The New No-Period, No-PMS Birth Control Pills

In the beginning, there was Seasonale -- the continuous birth control pill that offered women four periods a year. Women grabbed the chance to opt out of their periods. If you don't need it, why put up with it?

Today, "the pill" has been finessed even more, with lighter-period or no-period birth control pills as well as no-PMS, no-acne pills. Seasonale, Seasonique, Yaz, Yasmin, and Lybrel have changed the face of birth control pills.

All are variations of traditional birth control pills -- combining mini-doses of estrogen and progestin -- and proven safe after decades of research, explains Christopher Estes, MD, assistant professor of obstetrics and gynecology at the University of Miami School of Medicine.

"They all contain 25 to 50 micrograms of estrogen -- and anything less than 50 micrograms of estrogen is considered a low-dose pill," he tells WebMD. "There are no high-dose pills on the market anymore."

What are the key differences in this new wave of pills?

• There are fewer "non-active" pills, the ones that trigger a period.
  
• The hormone formulations are slightly different, creating lighter periods when you do have one.
  
• A new form of progestin used in some pills helps reduce severe mood and physical symptoms that some women get before their monthly periods, called premenstrual dysphoric disorder or PMDD. This form of progestin may also help treat acne.

As a general rule, any pill that contains estrogen can help prevent acne and PMS, says Patti J. Ross, MD, a professor of obstetrics, gynecology, and reproductive sciences at The University of Texas Medical School at Houston.

But the type of progestin in Yaz and Yasmin lets them work a bit differently, she tells WebMD. "It has a diuretic effect, so women don't get the bloating, fluid retention, and weight gain."

To help you choose, here are key facts about each brand:

• Lybrel is a no-period birth control pill. It has 28 active pills in every pack, which results in no monthly period in 365 days.
  
• Seasonale has 12 weeks of estrogen/progestin pills, followed by 7 days of no-hormone pills -- which means 4 menstrual periods a year.
  
• Seasonique has 12 weeks of estrogen/progestin pills, followed by 7 days of low-estrogen pills -- which results in 4 light, short periods a year.
  
• Yaz is a less-PMS pill. It has a 28-pill monthly pack -- 24 active pills and 4 inactive pills. Your monthly cycle is shorter, lighter, more regular.
  
• Yasmin is a less-PMS, less-acne pill. It has 28-pill monthly packs -- 21 active pills and 7 inactive pills. Your monthly period is lighter, more regular.

The hormones in today's birth control pills are "a little more forgiving than in the past," Estes tells WebMD. "With standard birth control pills, you really had to take them at the same time every day or risk ovulating. With the new pills, you have a few hours' leniency. If you forget to take your morning pill, you can still take it at lunch time and not worry."

Just as with standard birth control pills, fertility returns within one or two months of stopping, says Estes. But that's not a promise. "Not everyone can get pregnant in one to two months," he tells WebMD. "It can take time, just as with regular birth control pills."