Hesperian Health Guides

Family Planning: Using birth control pills

Birth Control Pills (Oral Contraceptives)

Most birth control pills contain 1 or 2 hormones similar to the hormones that a woman’s body normally makes. These hormones are called estrogen and progestin.

Birth control pills come in different strengths of each hormone and are sold under many different brand names. The first 3 types of pills shown below have both estrogen and progestin (see combination pills,) and the fourth type has progestin only (see minipill).

A very common kind of estrogen is called ethinyl estradiol. The most common dose is 35 mcg (micrograms). The most common amount of progestin in combination pills is 0.1 mg (milligrams).

Women who take birth control pills usually have lighter monthly bleeding than they would without the pills. This may be a good thing, especially for women who are anemic. But if a woman has no monthly bleeding or very light monthly bleeding for months and does not like this side effect, she can try changing to a brand with more estrogen.

All birth control pills work best at preventing pregnancy if taken at the same time every day. That also makes it easier to remember to take them. It is especially important to take the progestin-only pill (minipill) at the same time each day because for this pill, there is an increased chance of pregnancy if a woman forgets to take even 1 pill.

With a 28-day pack, take 1 every day and start a new pack right after finishing. A 28-day pack may have 21 pills that contain hormones along with 7 reminder pills that do not have any hormones. These reminder pills (also called placebo pills) are there to help the person remember to take a pill every day. Some 28-day packs, however, have only the pills with hormones. With a 21-day pack, take one each day and then wait seven days before starting the next pack (unless you are using pills continuously in order to have fewer periods).

These pills contain a mix of estrogen and progestin that changes throughout the month. Since the amounts change, it is important to take the pills in order.
Some brand names: Gracial, Logynon, Qlaira, Synphase, Trinordiol, Trinovum, Triquilar, Triphasil

These contain estrogen (usually 35 mcg) and progestin (usually 0.1 mg). A 28-pill pack has 21 pills with hormones and 7 reminder (placebo) pills. A 21-pill pack has only pills with hormones. The amount of each hormone is the same in the 21 pills in both types of pack.
Some brand names: Alesse, Cilest, Diane, Femoden, Gynera, Harmonet, Norinyl, Ortho-Novum, Ovysmen

These pills are higher in progestin (0.15 mg) and lower in estrogen (30 mcg). A 28-pill pack has 21 pills with hormones and 7 reminder (placebo) pills. A 21-pill pack has only pills with hormones.The amount of each hormone is the same in all 21pills in both types of pack. These pills may work better for a woman who has very heavy monthly bleeding or whose breasts become painful before her period begins.
Some brand names: Lo-Femenal, Lo/Ovral, Microgynon, Microvlar, Nordette

These pills contain only progestin and come in 28-pill packs. All of the pills in the pack have the same amount of progestin
Some brand names: Femulen, Microlut, Micronor, Micronovum, Neogest , Microval, Ovrette, Exluton

This page was updated:27 Sep 2018