Oral Contraceptives– Which One Is Right For You?

Stated simply, birth control prevents pregnancy. Pregnancy can occur any time you have unprotected sex. If you are sexually active, and you don’t want to have a baby, use birth control.

There are many different oral methods of birth control. Did you know that there are more than 40 different forms of “the pill” available? In addition, there are several new oral contraceptives to choose from. Being informed about your options can help you decide which method is right for you.

An explanation of how oral contraceptives work can help understand why birth control pills stabilize, limit or stop periods. Normally, a rise in hormones linked to ovulation causes the lining of the uterus to thicken in anticipation of a fertilized egg. If fertilization does not occur, hormone levels drop and the lining is shed in the form of menstrual blood. However, with birth control pills, normal hormone production shuts down and it is replaced with a very tiny amount - which helps prevent the buildup in the lining of the uterus. Therefore, there is no shedding; the only bleeding that occurs is when the pills are stopped, which causes a drop in hormones.

The Pill is an oral prescription medication. It comes in the form of a pill pack, which contains enough pills for one month of protection. One pill is taken at the same time, daily, for either 21 or 28 sequential days, depending on the type of pill your healthcare provider prescribes for you. Pill packs usually begin on the first Sunday after you start your period. The pill is 99% effective, if taken correctly. An additional form of birth control should be used during the first month of taking the pill since it takes a full month for it to become fully effective. Because there are many different types and dosages of the pill, talk to your healthcare provider about which one is right for you.

There are some medications, such as antibiotics, that cause the pill to be less effective. When taking these types of medications, ask your health care provider about an additional form of birth control. Most side effects of taking the pill are minor, but there can be serious side effects in certain instances. There is an increased risk of blood clots and related cardiovascular issues. The pill is not recommended for women who are over 35 years of age and smoke. If you do not smoke, it can be used until menopause.

The Mini Pill contains only one hormone, progestin; taken once daily. Mini pills thicken the cervical mucus so a sperm can’t reach the egg. The progestin also changes the lining of the uterus, so that a fertilized egg can’t be implanted into it. In some cases, the mini pill stops the release of an egg (ovulation). Mini pills make periods light and short. Some women may go several months without bleeding at all.

Continuous-Use Oral Contraceptives - These pills use estrogen and progestin to prevent ovulation like regular oral contraceptives. They limit or stop the menstrual period. There are currently three FDA approved products available.

Seasonale and Seasonique are extended-use oral contraceptives that limit menstrual cycles to four per year. Active pills of Seasonale are used for 84 consecutive days, followed by one week of inactive pills (during which time you experience bleeding).

Seasonique has 84 active pills and seven pills with a very small amount of estrogen. The perceived advantage of taking Seasonique is that taking low dose hormones for the seven-day off period minimizes estrogen withdrawal symptoms during menstruation.

Lybrel is the first continuous oral contraceptive taken continuously with no breaks in dosage and when taken over a period of time, a woman will no longer experience menstrual periods at all.

Not only is there the advantage of not having to deal with a period, but continuous contraception also reduces symptoms such as PMS (premenstrual syndrome), menstrual migraines, mood swings, and increased appetite since these are problems normally linked to monthly hormone fluctuations. These products are 99% effective as birth control methods.

The disadvantages of this method is that there is still an increased risk of blood clots and heart related problems, especially among women who smoke. In addition, these pills can cause breakthrough bleeding during the first six to 12 months of use. With Seasonale and Seasonique, breakthrough bleeding experienced is similar to the monthly period on the 21-day pill cycle. There may be less bleeding with Lybrel. After the first year, breakthrough bleeding usually stops.

Extended Hormone Oral Contraceptives offer you more days on hormones and shorter hormone-free days between cycles. These pills reduce menstrual-related symptoms, including PMS and PMDD (premenstrual dysphoric disorder). If you like some of the benefits of a long-term pill, but still want to give your body a break, these oral contraceptives are a good option. The products currently available are Yaz and Mircette.

Yaz contains estrogen and a newer form of progestin called drsp (drospirenone). Yaz offers active pills for 24 days and inactive pills for 4 days.

Mircette offers 21 days of estrogen and progestin combined, followed by two days of placebo and then followed by five days of a low dose of estrogen alone.

Similar to other forms of oral contraceptives, side effects include increased risk of blood clots and stroke, particularly in smokers. Both are 99% effective as birth control methods when used correctly.

Before you choose a method, you should discuss birth control with your health care provider. Birth control methods only are effective if used correctly. Be sure that you understand how to use the method you choose.