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Comparing Birth Control Pill Types

'The pill' isn't just one pill. It comes in many forms. Here are the options.
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Types of Pills continued...

Combination pills. These contain the hormones estrogen and progestin. Most birth control pills are combination pills. They're equally effective at preventing pregnancy -- again, when taken correctly. They may also have other benefits, including:

  • Shorter, lighter, more regular, and less painful periods
  • May reduce the severity or frequency of menstrual migraines
  • Can improve bleeding and pain associated with endometriosis and fibroids
  • May improve acne
  • Can lower risk of ovarian and uterine cancer
  • Can lower risk of pelvic inflammatory disease
  • May improve bone density in the years just before menopause

All combination pills slightly raise the risk of heart attacks, stroke, and blood clots that start in a leg vein but could travel to other parts of the body -- including the lungs, which could be fatal. That risk rises if you're a smoker older than 35.

Women who smoke and are older than 35 should not take any type of combination birth control pill, according to the FDA. Other factors -- such as being obese or having a family history of heart disease -- also make those clots more likely. So consider your overall risk.

Still, those clots are rare, overall.

"Somewhere on the order of two to four more women per 10,000 might experience a nonfatal [blood clot]," says Sarah Prager, MD, MAS, an assistant professor of obstetrics and gynecology at University of Washington Medical Center.

The FDA advises women not to take any combination birth control pills if they have a history of blood clots, heart attack, or stroke.

The FDA has reviewed recent observational studies on whether certain combination pills that contain drospirenone (a synthetic version of progesterone or a progestin) carry a higher risk than other pills of deep vein thrombosis (DVT) or pulmonary embolism -- two rare but serious blood clots. Based on that review, the FDA states that it has concluded that drospirenone-containing birth control pills "may be associated with a higher risk for blood clots than other progestin-containing pills." Pills containing drospirenone include Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, Yaz, and Zarah.

Progestin-only pills (also called the "mini pill"). These pills are most commonly used by nursing mothers, women with pre-existing risks for blood clots, or other conditions that prevent them from taking estrogen.

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