Sex & fertility

Which is the best birth control pill?

When we hear this question from a woman, we know that what she is interested in learning is which pill will work best for her needs. Because there really is no one best pill, and the differences between them tend to be subtle.

All birth control pills contain synthetic estrogen/s and/or a synthetic progestin, with the primary purpose of inhibiting ovulation — thickening cervical mucus and thinning the endometrium, which all help to prevent pregnancy. There is simply no birth control pill made with natural hormones. Pill brands basically differ their unique versions and dosages of the synthetic estrogen/s and/or the progestin they contain, with the variation in progestin being what varies most among brands.

Each woman’s hormone receptors respond uniquely to the hormones in birth control pills. What this means in terms of which pill is best is that you may love your prescription, while your best friend might hate the same one.

Although the primary purpose of birth control pills is to prevent pregnancy, they can have numerous other effects on the body’s systems — some desirable, others less so — and many pills these days are specifically designed by pharmaceutical companies to augment or diminish these effects. Their unique progestin agent is what targets issues like PCOS, acne, libido, and so forth.

For example, many women are prescribed birth control pills to help regulate irregularity in their menstrual cycles. Some women want a pill known for clearing up skin and acne — though all pills tend to help acne over time. Other women, particularly those in their 40’s and 50’s, may want a pill less likely to inhibit their sex drive, as all pills may have this effect to some degree.

It can take some trial and error on the part of a woman and her practitioner to find the best pill for her overall body type and menstrual patterns, and it often requires two to three months to see how well one particular choice will work. There are over 30 kinds of birth control pills to consider, and a woman can usually find a good match if she is patient.

Most pills nowadays are low dose (35 mcg or less of estrogen) and pose minimal proven health risk for those who are good candidates for the Pill in the first place. The latest versions — called “third-generation” pills — have even less hormone content and fewer side effects, making them very popular. Aggressive marketing, free samples provided to offices by pharmaceutical companies, and familiarity of individual practitioners with certain pills contribute to their widespread use.

At Women to Women, we commonly prescribe the following to our patients who opt for the Pill: Ortho Tri-Cyclen, Ortho Tri-Cyclen-Lo, Loestrin, Mircette, Yasmin, Ovcon-35, Allese, and Lo/Ovral. There are generic versions of most of these brands, sold under various names. If you want to go generic — or if you are on a generic and want to know which name-brand drug your prescription corresponds to — ask your practitioner for clarification.

When starting the Pill, you will be given a list of warning symptoms to report promptly if they occur, and you will usually have a brief follow-up visit within three to six months. Your body may take a few months to adjust to your new pill, so give it a chance. You can read more on the risks and benefits of birth control pill use in the FDA label insert that is in all pill packages.

Return to:

• Birth control FAQ’s
• An intro to choosing birth control

 

Last Modified Date: 04/19/2011
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician