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continued:

Choosing a birth control pill

What are the pros and cons of combination pills?

Pros

  • Decreased risk of ovarian and endometrial cancers
  • Improvement in acne
  • Less severe menstrual cramps (dysmenorrhea)
  • Possible decreased risk of postmenopausal hip fracture
  • Reduction in androgen production caused by polycystic ovary syndrome
  • Reduction in heavy bleeding (menorrhagia) and related anemia
  • Relief from premenstrual syndrome (PMS)
  • Shorter, lighter and more predictable periods, or fewer or no periods

Cons

  • No protection against sexually transmitted infections
  • Increased risk of blood clots, heart attack and stroke (recent studies suggest that the type of progestin used in the pill may have an impact on the risk of blood clots, with pills containing drospirenone showing a higher risk)
  • Side effects such as irregular bleeding, bloating, breast tenderness, nausea and headache

What are the pros and cons of the minipill?

Pros

  • Can be taken if you have health problems, such as a high risk of heart disease, blood clots, high blood pressure or migraines
  • Can be used during breast-feeding
  • Offers a quick return to fertility if you hope to get pregnant

Cons

  • No protection against sexually transmitted infections
  • Potentially less effective than combination birth control pills
  • Must be taken at the same time every day (taking the minipill more than three hours later than usual means backup birth control will be needed for at least two days)
  • Side effects such as irregular menstrual bleeding, ovarian cysts, decreased libido, headache, breast tenderness, acne, weight gain, depression and hirsutism
  • Slightly increased risk that if pregnancy occurs it will be ectopic — the fertilized egg implants outside the uterus.

What's the bottom line?

You have many options for birth control. If you choose to take birth control pills, work with your health care provider to decide which type of birth control pill is right for you.

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References
  1. Zieman M. Overview of contraception. http://www.uptodate.com/home/index.htm. Accessed Oct. 25, 2011.
  2. Birth control pills. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq021.cfm. Accessed Oct. 25, 2011.
  3. Frequently asked questions: Birth control methods. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm. Accessed Oct. 25, 2011.
  4. Cullins V. Counseling women seeking hormonal contraception. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
  5. Kaunitz AM. Progestin-only (minipills) for contraception. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
  6. Cunningham FG. Contraception and sterilization. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: The McGraw-Hill Companies, Inc.; 2008. http://accessmedicine.com/content.aspx?aid=3151307. Accessed Oct. 25, 2011.
  7. Combined (estrogen & progestin) contraceptives. In: Zieman M, et al. A Pocket Guide to Managing Contraception. Tiger, Ga.: Bridging the Gap Communications; 2010:94.
  8. Kaunitz AM. Hormonal contraception for suppression of menstruation. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
  9. Martin KA, et al. Overview of the use of estrogen-progestin contraceptives. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
  10. Martin KA. Risks and side effects associated with estrogen-progestin contraceptives. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
  11. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR. 2010;59:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5904a1.htm. Accessed Oct. 25, 2011.
  12. Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised Recommendations for the Use of Contraceptive Methods During the Postpartum Period. MMWR. 2011;60:878. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6026a3.htm. Accessed Oct. 25, 2011.
  13. Lidegaard O, et al. Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9. BMJ. 2011;343:6423.
  14. Hannaford PC. The progestogen content of combined oral contraceptives and venous thromboembolic risk. BMJ. 2011;343:6592.
MY00996 Jan. 21, 2012

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