Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 5/15/2020
The birth control pill, or “the pill” as it’s more commonly known, hit the market in 1960, marking the beginning of a movement in women’s ability to have dominion over their reproductive life.
It was game-changing. Within two years, 1.2 million American women were taking it, according to the Journal of Ethics.
The pill is still a remarkable tool, and today, women have more options than ever.
You may have heard of low dose birth control pills from a friend, your healthcare provider or even an advertisement. They’re quite common and come in several different brand names. But how do you know if it’s the right choice for you?
You can start here, doing your research and getting your questions answered.
Most oral contraceptives are made with two hormones — estrogen and progestin. They’re known as “combination pills” because of these two components. Both work to prevent your ovaries from releasing an egg, as well as slow an egg’s progress down the fallopian tubes, thin the lining of the uterus and thicken your cervical mucus.
If your body doesn’t prepare an egg for fertilization (ovulation), you cannot get pregnant. The progestin in the pill goes a few steps further, thickening the cervical mucus to make it more difficult for sperm to penetrate, and thinning the uterine wall to prevent a fertilized egg from implanting.
Despite this triple action of pregnancy prevention, the pill is not error free. If you take it exactly as you’re supposed to, it’s 99 percent effective. But because, as humans, we’re prone to error, it’s about 91 percent effective, according to Planned Parenthood.
Also, the pill does not protect against sexually transmitted infections, so to be truly safe, you should definitely employ a back-up method like condoms.
When the pill first came out, it had high levels of estrogen, 150 mcg or more. At this level, side effects were common. Over the years, drug makers realized they could reduce estrogen amounts and still maintain effectiveness.
Low-dose birth control pills are those with 50 mcg of estrogen or less. “Ultra low dose” birth control pills may have 20 mcg or less. By lowering estrogen levels, drug makers have made the pill more tolerable, with fewer serious side effects.
Short answer: no. The mini pill is another form of oral contraceptive. Unlike low dose combination pills, mini-pills contain progestin only. There is no estrogen in them.
The primary way progestin only pills work is by thickening cervical mucus and thinning the uterine wall. Occasionally they prevent ovulation, according to the Mayo Clinic, but that’s generally attributed to the estrogen in combination pills.
Low-dose birth control is effective at preventing pregnancy. Several academic papers admit that not enough research has been conducted to determine if low-dose formulations are as effective at preventing pregnancy as higher-estrogen birth control pills. However, it’s believed that they are equally effective when taken as directed.
Failing to consistently take your birth control pills every day reduces their effectiveness, and there is some evidence to suggest that low dose birth control pills have lower adherence rates.
If this is true, it stands to reason they may be less effective, but that isn’t because of the pill, but rather the person who forgets to take it.
You will have regular bleeding with low dose birth control pills. You don’t technically menstruate, as menstruation is part of the monthly cycle, which is something that’s stopped by the birth control pill hormones — remember, you don’t ovulate! However, you will have bleeding similar to a regular menstruation.
Most low dose birth control (and birth control pills in general) contain 21 active pills and seven inactive or placebo pills in a packet. Those inactive pills do not include hormones, and generally result in something called breakthrough bleeding.
Some low dose birth control may have more active pills or be active pills only. These are known as continuous birth control pills and are designed to skip bleeding altogether.
All prescription drugs have side effects, including low dose birth control.
Low dose pills have many of the same side effects as all other birth control pills, though lowering the dose does make them more tolerable to some people.
Side effects that set low dose birth control apart from others include greater incidence of breakthrough bleeding and less consistent adherence. These two things may very well be related. If you miss your pill for a day or two, there’s a good chance you’ll experience breakthrough bleeding.
Consistency — taking your pill at the same time each day — lessens the risk of side effects and increases the pill’s effectiveness.
There are numerous low dose birth control medications on the market. Many of them are available under both brand names and generic options. Some include Ortho-Novum®, Yasmin®, Levlen®, Amethyst®, Apri® and Aviane®.
Choosing a birth control method and oral contraceptive type is a personal decision that should be reached after doing your research and potentially discussing your options with a healthcare professional.
There are many effective choices out there that can not only prevent pregnancy, but help regulate your periods or stop them altogether.