What are birth control pills, and what are they used for?
Oral contraceptives (birth control pills) are medications that prevent pregnancy. They are one method of birth control.
Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin or progestin alone. Combinations of estrogen and progestin prevent pregnancy by inhibiting the release of the hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland in the brain.
LH and FSH play key roles in the development of the egg and preparation of the lining of the uterus for implantation of the embryo. Progestin also makes the uterine mucus that surrounds the egg more difficult for sperm to penetrate and, therefore, for fertilization to take place. In some women, progestin inhibits ovulation (release of the egg).
3 birth control types
There are different types of combination birth control pills that contain estrogen and progestin that are referred to as monophasic, biphasic, or triphasic.
- Monophasic birth control pills deliver the same amount of estrogen and progestin every day.
- Biphasic birth control pills deliver the same amount of estrogen every day for the first 21 days of the cycle. During the second half of the cycle, the progestin/estrogen ratio is higher to allow the normal shedding of the lining of the uterus to occur.
- Triphasic birth control pills have constant or changing estrogen concentrations and varying progestin concentrations throughout the cycle. There is no evidence that bi- or triphasic oral contraceptives are safer or superior to monophasic oral contraceptives, or vice versa, in their effectiveness for the prevention of pregnancy.
What are the side effects of birth control pills?
The most common side effects of the birth control pills include;
- nausea,
- headache,
- breast tenderness,
- weight gain,
- irregular vaginal bleeding, and
- mood changes.
These side effects often subside after a few months of use.
Scanty menstrual periods or breakthrough bleeding may occur but are often temporary, and neither side effect is serious.
Women with a history of migraines may notice an increase in migraine frequency. On the other hand, women whose migraines are triggered by fluctuations in their own hormone levels may notice improvement in migraines with oral contraceptive use because of the more uniform hormone levels during oral contraceptive use.
Rarely, oral contraceptives may contribute to;
- increased blood pressure,
- blood clots,
- heart attack, and
- stroke.
Women who smoke, especially those over 35, and women with certain medical conditions, such as a history of blood clots or breast or endometrial cancer, may be advised against taking oral contraceptives, as these conditions can increase the adverse risks of oral contraceptives.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
List of birth control pill brands and generic names
List of examples of oral contraceptives of different brands and categories:
MONOPHASIC PRODUCTS | ||
BRAND NAME(S) | ESTROGEN | PROGESTIN |
Alesse-28 | ethinyl estradiol | levonorgestrel |
Apri | ethinyl estradiol | desogestrel |
Aviane | ethinyl estradiol | levonorgestrel |
Brevicon | ethinyl estradiol | norethindrone |
Demulen 1/35-21 Demulen 1/35-28 Demulen 1/50-21 Demulen 1/50-28 |
ethinyl estradiol | ethynodiol diacetate |
Desogen | ethinyl estradiol | desogestrel |
Genora 1/35 | ethinyl estradiol | norethindrone |
Genora 1/50 | mestranol | norethindrone |
Levlite 28 | ethinyl estradiol | levonorgestrel |
Levlen 21 Levlen 28 |
ethinyl estradiol | levonorgestrel |
Levora 0.15/30-21 Levora 0.15/30-28 |
ethinyl estradiol | levonorgestrel |
Loestrin 21 1/20 Loestrin 21 1.5/30 Loestrin FE 1/20 Loestrin FE 1.5/30 |
ethinyl estradiol | norethindrone acetate |
Lo-Ovral 28 Ovral 28 |
ethinyl estradiol | norgestrel |
Low-Ogestrel 28 Ogestrel 0.5/50-28 |
ethinyl estradiol | norgestrel |
Microgestin 1/20 Microgestin 1.5/30 Microgestin FE 1/20 Microgestin FE 1/5/30 |
ethinyl estradiol | norethindrone acetate |
Modicon | ethinyl estradiol | norethindrone |
Necon 0.5/35-21 Necon 0.5/35-28 Necon 1/50-21 Necon 1/50-28 Necon 1/35-21 Necon 1/35-28 |
ethinyl estradiol | norethindrone |
Nordette 28 | ethinyl estradiol | levonorgestrel |
Norinyl 1/50 | mestranol | norethindrone |
Norinyl 1/35 | ethinyl estradiol | norethindrone |
Nortrel 0.5/35 Nortrel 1/35 |
ethinyl estradiol | norethindrone |
Ortho-Cept | ethinyl estradiol | desogestrel |
Ortho-Novum 1/35 | ethinyl estradiol | norethindrone |
Ortho-Novum 1/50 | mestranol | norethindrone |
Ortho-Cyclen | ethinyl estradiol | norgestimate |
Ovcon 50 Ovcon 35 |
ethinyl estradiol | norethindrone |
Tri-Norinyl 28 | ethinyl estradiol | norethindrone |
Yasmin 28 | ethinyl estradiol | drospirenone |
Zovia 1/50E Zovia 1/35E |
ethinyl estradiol | ethynodiol diacetate |
BIPHASIC PRODUCTS | ||
BRAND NAME(S) | ESTROGEN | PROGESTIN |
Jenest 28 | ethinyl estradiol | norethindrone |
Mircette | ethinyl estradiol | desogestrel |
Necon 10/11-21 Necon 10/11-28 |
ethinyl estradiol | norethindrone |
Ortho-Novum 10/11 | ethinyl estradiol | norethindrone |
TRIPHASIC PRODUCTS | ||
BRAND NAME(S) | ESTROGEN | PROGESTIN |
Estrostep 21 Estrostep FE |
ethinyl estradiol | norethindrone |
Ortho-Novum 7/7/7 | ethinyl estradiol | norethindrone |
Ortho Tri-Cyclen Ortho Tri-Cyclen LO |
ethinyl estradiol | norgestimate |
Tri-Levlen 21 Tri-Levlen 28 |
ethinyl estradiol | levonorgestrel |
Tri-Norinyl 28 | ethinyl estradiol | norethindrone |
Triphasil 28 | ethinyl estradiol | levonorgestrel |
Trivora 28 | ethinyl estradiol | levonorgestrel |
24-4 PREPARATIONS (24 days of hormone pills and 4 days of placebo pills) | ||
Yaz | ethinyl estradiol | drospirenone |
Lo Estrin 24-4 | ethinyl estradiol | norethindrone acetate |
EXTENDED-CYCLE PREPARATIONS | ||
Seasonale | ethinyl estradiol | levonorgestrel |
Seasonique | ethinyl estradiol | levonorgestrel |
PROGESTIN-ONLY PRODUCTS | ||
BRAND NAME(S) | ESTROGEN | PROGESTIN |
Micronor | norethindrone | |
Nor-QD | norethindrone | |
Ovrette | norgestrel |
Previous contributing medical author: Carolyn Janet Crandall, MD, MS, FACP

SLIDESHOW
Sex-Drive Killers: The Causes of Low Libido See SlideshowWhat is the dosage for birth control pills? How do you take them?
Many of the birth control pills come in easy-to-use dispensers in which the day of the week or a consecutive number (1, 2, 3, etc.) is written on the dispenser with a corresponding tablet for each day or number.
- For example, some Ortho-Novum dispensers are labeled "Sunday" next to the first tablet. Thus, the first tablet is to be taken on the first Sunday after menstruation begins (the first Sunday following the first day of a woman's period). If her period begins on Sunday, the first tablet should be taken on that day.
- For birth control pills that use consecutive numbers, the first tablet (#1) is taken on the first day of the menstrual period (the first day of bleeding). Tablet #2 is taken on the second day and so on.
- Still other packages instruct women to begin on day five of the cycle. For such products, women count from day one of their menstrual cycle (day one is the first day of bleeding). On the fifth day, the first tablet is taken. Tablets then are taken daily.
- Most birth control pills are packaged as 21-day or 28-day units. For 21-day packages, tablets are taken daily for 21 days. This is followed by a seven-day period during which no birth control pills are taken. Then the cycle repeats.
- For the 28-day units, tablets containing medication are taken for 21 consecutive days, followed by a seven-day period during which placebo tablets (containing no medication) are taken.
- Newer formulations with 24 days of hormone pills and only four days of placebo pills are now available, as are continuous or extended-cycle oral contraceptive regimens, in which only active hormone pills are taken. Extended-cycle preparations include seven-day intervals of placebo pills to be taken approximately every three months.
- Women just starting to take birth control pills should use additional contraception for the first seven days of use because pregnancy may occur during this period.
- If women forget to take tablets, pregnancy may result. If a single tablet is forgotten, it should be taken as soon as it is realized that it is forgotten. If more than one tablet is forgotten, the instructions that come with the packaging should be consulted, or a physician or pharmacist should be called.
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What drugs interact with birth control pills?
Estrogens can inhibit the metabolism (elimination) of cyclosporine, resulting in increased cyclosporine blood levels. Such increased blood levels can result in kidney and/or liver damage. If this combination cannot be avoided, cyclosporine concentrations can be monitored, and the dose of cyclosporine can be adjusted to assure that its blood levels do not become elevated.
Estrogens appear to increase the risk of liver disease in patients receiving dantrolene (Dantrium) through an unknown mechanism. Women over 35 years of age and those with a history of liver disease are especially at risk.
Estrogens increase the liver's ability to manufacture clotting factors. Because of this, patients receiving warfarin (Coumadin) need to be monitored for loss of anticoagulant (blood thinning) effect if an estrogen is begun.
Several medications, including some antibiotics and antiseizure medications, can decrease the blood levels of oral contraceptive hormones, but an actual decrease in the effectiveness of the oral contraceptive has not been convincingly proven. Nonetheless, because of this theoretical possibility, some physicians recommend backup contraceptive methods during antibiotic use. Examples of medications that increase the elimination of estrogens include
- carbamazepine (Tegretol),
- phenobarbital,
- phenytoin (Dilantin),
- primidone (Mysoline),
- rifampin (Rifadin),
- rifabutin (Mycobutin), and
- ritonavir (Norvir).
Birth control pills with higher concentrations of estrogen or alternative forms of contraception may be necessary in women using those medications.
Are birth control pills safe to take if you are breastfeeding?
Use of birth control pills during lactation has been associated with decreased milk production, decreased infant weight gain, and decreased nitrogen and protein content of milk. The amount of estrogen consumed by an infant whose mother takes a standard dose of birth control pills is considered to be the same as from a lactating woman who is not taking birth control pills, and side effects have not been reported.
Using a progestin-only product is most often recommended during lactation if birth control pills are to be used during this period. The American College of Obstetrics and Gynecology (ACOG) recommends delaying taking combined estrogen-progestin contraceptives until at least six weeks postpartum, while the World Health Organization (WHO) recommends delaying the initiation of combined contraceptives until six months.
How do you store birth control pills safely?
- All oral contraceptives should be stored in a safe place, out of the reach of small children, at a temperature between 15 C (59 F) and 30 C (86 F).
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Summary
Birth control pills (oral contraceptives) are prescription medications that prevent pregnancy. Three combinations of birth control pills that contain progestin and estrogen are 1) monophasic, 2) biphasic, and 3) triphasic. Birth control pills may also be prescribed to reduce menstrual cramps or prevent anemia. Certain prescription medications may cause drug interactions. Some women experience various levels of side effects of birth control pills.
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DVT and Birth Control Pills (Oral Contraceptives)
Deep vein thrombosis (DVT) is a blood clot that has traveled deep into the veins of the arm, pelvis, or lower extremities. Oral contraceptives or birth control pills can slightly increase a woman's risk for developing blood clots, including DVT. DVT symptoms and signs in the leg include leg or calf pain, redness, swelling, warmth, or leg cramps, and skin discoloration. If a blood clot in the leg is not treated, it can travel to the lungs, which can cause a pulmonary embolism (blood clot in the lung) or post-thrombotic syndrome, both of which can be fatal if not treated immediately. Increased risk factors for DVT and birth control pills include over 40 years of age, family history, smoking, and obesity. Other medical problems that increase the risks of blood clots, for example, lung or heart disease, or inflammatory bowel disease or IBD (Crohn's disease and ulcerative colitis (UC). Other options for preventing pregnancy include IUDs, birth control shots, condoms, diaphragms, and progestin-only oral contraceptives.
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Erythema Nodosum
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in three to six weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
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Menstrual Cramps and PMS (Premenstrual Syndrome) Treatment
Menstrual cramps and premenstrual syndrome (PMS) symptoms include abdominal cramping, bloating, a feeling of fullness, abdominal pain, mood swings, anxiety and more. Treatment for menstrual cramps and premenstrual syndrome (PMS) symptoms include regular sleep, exercise, smoking cessation, diet changes, and OTC or prescription medication depending on the severity of the condition.
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Why Is Birth Control So Bad for You?
Birth control is used all over the world. The main use of birth control is to avoid unplanned pregnancy. Although there are various means of birth control, birth control pills are popular because they have a good success rate and are relatively safe for the majority of the population.
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Hemolytic Uremic Syndrome
Hemolytic uremic syndrome (HUS) is a diseases in which blood clots within the capillaries. Causes associated with HUS include: E. coli, birth control pills, pneumonia, medications such as chemotherapy, Ticlid, and quinine. Symptoms of HUS include: gastroenteritis, abdominal cramping, vomiting, and bloody diarrhea. Diagnosis of HUS includes: medical history, physical examination, and medical tests. Treatment includes: rest, fluids, possible hospitalization for blood transfusion or complications due to kidney failure.
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Is It OK To Skip the 7-Day Break on the Pill?
There seems to be no additional risks associated with using the pill to suppress the seven-day break (beyond the health risks already linked to hormonal pills or devices).
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Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back.
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What Does Birth Control Do to Your Body?
Different birth control methods work in different manners. No birth control method is perfect and every procedure or method has a side effect.
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Sexual Health
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
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What Is the Best Form of Birth Control?
What's "best" among birth control methods differs from person to person. What's right for one person may not be right for others. And a person’s needs may also change over time.
Treatment & Diagnosis
- Natural Birth Control
- Triglycerides (Tests and Lowering Your Triglyceride Levels)
- Parathyroidectomy Surgery
- IUD (Intrauterine Device for Birth Control)
- Birth Control: Surgical Sterilization
- Hormonal Methods of Birth Control
- Barrier Methods of Birth Control Side Effects, Advantages, and Disadvantages
- Contraceptive Measures after Unprotected Sex
- What Are the Natural Contraception Methods?
- Weight Gain
- Nausea
- Missed Menstrual Period
- Vaginal Bleeding
- Pregnancy: Trying to Conceive: After Birth Control
- Menstrual Cramps
- Headache
- Breast Pain
- PMS (Premenstrual Syndrome)
- Menorrhagia
- Endometriosis
- Doctor: Checklist to Take To Your Doctor's Appointment
- Perimenopause
- Birth Control Choices-- Laura Corio, MD
- Birth Control: Contraception: What's New?
- Endometriosis FAQs
- Birth Control FAQs
- How Much Do You Know About Birth Control FAQs
- What are granulomatosis with polyangiitis and erythema nodosum?
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Birth Control Prescribed by Pharmacists
- Ovarian Cancer Symptoms, Early Warning Signs, and Risk Factors
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Do Antibiotics Interfere With Birth Control Pills?
- Can Birth Control Pills Cure PCODS?
- Do I Need Birth Control After Menopause?
- Birth Control: The Contraceptive Patch
- Birth Control Types
- Generic Drugs, Are They as Good as Brand-Names?
- Ask The Experts: Women's Health
Medications & Supplements
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- estradiol, Alora, Climara, Delestrogen, Depo-Estradiol, Divigel, Elestrin, Estrace, and Others
- What Are Hormonal Methods of Contraception?
- What Are the Barrier Methods of Contraception?
- nonoxynol-9 vaginal
- Side Effects of Ortho Micronor (norethindrone)
- mifepristone
- What Are Intrauterine Devices?
Prevention & Wellness
- FDA Updates Guidance on ‘Morning After’ Pill, Making Clear It Does Not Cause Abortions
- Study Counters Myth That Contraceptive Pill Enlarges Breasts in Teen Girls
- FDA Mulling Over-the-Counter Sale of Contraceptive Pill
- Some Pharmacy Chains Limit Morning-After Pill Sales to Avoid Potential Shortage
- New 'On-Demand' Birth Control Pill on the Horizon
- New Male Birth Control Pill Works in Study
- Heart Attack Symptoms in Women
- Birth Control Myths
- Drug Name Confusion: Preventing Medication Errors
- FDA Strengthens Warning on RU-486
- Stopping Sperm in Their Tracks
- Sexual Infections with Depo Provera?
- Contraceptive: Fake Contraceptive Patches Warning
- FDA Approves First Chewable Oral Contraceptive Tablet
- New Pill, Fewer Periods
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