1. Lets start with combination pills They contain two types of hormones: estrogen and progestin. They prevent pregnancy by preventing ovulation, thickening cervical mucous and thinning the lining of your uterus, thus preventing a pregnancy from implanting there. The patch and the nuvaring have both hormones and so are essentially comparable to the pill. Different types of combination pills have different types of estrogens and progestins and at different dosages.
2. Let's further break it down: There are two major types of combination pills: monophasic pills and triphasic pills. Monophasic pills have the same amount of estrogen and progestin in their active pills. Triphasic pills vary the amount of hormones every week. The marketing guys for triphasic pills claim that they are trying to mimic the hormonal changes that happen during the cycle. However, there is no evidence that says that triphasic pills work better or have any other benefit.
3. Different combination pills have different amounts of estrogen. Is a low dose estrogen pill better for me since it has less hormone? Not necessarily. Some women are very sensitive to the effects of estrogen, and higher doses can cause worsening nausea or breast tenderness. For them, a low dose estrogen pill may help with these symptoms. However, low dose estrogen pills are notorious for causing breakthrough bleeding. So while your breasts may be less sore, you may be bleeding a lot more. I guess it's pick your poison, huh?
4. Different combination pills have different types of progestins. Some progestins may be less androgenic than others. What does that mean? Essentially some progestins may help decrease acne or affect unwanted hair growth.
5. What if I can't take a combination pill? For some women, the combination pill can worsen preexisting health problems. If you are over the age of 35 and a smoker or have high blood pressure, diabetes, history of blood clot or have migraines with aura, you may not be a candidate for combination birth control that includes estrogen and progestin.
6. So what is the mini-pill? The mini-pill only contains progestin. It thickens cervical mucous and thins the lining of your uterus, but does not necessarily prevent ovulation. The mini-pill is usually a great option for women who are not allowed to use the combination pill because of certain medical conditions or if they are breastfeeding. The estrogen in the combination pill can decrease milk supply and so for breastfeeding women, the mini-pill is recommended. With the mini-pill, you must take it at the same time every day to prevent pregnancy.
So back to which pill is best for me. It's not that easy, is it? It is best to have a discussion with your provider. Based on your medical history and goals of treatment, together, you can come up with a plan to best suit your needs. Keep following for a follow-up blog: Does the birth control pill make me fat and crazy?!