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By Mayo Clinic staffYou'll need to request a prescription for combination birth control pills from your health care provider. Your health care provider will check your blood pressure and review your medical history, including asking about any medications you're taking.
Your health care provider will also ask about your concerns and preferences to help determine which type of combination birth control pill is right for you. Health care providers generally recommend pills with the lowest dose of hormones that will provide pregnancy protection while also maximizing important noncontraceptive benefits and minimizing side effects.
Although the amount of estrogen in combination pills varies from 20 to 50 micrograms (mcg) of ethinyl estradiol, most pills contain 35 mcg or less. Women who are sensitive to hormones may benefit from taking a pill with a lower dose of estrogen. However, low-dose pills may result in more breakthrough bleeding than may other pills.
Combination pills are categorized based on whether the dose of hormones stays the same or varies:
- Monophasic. In this type of combination birth control pill, each active pill contains the same amount of estrogen and progestin.
- Biphasic. In this type of combination birth control pill, active pills contain two different combinations of estrogen and progestin.
- Triphasic. In this formulation, active pills contain three different combinations of estrogen and progestin. In some types, the progestin content steadily increases — while in others the progestin dose remains steady and the estrogen content increases.
- FAQs: Birth control pills. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq021.cfm. Accessed Sept. 28, 2011.
- 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.
- Frequently asked questions: Birth control methods. U.S. Department of Health and Human Services. http://www.womenshealth.gov/faq/birth-control-methods.pdf. Accessed Sept. 28, 2011.
- Cullins V. Counseling women seeking hormonal contraception. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2011.
- Kaunitz AM. Hormonal contraception for suppression of menstruation. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2011.
- Martin KA, et al. Overview of the use of estrogen-progestin contraceptives. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2011.
- Martin KA. Risks and side effects associated with estrogen-progestin contraceptives. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2011.
- Schorge JO, et al. Contraception and sterilization. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=3151449. Accessed Sept. 28, 2011.
- Hatcher RA, et al. Contraceptive Technology. 19th ed. New York, N.Y.: Ardent Media, Inc.; 2007:1.
- In: Combined (estrogen and progestin) contraceptives. Zieman M, et al. A Pocket Guide to Managing Contraception. Tiger, Ga.: Bridging the Gap Communications; 2010:94.
- 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.
- Hannaford PC. The progestogen content of combined oral contraceptives and venous thromboembolic risk. BMJ. 2011;343:6592.
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