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Birth Control Health Center

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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.

Types of Pills continued...

If you don't take them at the same time every day, they may not work. Being as little as three hours late could result in ovulation.

This type of pill works for nursing mothers because continuous breastfeeding already protects against pregnancy, and the mini pill simply provides added security. "Nursing moms have lower fertility. The mini pill's efficacy may be unacceptably low in women who have normal fertility," says Andrew Kaunitz, MD, who is associate chair of the ob-gyn department at the University of Florida College of Medicine in Jacksonville, Fla.

What's in That Pill Packet?

Combination birth control pills come in different phases, depending on whether the level of hormones in the pills changes throughout the month.

  • Monophasic (one-phase) pills contain the same amount of estrogen and progestin in all of the active pills. Alesse, Loestrin, Ortho-cyclen, Seasonale, and Yaz are a few examples. Each active pill in the pack is the same. If you forget to take a pill one day, you take it as soon as you remember, and then take your next pill at your regularly scheduled time.
  • Biphasic (two-phase) pills change the level of hormones estrogen and progestin once during the menstrual cycle. Examples include Kariva and Mircette Ortho-Novum 10/11.
  • Triphasic (three-phase) pills contain three different doses of hormones in the active pills. Those levels change every seven days during the first three weeks of pills. This was the first type of birth control pill. Examples include Cyclessa, Ortho Tri-Cyclen, Nortel 7/7/7, Enpresse, and Ortho-Novum 7/7/7.
  • Quadraphasic (four-phase) pills. The hormone levels in these pills change four times per cycle. Natazia is the only quadraphasic pill on the U.S. market.

Multi-phase pills (biphasic, triphasic, or quadraphasic) have two disadvantages, compared to monophasic pills:

  1. They can be trickier to take. The more phases in the cycle, the more complicated the instructions are about what to do if you miss a day. Those instructions vary by pill.
  2. Be careful not to start the next pack late. Except for Natazia, Kariva, and Mircette, all multi-phase pill cycles include seven hormone-free days. Starting the next pack late means more than a week without hormones, making pregnancy more likely. One of the most common ways women become pregnant on the pill is to start the next pack late.

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