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    Birth Control Pills: What Are the Choices?

    Do Combination Pills Have Side Effects? continued...

    Some pills (Beyaz, Gianvi, Yasmin, Yaz, and others) use a man-made progesterone called drospirenone. These are linked to a higher risk of blood clots than brands that use other kinds of synthetic progesterone.

    These types of pills also aren't right for you if you have migraine headaches that affect vision, or if you gave birth less than 3 weeks ago.

    You’re at greater risk of serious side effects if you smoke, especially if you’re over 35. If you're not ready to quit, ask your doctor about other birth control options.

    Do Combination Pills Contain the Same Level of Hormones?

    Most of them use between 20-35 micrograms of estrogen, along with some man-made progesterone. Your doctor may start you on this level and then change it if side effects bother you.

    Some pills have as little as 10 micrograms of estrogen. Low-dose pills may be a good option if you’re in perimenopause. They can help with symptoms like hot flashes or irregular periods.

    Combination pills are either monophasic (one phase) or multiphasic (multi-phase).

    • Monophasic pills deliver an even level of hormones throughout the month.
    • Multiphasic ones have slightly different levels of hormones in active pills. They mimic normal hormonal changes that happen during your menstrual cycle.

    Both are equally effective at preventing a pregnancy.

    How Do You Take Combination Pills?

    It depends on the kind you choose.

    Monthly: Pills come in 21- or 28-day packs. With 21-day pills, you take one every day for 3 weeks straight. During week 4 you take no pills and have your period.

    The 28-day packs include pills with hormones and some inactive pills with none. With most brands, you take 21 active pills, and seven inactive ones to keep you in the habit of taking it every day. You’ll have your period during the days you take the inactive pills.

    Other brands include 24 active pills and four that aren’t. You may have shorter periods with this type.

    Extended-cycle: You take pills with hormones for 12 weeks straight and inactive ones for a week. You only have three or four periods a year.

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