Why it's doneBy Mayo Clinic staff
Combination birth control pills are a reliable form of contraception that is also easily reversed. Fertility may return to normal two weeks after stopping combination birth control pills. Combination birth control pills have noncontraceptive benefits as well, such as:
- Decreased risk of ovarian and endometrial cancers, ectopic pregnancy, ovarian cysts, uterine fibroids, benign breast disease
- 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 menorrhagia and related iron deficiency anemia
- Relief from premenstrual syndrome (PMS)
- Shorter, lighter and more predictable periods or, for some types of combination pills, fewer periods each year
Combination birth control pills come in different mixtures of active and inactive pills, including:
- Conventional pack. The most common type of combination birth control pills contains 21 active pills and seven inactive pills. Formulations containing 24 active pills and four inactive pills, known as a shortened pill-free interval, also are available. Bleeding occurs every month during the week when you take the last four to seven inactive pills.
- Continuous dosing or extended cycle. These combination birth control pills typically contain 84 active pills and seven inactive pills. Bleeding generally occurs only four times a year during the week when you take the last four to seven inactive pills. Formulations containing only 28 active pills — eliminating bleeding — also are available.
Continuous dosing or extended cycle pills may provide additional benefits of suppressing menstruation, such as:
- Prevention and treatment of excessive bleeding related to uterine fibroids
- Prevention of menstrual migraine
- Reduction in the menstruation-associated worsening of certain conditions, including seizures and asthma
- Relief from pain related to endometriosis
Combination birth control pills aren't appropriate for everyone, however. Your health care provider may suggest another form of birth control instead of combination birth control pills if you:
- Are breast-feeding
- Are older than age 35 and smoke
- Have poorly controlled high blood pressure
- Have a history of or current deep vein thrombosis or pulmonary embolism
- Have a history of stroke or heart disease
- Have a history of breast cancer
- Have migraines with aura
- Have diabetes-related complications, such as nephropathy, retinopathy or neuropathy
- Have liver disease
- Have unexplained uterine bleeding
- Will be immobilized for a prolonged period due to major surgery
- 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.