Birth Control Pills: Does The Brand I Take Matter?
So, you’re wondering if you should a start a birth control pill, and maybe you are a bit confused by all the different types. There are so many! It’s true. We sat down with Dr. Stephanie Cox-Batson to learn more about the types of birth control pills available and how to determine what birth control pill is best suited for you. “Basically, there is very little difference from one birth control pill to the next and as an OBGYN, I’d like you to feel a bit more comfortable with giving a pill a try” Says Dr. Cox-Batson.
You have probably heard that aside from pregnancy prevention, some birth control pills are good for reducing acne. Some are good to help with heavy periods. Some are good to help with unwanted hair growth. Some are good if you don’t want to feel heavy mood swings and appetite changes with each period cycle. So many choices! What’s really the difference between all these different birth control pills? The short answer…Not much.
Two Classes of Pills: Estrogen with Progesterone or Progesterone Only
There are two major categories of birth control pills. Pills with both estrogen (estradiol) and a progesterone (progestin), which is sometimes called combined pill; and the less common pills that only have a progesterone (progestin), sometimes called the mini-pill.
I’m going to talk about the more common combined pill. Almost all combined pills have the same type of estradiol and there are four types of progestins. By rearranging the doses of estradiol and the type and doses of the progestins we come up with almost an endless variety of birth control pills. Choosing which will be the best for you is almost impossible to predict upfront because every person is different hormonally, and every person has different wants and needs. To make it even more interesting, each person changes hormonally throughout their life. Your hormones at 15 years old are not going to be the same your whole life. They change!
Most of the estrogen and progesterone pills are not only helpful to plan, prevent or space pregnancy, they are also helpful with acne, menstrual cycle control and cramps. Believe it or not, significant weight gain or loss with the combined pill is rare. As far as effectiveness- the pills are about 99% percent effective for preventing pregnancy with perfect use (ie taking it at the same time every day, never missing a pill), but perfection is hard to achieve. You may spend the weekend away from home and forget to take a pill or wake up late for work/school and forget to take our pill, or even misplace the pack; thus, it’s hard to be a perfect user! So, the “normal use” effectiveness is about 93%. This means 7 out of 100 people taking the pill may get pregnant over the course of one year.
How Do I Decide Which Pill Is The Best For Me?
Unfortunately, there is no pill type or brand that is “the best” for every person. For my patients, I like to explain that choosing a birth control pill is like taking someone to try ice cream for the first time. In general, you’re going to start them off with a common flavor like vanilla or chocolate. If they don’t like that flavor, that doesn’t mean they don’t like ice cream. Maybe you picked the wrong flavor. And so, and if they are willing to try something different, you might pick strawberry, and they love it! It’s like that with the pills, (but sadly pills are not as delicious as ice-cream)!
If you decide to start taking a birth control pill, it’s important to tell your health care provider what is important to you so they can try to pick a type “or flavor” that you will like adjust from there if needed. A big part of the success is you! Remember to take you pill daily at the same time, communicate with your provider on how the pill is working for you, including any questions or side affects you have, and be willing to try it for more than a few days as it can take a few weeks to months for your body to get used to this new hormone. We can almost always find a pill that will meet your needs.
Remember only YOU can determine which method of birth control is best for you! Still unsure about the pill? Take our birth control quiz or click here to learn about all of your birth control options!
About the Author
Dr. Stephanie Cox-Batson is an experienced board certified ob/gyn physician focused on advancing health equity, especially for patients at community health centers. She is an attending physician at Northwestern Prentice Hospital and has twin daughters who keep her on her toes
