Hesperian Health Guides
Oral contraceptives (birth control pills)
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HealthWiki > A Book for Midwives > Medicines: uses, dosage, and precautions for the medicines referred to in this book > Oral contraceptives
Most birth control pills contain 2 hormones similar to the hormones that a woman’s body normally makes. These hormones are called estrogen (ethinyl estradiol) and progestin (levonorgestrel). Birth control pills come in different strengths of each hormone and are sold under many different brand names. Some of the brand names are listed below.
Usually, brands that contain a smaller amount of both hormones are the safest and work best for most women. These “low dose” pills are found in Groups 1, 2, and 3.
To assure effectiveness and minimize spotting (small amounts of bleeding at other times than normal monthly bleeding), take birth control pills at the same time each day, especially with pills that have low amounts of hormones. If spotting continues after 3 or 4 months, try one of the brands in Group 3. If there is still spotting after 3 months, try a brand from Group 4.
As a rule, women who take birth control pills have less heavy monthly bleeding. This may be a good thing, especially for women who are anemic. But if a woman misses her monthly bleeding for months or is disturbed by the very light monthly bleeding, she can change to a brand with more estrogen from Group 4. For a woman who has very heavy monthly bleeding or whose breasts become painful before her monthly bleeding begins, a brand low in estrogen but high in progestin may be better. These pills are found in Group 3.
Women who continue to have spotting or miss their monthly bleeding when using a brand from Group 3, or who became pregnant before while using another type of pill, can change to a pill that has a little more estrogen. These “high dose” pills are found in Group 4.
Women who are breastfeeding, or who should not use regular pills because of headaches or mild high blood pressure, may want to use a pill with only progestin. These pills in Group 5 are also called “mini-pills.”
Progestin only pills should be taken at the same time every day, even during the monthly bleeding. Menstrual bleeding is often irregular. There is also an increased chance of pregnancy if even a single pill is forgotten.
|group 1 — triphasic pills||group 2 — low dose pills|
|These contain low amounts of both estrogen and progestin in a mix that changes throughout the month. Since the amounts change, it is important to take the pills in order.||These contain low amounts of estrogen|
(35 micrograms of the estrogen “ethinyl
estradiol” or 50 micrograms of the estrogen
“mestranol”) and progestin in a mix that
stays the same throughout the month.
|Brand names:||Brand names:|
|Logynon||Triquilar||Brevicon 1 + 35||Ortho-Novum 1/35, 1/50|
|Tricyclen||Noriday 1 + 50||Perle|
|Trinovum||Norinyl 1 + 35, 1 + 50|
|group 3 — low dose pills||group 4 — high dose pills|
|These pills are high in progestin and low in estrogen (30 or 35 micrograms of the estrogen “ethinyl estradiol”).||These pills are higher in estrogen (50 micrograms of the estrogen “ethinyl estradiol”) and most are also higher in progestin.|
|Brand names:||Brand names:|
|group 5 — progestin only pills|
|These pills, also known as “mini-pills,” contain only progestin.|
|These brands can also be used for emergency contraception.|