How to Choose a Birth Control Pill

Birth control pills can be a very effective way of preventing an unwanted pregnancy. Unfortunately, choosing the type that works best for you isn't as simple as it may have once been when the pill became easily available in the 1960s. To make sure you get the type of oral contraceptive that works best for you, it's a good idea to have a candid discussion with your health care provider about your needs, how long you would like to use the pill, and your current health. Here's an overview of what to consider.

Not For Everyone

The birth control pill is very popular and convenient, but it's not for everyone. Certain types of pills can aggravate existing medical conditions or cause problems.

The following conditions may require an alternate form of birth control

· Over the age of 35 and a smoker

· Problems with migraines, specifically migraines with an aura

· Breastfeeding

· About to have major surgery which could cause an extended period of immobilization

· Uterine bleeding that cannot be explained

· A family or personal history of stroke, liver cancer, breast cancer, blood clots or endometrial cancer

· Adrenal gland, kidney or liver problems

· A family or personal history of heart disease, deep vein thrombosis or pulmonary embolism

· Ingesting anticonvulsants or St. John's Wort

· Damaged retina

· Diabetes-related complications

· Taking medications with anti-tuberculosis agents

Combination vs. Continuous

There are many different brand names of birth control pills and they all vary slightly in the level of hormones. Still, oral contraceptives can usually be divided into two categories: combination birth control pills and continuous dosing birth control pills. The latter is also described as extended cycle pills.

Combination pills get their name because they contain a combination of the hormones estrogen and progestin. Progestin is the artificial version of the hormone progesterone. Both of these are hormones found naturally in the body. The pill works by altering the hormone levels to prevent ovulation and ultimately pregnancy since there's no egg to fertilize.

Continuous dosing pills only contain progestin and are sometimes called the mini pill. The mini pill does not always suppress ovulation making it slightly less effective.

Combination pills usually come in a conventional pack with 21 active pills and seven inactive pills. You get your period during the time when you take the seven inactive pills. Sometimes combination packs come with 24 active pills and four inactive pills. With combination pills you have a period every month.

Women who take the continuous dosing pill have their periods only four times a year. The pack typically contains 84 active pills and seven inactive pills. Periods occur during the time the inactive pills are taken. Packs of continuous 28 active pills are also available which eliminates menstruation entirely. Women who go this route may experience some cramping and break through bleeding more so than they would with either the combination pills or the 84-active-day continuous dosing pills.

Your Sensitivity to Hormones

Women who are sensitive to hormones and find that their moods fluctuate more drastically with shifts in hormones or that they break out more often can still take oral contraceptives. There are some pills that are considered low dose because they contain less than 50 micrograms of ethinyl estradiol, a type of estrogen. This may be the pill for you if you're sensitive to hormone fluctuations.

Combinations pills are broken down into two different formulations. This is also something to consider based on any health issues or sensitivity to hormones. Monophasic pills have an equal amount of estrogen and progestin which can either be low or high. Multiphasic pills do not necessarily have an equal amount of these two hormones.


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