What's the Best Birth Control Pill For You?

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    Kristin Hall, FNP
    Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 9/04/2020

    If you're concerned about becoming pregnant, the birth control pill (better known as simply “the pill”) is one of the safest, most reliable forms of contraception available. 

    Used perfectly, the pill can be up to 99 percent effective at stopping you from becoming pregnant from unprotected sex. It can also have a range of other benefits, from preventing acne to helping you deal with a shorter, less painful period.

    Using the pill is easy. However, choosing which pill to use from the myriad of options that are now available isn’t so easy. With numerous types of birth control pills on the market, working out which is the best option for you can be a stressful, challenging process. 

    Below, we’ve compared the various birth control pill types and brands that are available on the market to help you choose the best option for your unique needs. We’ve also provided a bit of background on how the pill works to help you better understand your options. 

    The Birth Control Pill: Basics

    Birth control pills work by releasing certain hormones into your body. Most pills either contain a mix of progestin and ethinyl estradiol (these are known as combination birth control pills), or just a small dose of a progestin hormone (these are called progestin-only pills, or “mini-pills”). 

    The estrogen and/or progestin hormones released by the birth control pill change the way your reproductive system works. When you take the pill every day, the following biological changes can happen:

    • Your body will stop ovulating, meaning your ovaries will no longer release eggs during each menstrual cycle. This makes it significantly less likely for your partner’s sperm to come into contact with and fertilize an egg.

    • The layer of mucus around your cervix can thicken, making it more difficult for sperm to enter into your uterus and come into contact with an egg.

    • The lining of your uterus can become thinner, making it more difficult for a fertilized egg to successfully attach and implant itself inside your uterus. 

    It’s worth noting that not all birth control pills will stop you from ovulating. For example, certain progestin-only pills may only reduce your risk of pregnancy via the second and third biological changes listed above. We’ve explained this in more detail further down the page. 

    The hormones in the pill can also cause several other changes in your body that aren’t related to your reproductive system. For example, certain versions of the pill can help to prevent acne breakouts — something we’ve covered in more detail below.

    All forms of the birth control pill are designed for daily use. Used perfectly, the pill is up to 99 percent effective at preventing pregnancy. Used under “real life” circumstances, such as the occasional late or missed dose, most versions of the birth control pill are around 91 percent effective. 

    The pill was developed throughout the mid-20th century and in the 1960s emerged onto the market. Today, there are numerous different birth control pills available, many of which provide different cycle lengths, secondary benefits and side effects.

    The Different Types of Birth Control Pill

    When the birth control pill first came onto the market as an oral contraceptive in 1960 (it had been used previously to regulate menstruation), women only had one option to choose from: a pill called Enovid®, which used a combination of mestranol and norethynodrel.

    As of today, there are dozens of different brand names of birth control pills in regular use by women all over the world.

    The end result for many women is, not surprisingly, confusion. On our birth control page alone, there are 10 different generic forms of the pill available.

    While the sheer number of birth control pills that are available can look confusing, the majority of these pills fit into one of three categories:

    • Combination pills, or combined oral contraceptives. These birth control pills contain a progestin hormone and ethinyl estradiol, a synthetic form of estrogen. The combination of hormones work to prevent pregnancy.
    • Progestin-only pills, or “mini-pills.” These pills only contain a progestin hormone and don’t contain any estrogen. Even at a relatively low dose, this single progestin hormone can significantly lower your risk of pregnancy if you take your pill every day.
    • Extended cycle, or continuous cycle, birth control pills. These birth control pills are designed to have a longer-than-normal cycle length, meaning you won’t get your period as often as normal. Some pills will only give you one period every three months. 

    Like with many other topics related to health and wellbeing, there’s no best birth control pill for everyone. Instead, each type of birth control pill has a range of advantages and disadvantages that could make it a good or bad choice for your unique needs.

    We’ve listed these advantages and disadvantages, as well as any other interesting information about each type of birth control pill below.

    Combination Birth Control Pills

    Combination birth control pills contain a progestin hormone as well as ethinyl estradiol, a form of the hormone estrogen.

    Birth control pills of this type can reduce your risk of pregnancy in three ways. First, they prevent you from ovulating. Second, they can thicken your cervical mucus. Third, they can change your cervical lining, reducing the chance of a fertilized egg from attaching and developing.

    There are several different combination birth control pills available on the market today. Some of the most widely used combination birth control pills are Yaz® (drospirenone and ethinyl estradiol), Estrostep® (norethindrone and ethinyl estradiol) and Ortho Tri-Cyclen® (norgestimate and ethinyl estradiol)

    We offer generic versions of all of these combination birth control pills, as well as several others, subject to a healthcare provider’s prescription online. 

    As you can see above, each of these pills contains a different progestin hormone in combination with ethinyl estradiol. There are also several other, less popular combination birth control pills in the US and abroad that contain different progestin hormones. 

    All combined oral contraceptives are designed for daily use. To use the pill, you’ll need to follow the instructions provided and take it at approximately the same time every day. 

    Advantages of Combination Birth Control Pills

    Obviously, by far the biggest advantage of any type of birth control pill is that it can prevent you from becoming pregnant. Combination pills are no exception. 

    With perfect use, most combination birth control pills are 99 percent effective at preventing you from becoming pregnant. Under “real life” circumstances, such as the occasional late or missed pill, most of the combination birth control pills on the market are about 91 percent to 92 percent effective.

    However, combination birth control pills can do much more than just lower your risk of becoming pregnant. Other benefits of the combination pill include:

    • Acne prevention. Certain combination birth control pills, such as Yaz, Ortho Tri-Cyclen and Estrostep, are approved by the FDA for treating acne. The combination of hormones in these pills can lower androgen levels, helping to prevent some acne breakouts.

      Combined oral contraceptives such as Yaz, Ortho Tri-Cyclen and Estrostep are generally the best forms of birth control to choose if you also want to treat acne.

      Our guide to birth control and acne explains how this benefit works in more detail. Many women who are prone to acne notice fewer pimples and less significant acne breakouts after they start using this form of contraception.
    • A more predictable menstrual cycle. Most combination birth control pills have a 21 to 28 day cycle length. This means that you’ll start your period at a predictable, consistent time every month, making it easier to plan for your period ahead of time.
    • Milder, less painful periods. As we’ve explained in our guide to birth control and your period, combination pills can potentially make your period lighter and reduce the risk of menstrual cramps and other common forms of menstrual discomfort.
    • A reduced risk of ovarian cysts and cancer. Combination birth control pills are linked to a reduced risk of developing certain diseases and health conditions, including ovarian cysts and ovarian cancer.

      In a 2018 study from Denmark, researchers discovered that women who used combined hormonal contraceptives had a reduced risk of developing ovarian cancer. Combination pills may also reduce your risk of developing pelvic inflammatory disease, sometimes called PID.
    • Management of PCOS symptoms. If you have polycystic ovary syndrome (PCOS), you may be able to manage your symptoms using certain combined oral contraceptives. This is something that you should discuss with your healthcare provider
    • Fewer consequences if you take a pill late. While you’ll need to take the combination pill every day, most combination pills don’t need to be taken within a three-hour window like the progestin-only mini-pill. 

    Disadvantages of Combination Birth Control Pills

    Used correctly, combination birth control pills are very effective at preventing you from becoming pregnant. They can also offer a range of additional benefits, as we’ve listed above. 

    However, this form of birth control pill can also have potential disadvantages. We’ve listed these below:

    • Health issues for smokers. If you smoke, and particularly if you’re 35 or older, you should not take a combined oral contraceptive. Our guide to smoking and the birth control pill explains the additional risks of birth control for smokers in more detail.
    • Cardiovascular side effects. All birth control pills have the potential to slightly increase your risk of blood clots, stroke and other cardiovascular side effects. This risk is slightly higher with combination birth control pills than it is with progestin-only pills.

      In general, the risk of experiencing a blood clot or stroke while using birth control is very low, even if you use a combined oral contraceptive. We’ve covered this in more detail in the “Rare, Serious Side Effects” section of our guide to the side effects of the pill.
    • A 21- to 28-day cycle length. Most combined oral contraceptives have a cycle that lasts for 21 to 28 days. If you’d prefer to skip or delay your period, you’ll need to use a birth control pill with a longer cycle length.
    • Effects on breastfeeding. The combination birth control pill may potentially have the ability to affect your milk volume, making it more difficult to breastfeed. If you’ve recently given birth and plan to breastfeed, talk to your healthcare provider before considering this type of oral contraceptive. 

    Combination Birth Control Pills Summary

    Overall, combination birth control pills are usually the best choice if you’d like to reduce your risk of becoming pregnant and treat hormonal acne at the same time. This type of pill can also make your period less severe, more predictable and easier to tolerate.

    Pills such as Yaz, Estrostep and Ortho Tri-Cyclen are all approved by the FDA as treatments for acne, making them the best birth control pills for managing acne breakouts. 

    The combination pill is also a good choice if you’re prone to forgetting to take medication. While you’ll need to take it every day, it won’t lose effectiveness as quickly if you forget to take a pill on time — a common issue with the progestin-only mini-pill. 

    Progestin-Only Birth Control Pills (Mini-Pills)

    Progestin-only birth control pills, or mini-pills, contain a progestin hormone but do not contain ethinyl estradiol. 

    Unlike combination birth control pills, the majority of progestin-only pills won’t cause you stop ovulating. Instead, they’ll reduce your risk of pregnancy by thickening the cervical mucus and thinning your uterine lining, making it more difficult for a fertilized egg to attach and develop. 

    You may have seen this pill marketed under brand names such as Lyza®, Heather®, Sharobel®, Deblitane®, Camila®, Nora-Be®, Norlyda®, Errin®, Jolivette®, Jencycla®, Micronor® or Nor-QD®.

    Like the combination pill, the progestin-only pill is designed for use every day. To make sure it’s fully effective, you’ll need to take it at the same time daily.

    Advantages of Progestin-Only Birth Control Pills

    Like the combination pill, the progestin-only pill has a few advantages that you should be aware of before you consider it as a contraceptive. 

    The biggest advantage of the progestin-only birth control pill is that it will significantly lower your risk of becoming pregnant. Like the combination pill, the progestin-only pill is approximately 99 percent effective when used perfectly, with 91 percent effectiveness in typical, “real life” conditions. 

    Other benefits of the progestin-only birth control pill include:

    • Fewer estrogen-related side effects. Estrogen can contribute to several common side effects of the pill, such as headaches and fluid retention. Because the progestin-only pill doesn’t contain ethinyl estradiol, many people find that these side effects are milder.
    • A lower risk of cardiovascular side effects. Although all birth control pills carry a slight risk of causing blood clots or stroke, the risk is lower with a progestin-only mini-pill than it is with a combined oral contraceptive.
    • Easier, safer breastfeeding. If you’ve recently given birth and would like to breastfeed, the mini-pill is often prescribed. Due to the lower dose of hormones, this type of pill usually does not affect your breast milk production. 

    Disadvantages of Progestin-Only Birth Control Pills

    Just like the combination pill, the progestin-only mini-pill also has several disadvantages. These include:

    • No improvements in acne. If you’re prone to acne, especially hormonal acne, you may want to choose a combined oral contraceptive instead. While the progestin-only pill will help you avoid pregnancy, it won’t reduce the frequency or severity of acne breakouts.
    • Higher risk of pregnancy if you take the pill late. Because the progestin-only pill only contains a low dose of one hormone, it’s essential that you take it at approximately the same time every day.

      If you take your mini-pill more than three hours late, follow the instructions provided with the medication to make sure you’re protected. Depending on the type of medication you use, you may need to use extra contraception for the next 48 hours.
    • Increased risk of ectopic pregnancy. In the event that the progestin-only pill fails and you become pregnant, you have an increased risk of experiencing an ectopic pregnancy if you continue using the mini-pill after fertilization.

    In addition to these disadvantages, the mini-pill may not be suitable for you if you’re affected by certain health conditions. Your healthcare provider may recommend against using the mini-pill if you have or have had breast cancer, if you have uterine bleeding, liver disease or other conditions.

    The mini-pill may also not be suitable if you currently use any medications to treat seizures, HIV or tuberculosis. 

    Progestin-Only Birth Control Pills Summary

    Overall, the mini-pill is a great option if you want a safe, effective form of birth control that likely won’t affect your ability to breastfeed in the way a combined birth pill might. It’s also an ideal option if you don’t need treatment for acne and want to reduce your risk of experiencing the potential cardiovascular side effects of the pill.

    If you’re above the age of 35, or if you have a history of cardiovascular health conditions or high blood pressure, your healthcare provider may recommend this type of birth control pill due to its lower risk of side effects. 

    If you opt for this type of birth control pill, you’ll need to make sure that you take it at close to the same time every day. If you often forget to take medication, or if your schedule is unpredictable, the combination birth control pill might be a more appropriate choice for you.

    We offer the norethindrone 0.35mg progestin-only birth control pill, which can be prescribed by a healthcare provider after an online consultation. 

    Extended Cycle Birth Control Pills

    Extended cycle birth control pills have a cycle length that’s longer than your natural menstrual cycle. When you use this type of birth control pill, you’ll get your period about once every three months instead of every 28 days. 

    Birth control pills of this type are also referred to as “continuous cycle” contraceptives, as they can be used to continually delay or skip your period. 

    Currently, all of the extended cycle birth control pills sold in the United States are combination pills. Used daily, birth control pills of this type are equally as effective as regular, shorter-cycle combined oral contraceptives.

    Advantages of Extended Cycle Birth Control Pills

    Beyond preventing pregnancy, the biggest advantage of extended cycle birth control is that it allows you to skip most of your periods. 

    If you use an extended cycle birth control pill, you’ll get your period approximately once every three months instead of once every 28 days. As a result, this type of birth control is a helpful, convenient option if you have a busy schedule and prefer not to get a period.

    Extended cycle birth control is also a great option if you frequently get menstrual cramps and other forms of discomfort during your period. 

    Since extended cycle birth control pills use a combination of progestin hormones and ethinyl estradiol, they also offer the same benefits as the regular combination pill. However, the FDA has not yet approved any extended cycle birth control pills as treatments for acne.

    Disadvantages of Extended Cycle Birth Control Pills

    Extended cycle birth control pills have the same disadvantages as shorter-cycle combination birth control pills. You can learn more about these in our detailed guide to the birth control pill’s side effects

    Extended Cycle Birth Control Pills Summary

    Because of their long cycle length, extended cycle birth control pills are ideal if you want to skip or delay your period. Since they use a combination of progestin hormones and ethinyl estradiol, they’re also a good choice if you have a schedule that makes the mini-pill impractical. 

    Which Type of Birth Control Pill is Best?

    As we covered above, there’s no such thing as a “best” birth control pill for everyone. Each type of birth control pill offers its own advantages and disadvantages, from the ability to treat acne to a reduced risk of certain side effects. 

    If you’re interested in using hormonal contraceptives and want to know more about which birth control pill is best for you, talk to a healthcare provider. We offer 10 different generic birth control pills online, complete with prescription after an online consultation with a healthcare provider. 

    You can also learn more about the birth control pill in our guide to common and uncommon side effects, as well as our comparisons between the pill and other methods of birth control, such as the birth control patch and the IUD (intrauterine device)

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.