When birth control pills (or the Pill) were first made available to women in 1960, it was a liberating breakthrough. For the first time, women had a way to directly control reproduction. What they couldn’t control were the significant side effects associated with birth control pills, which until the 1980s were produced as a one-dose, one-hormone-fits all medication. Today however there are a number of different types of birth control pills available, with different hormones in differing levels, giving women a number of options to minimize side effects and maximize reproductive control.
Monophasic Pills
Monophasic birth control pills are part of a broader category known as “combination pills.” Unlike the Pill of the 1960s, which only contained a high dose of progesterone, combination pills contain estrogen and progestin, two hormones that play a big role in regulating a woman’s natural menstrual cycle. The level of estrogen and progestin in monophasic pills is the same in all the active pills in the pack. Typically, there are 21 active pills followed by 7 placebo pills. The placebo causes hormone levels to drop, effectively inducing menstruation. While combination pills carry the risk of side effects, such as nausea, weight gain and (in rare cases) blood clots, the benefits are many. The Pill can reduce endometriosis, regulate periods, decrease acne and lessen pre-menstrual symptoms.
Multiphasic pills
Also part of the combination pill category are multiphasic pills, which are sometimes referred to as the biphasic or triphasic pill. Like the monophasic pill, these pills contain estorgen and progestin. The difference is that the levels of the hormones are varied throughout the monthly pill pack, as a way to more closely simulate the natural rise and drop of hormones in a woman’s monthly cycle. Though the risks and benefits remain the same, women taking multiphasic birth control pills tend to have fewer instances of breakthrough bleeding and spotting mid-cycle than those taking monphasic pills.
Mini-Pill (Progestin-only pills)
Mini-pills, or pills that simply contain progestin, are ideal for women who have allergies or sensitivities to estrogen or for women who are breastfeeding. Unlike combination pills, which need to be taken daily, but have some flexibility in terms of the time of dosing, the mini-pill must be taken at the same time every day to remain effective. Since the progestin works to thicken cervical mucus, as opposed to changing the uterine lining, the mini-pill has a slightly higher failure rate than combination pills. However, the same mechanism makes it easier to restore fertility after discontinuing the birth control pill.
Extended-Cycle Pills
The newest type of birth control pill available give women greater control than ever over their reproductive systems. The extended-use pill is a combination pill designed to significantly reduce the number of periods a woman has per year. While the typical combination pill uses a placebo or low-dose estrogen pill every four weeks to induce period-like bleeding, the extended-use pill increases the number of active dose pills from 21 to 84, allowing women to have only four periods per year (or once per season). Though questions have been raised as to whether it’s detrimental to a woman’s health to suppress menstruation for that long, studies published in the Journal of Reproductive Medicine found no veracity to the claim.
