Lightheaded
  • Dizziness
  • Nausea
  • Vomiting within two hours of taking the pill will render it ineffective
  • May not be suitable for women taking medication for liver problems, epilepsy, or severe asthma 

Popular emergency contraception pills

There are a number of emergency contraception options available, including:

Frequently asked questions about birth control pills

What is the most common birth control pill?

The combination birth control pill, containing estrogen and progesterone, is the most commonly prescribed form of birth control pill. The hormone progesterone works to prevent pregnancy, while the hormone estrogen works to keep menstrual bleeding under control.

What is the safest birth control pill?

Generally, low-dose birth control pills, be it combination or progestin-only minipill, are considered safest as they are associated with the lowest risk of causing blood clots. According to the FDA, drospirenone-containing birth control pills such as Beyaz, Safyral, Yasmin and Yaz can increase the risk of blood clots up to three times as much as pills containing levonorgestrel or other progestins. Ask your healthcare provider which pill is right for you.

What are the most common birth control pill side effects?

The most common side effect of combined oral contraceptive pills is breakthrough vaginal bleeding, or bleeding between expected periods. Other possible side effects across brands include: 

  • Nausea
  • Headaches
  • Abdominal cramping
  • Breast soreness or tenderness
  • Increased vaginal discharge
  • Decreased libido

The following side effects are common with progestin-only birth control pills: 

  • Acne
  • Weight gain
  • Irregular periods
  • Headaches
  • Breast soreness or tenderness
  • Nausea
  • Dizziness
  • Increased hair growth

Do birth control pills affect fertility?

According to a systematic review and meta-analysis conducted in 2018, the use of oral contraceptives does not affect future fertility. This is true regardless of the type and duration of birth control pills used. Most women can conceive two months after stopping oral contraceptive pills.

What is the difference between 21- and 28-day birth control?

The only difference between the 21- and 28-day birth control pills is that the 28-day includes seven placebo pills: either seven inactive “sugar” pills or seven iron pills. If you’re taking a 21-day birth control pill, you’ll take the pill for three weeks, and then skip a week before starting a new pack. For 28-day pills, you’ll start a new pack immediately after finishing your last one.

What should I do if I miss a birth control pill?

If it’s been less than 48 hours since you missed a pill, take it as soon as you can. If you’re due for your next pill, it’s okay to take them both together. If it’s been more than 48 hours since you missed a pill, take the missed pill as soon as possible, and use a backup method of contraception, such as condoms, for 7 days. Emergency contraception is recommended if your pill was missed early in your cycle, or during the last week of your pill pack and you had unprotected sex in the last 5 days.

Which birth control pill does not cause weight gain?

Although some women report weight gain from various types of hormonal contraception, studies indicate no sign of weight gain when using a low-dose birth control pill.

What is the best birth control pill for acne?

Only three types of contraceptive pill have been approved by the FDA to treat acne. These are all combination pills: Ortho Tri-Cyclen, Yaz (or Yasmin), and Estrostep. 

When should I take birth control pills?

Any time of day, just be consistent. For birth control pills to be most effective, you should take one pill at the same time each day.

How do I know if I should switch birth control?

If you’re not satisfied with your current birth control pill—for example, due to side effects—it’s a good idea to discuss better options with your healthcare provider. Hang in there for the first three months to see how your body will do with your current pill as this is how long it takes for your body to become accustomed to a new form of contraception. It’s also important to discuss any new health conditions or medication history that might affect your current pill’s safety and effectiveness

Who shouldn’t take birth control?

If you have any of the following risk factors, it is not recommended that you take any combination birth control containing estrogen as it increases your risk of experiencing blood clots, strokes, and heart attack. 

  • You are over 35 years of age and smoke.
  • You are scheduled to have surgery that will reduce your mobility for extended periods.
  • You have a history of heart disease, deep vein thrombosis, or pulmonary embolism.
  • Any condition that is a 3 or a 4 MEC should not have combined oral contraceptives (COCs). 

RELATED: What’s the best birth control after 35?

How effective are birth control pills?

With perfect use– when taken as indicated every day– birth control pills are 99% effective. Research indicates that less than one woman in 100 will become pregnant in the first year of taking the pill. But when pills are missed or taken late, the effectiveness drops to 91%. That’s why it’s important to be consistent when taking hormonal contraceptives. 

Certain medications may interfere with the effectiveness of your birth control pills. These include some antibiotics, general anesthesia, the anti-HIV drug Sustiva (efavirenz), antifungals including Gris-peg (griseofulvin), fluconazole, and itraconazole, anticonvulsants like topamax, anti-nausea medications such as Emend (aprepitant), high blood pressure meds including Tracleer (bosentan), the diabetes medications Actos (pioglitazone) and Avandia (rosiglitazone maleate). As well, herbal supplements such as St. John’s Wort, soy products, and vitamin C may decrease birth control’s effectiveness.

How do I start birth control pills?

You can start taking birth control pills whenever you receive a prescription—any day of the week, and at any point in your cycle. However, when the protection from pregnancy starts depends on when you start and the type of pill you’re using. 

How soon do birth control pills work?

If you’re taking a combination pill and you begin your first pack within 5 days of the start of your menstrual period, you’re protected from pregnancy right away. If you start later in your cycle, the combination pill takes 7 days to become effective. If you’re taking a progestin-only pill, protection from pregnancy occurs 48 hours after your first pill, no matter where you are in your cycle—except Slynd. You need to use backup contraception for the first 5 days of taking Slynd, unless you begin taking it within the first 5 days of your period.

If you have had unprotected sex since your last menstrual period, take a urine pregnancy test before starting birth control pills.  You may choose to repeat a home pregnancy test in 2 to 4 weeks.  Hormonal contraceptives do not cause birth defects, pregnancy loss, or fetal growth problems. 

If you have had unprotected sex within five days, use emergency contraception (such as Plan B or Ella). Birth control pills can be started immediately after taking Plan B. But, if Ella was taken, then birth control pills should be started 5 days after Ella (so that the progestins don’t decrease the effectiveness of the Ella). 

Which birth control method is most effective?

The most effective birth control method is abstinence; however, this is not the preferred method for most people. Alternatively, the most effective birth control options are the implant and IUDs (intrauterine device), especially when paired with a condom. 

The implant is a small device that is inserted into your arm and slowly releases the hormone progestin into your body. It lasts for up to four years. 

Non-hormonal and hormonal IUDs are available as small devices. The IUD is placed into your uterus and can last up to 12 years.

Implants and IUDs are considered more effective than the pill as there is no human error in remembering to take your medication. If taken perfectly, the contraceptive pill (combination birth control pill or the minipill), Depo-Provera shot , vaginal ring, and patch can all be highly effective. Speak to your doctor about which method will work with your medical history and lifestyle. 

Remember that birth control pills only protect from pregnancy. They do not protect against sexually transmitted infections or diseases. That’s why it’s always recommended to use them in conjunction with condoms. Consider both getting STI testing before having intercourse with a new partner and asking your partner if they intend to be monogamous.

RELATED: Birth control options: What’s right for you?

Where can I get birth control pills? Do I need to see a doctor?

Birth control pills require a prescription, which you can obtain by visiting your doctor or nurse practitioner, a local health clinic, a Planned Parenthood center, or a telehealth provider.