Starting birth control pills can be a daunting task. When discussing your options with your health care provider on the best birth control pill for you, it is useful to understand the different options that are available to you and how birth control pills work. Read on to learn about starting birth control pills and which pill to begin with.
Types of Birth Control Pills
Birth control pills (BCPs) are either combination pills containing both estrogen and progestin or progestin-only pills known as mini pills. Both types of pills work by preventing ovulation and thickening cervical mucus to prevent fertilization of an egg by sperm. They also thin the lining of the uterus to prevent implantation of a fertilized egg.
Active combination BCPs containing estrogen and progestin are taken for three weeks, and then placebo pills are taken for the next seven days as withdrawal bleeding occurs.
Mini pills which only contain progestin are taken every day and should be taken at the same time of day.
If you have the following risk factors, you should not be taking combination birth control pills containing estrogen:
- History of a heart attack (MI)
- History of complications arising from diabetes mellitus
- History of liver disease
- History of kidney disease
- History of migraine headaches with auras
- History of coronary artery disease
- Taking anti-seizure medications
Side effects of combination birth control pills include:
- Spotting
- Nausea
- Breast tenderness
- Headaches
- Migraines headaches
- Weight gain
- Missed periods
- Decreased sex drive
Reasons to Take Progestin-Only “Mini” BCPs
The following are reasons to consider using a progestin-only or mini pill:
- You are currently breastfeeding
- You are over the age of 35
- You are a cigarette smoker
- You have a history of uncontrolled high blood pressure (hypertension)
- You have a history of blood clots
- You are at high risk for coronary vascular disease (CAD)
- You have a history of migraine headaches with auras
Potential Side Effects of the Progestin-Only Birth Control Pill
Potential side effects to consider when taking the “mini” pill include:
- Increased weight
- Nausea
- Vomiting
- Headache
- Breast Tenderness
- Bloating
- Light periods
- Irregular periods
- Periods stopping entirely
- Frequent bleeding
- Heavier bleeding
- Depression
- Anxiety
Medications that interfere with the mini pill include:
- Seizure medications
- Barbiturates
- Rifampin to treat TB
- St. John’s Wort (natural remedy used to treat depression)
Specialty BCPS to Consider When Starting BCPs
1. Low Estrogen BCPs – These BCPS have fewer inactive pills which will trigger periods and contain a new form of progestin that decreases mood disorders.
2. Lybrel Generic Form – Low dose BCP are taken every day and stops all periods. No longer available as “Lybrel.” Main side effects can be cramping, headache, and nausea.
3. Seasonale – Seasonale is a combination BCP taken for 12 week periods and then with placebo taken for seven days. This results in only four periods per year.
4. Seasonique ( online prescription)- Seasonique is also taken for 12 weeks like Seasonale and results in 4 periods also which are lighter and shorter than usual.
5. Yaz (online prescription) – Yaz is taken for 28 days (24 active pills and 4 inactive pills) and leads to shorter, lighter, and more regular periods. Yaz also leads to less severe Premenstrual Syndrome (PMS).
6. Beyaz (online prescription) – Beyaz is similar to Yaz but also contains folic acid, which prevents neural tube congenital disabilities if a woman becomes pregnant. Beyaz is also approved for the treatment of acne and premenstrual dysphoric syndrome.
7. Yasmin (online prescription) – Yasmin is also a combination birth control pill that is approved for the treatment of acne and PMS. Periods while on Yasmin are usually lighter and more regular than usual.
When starting birth control pills, a thorough consultation with your doctor will determine the BCP that best fits your medical and health profiles. All BCPs have benefit and risk profiles, which will help determine if they are safe for you.