The Ultimate Guide to Choosing the Right Birth Control Pill for You

Birth control isn’t one-size-fits-all. There are plenty of options to suit various lifestyles. Stats from the Guttmacher Institute show that in 2014, 60% of all women of reproductive age were using some form of birth control.

Deciding whether to use birth control pills (“the pill”) or another form of contraception can be overwhelming enough. If you do decide to start taking birth control pills, you’ll quickly realize that choosing which pill presents an entirely new set of hurdles.

This guide will give you a clear rundown of the available birth control pill options and help you figure out which pill might be best for you.

How do birth control pills work?

The hormones in birth control pills help prevent a pregnancy from occurring. Birth control pills may contain both estrogen and progestin or progestin only.

  • Combination pills contain a combination of estrogen and progestin.
  • Progestin-only pills, also known as “minipills” only contain progestin.

What are the major differences between combination pills and progestin-only pills?

Combination pills

How combination pills work

Combination pills help prevent pregnancy in 3 ways:

  1. They keep your ovaries from releasing an egg.
  2. They thicken the mucus at the opening of your cervix to keep sperm from reaching the area where an egg might be.
  3. They make the lining of your uterus thinner to keep any eggs from attaching.

As you can see, there’s combination pills use a triple-pronged approach to prevent pregnancy.

Types of combination pills

Combination pills come in packs that may contain active pills--pills with hormones--and inactive pills--pills with no hormones. On days when you take inactive pills, you’ll experience bleeding, much like a period. The amount of active and inactive pills in your pack determines how often you’ll have a period.

  • Conventional birth control contains combinations of 21 active pills + 7 inactive pills or 24 active pills + 4 inactive pills.
  • Continuous or extended birth control contains fewer inactive pills. Packs with 84 active pills + 7 inactive pills result in a period just 4 times a year. Other continuous packs contain no inactive pills, which means you won’t have a period at all. (However, you may experience light bleeding or spotting.)

The active pills (the ones that contain hormones, remember?) can also vary by strength.

  • Monophasic pills have the same amount of estrogen and progestin in each active pill.
  • Multiphasic pills have different amount of hormones in the active pills.

Possible side effects of combination pills

All medications come with the potential for side effects. With combination birth control pills, those side effects could include:

  • Weight gain
  • Nausea
  • Vomiting
  • Headaches
  • Breast tenderness
  • Spotting or bleeding between periods

Who combination pills might be good for

Combination pills are very effective, but generally have a higher risk of side effects than progestin-only pills. Combination pills may be better suited to women under age 35 who are generally healthy.

Who shouldn’t use combination pills

Knowing your medical history is critical in order to take birth control pills safely. Combination pills might not be the best option if you:

  • Are breastfeeding
  • Are 34 or older and smoke or have migraines
  • Have high blood pressure or hypertension
  • Have ever had a blood clot, sometimes called deep vein thrombosis (DVT) or pulmonary embolism (PE)
  • Won’t be able to move for an extended period of time due to a major surgery
  • Have ever had breast cancer, stroke, or heart disease
  • Have complications from diabetes, like nerve damage, eye damage, or kidney damage
  • Have liver disease
  • Have abnormal uterine bleeding
  • Take a supplement called St. John’s wort
  • Take certain drugs like anticonvulsants or anti-tuberculosis drugs

These are a select few of the combination birth control pills available in the US market

  • Alaycen 1/35
  • Amethia
  • Apri
  • Enpresse
  • Levora
  • Loestrin
  • Mircette
  • Ortho Novum 777
  • Ortho Tri-Cyclen
  • Seasonale
  • Seasonique
  • Sprintec
  • Taytulla
  • Yasmin
  • Yaz

Progestin-only pills

How progestin-only pills work

For the most part, progestin-only pills work the same way as combination pills.

  1. They thicken the cervical mucus to make it difficult for sperm to pass through.
  2. They thin the lining of the uterus to make it difficult for an egg to attach.

You may have noticed one exception. For the most part, progestin-only pills do not prevent a woman’s ovaries from releasing an egg.

Still, progestin-only pills are highly effective when taken consistently at the same time every day.

Types of progestin-only pills

Remember how many types of combination pills there are? Well, the progestin-only pill landscape is much simpler. There’s only one dosing option, and every pill is an active pill.

Possible side effects of progestin-only pills

Progestin-only pills can also cause side effects such as:

  • Breast tenderness
  • Acne
  • Headache
  • Fatigue
  • Spotting or bleeding between periods
  • No periods
  • Ovarian cysts
  • Weight gain
  • Decreased libido

Who progestin-only pills might be good for

Progestin-only pills might be a better option for women who are over age 35 or have high blood pressure.

Who shouldn’t use progestin-only pills

Progestin-only pills may not be the safest option for you if you:

  • Have breast cancer
  • Have abnormal vaginal bleeding
  • Take a supplement called St. John’s wort
  • Take certain drugs like anticonvulsants or anti-tuberculosis drugs

Also, since your body needs a steady amount of progestin in order to successfully prevent pregnancy, women taking progestin-only pills must remember to take them at the same time each day. If you don’t think you’ll be able to stick to the routine, it may be best to consider a combination pill or a different method of birth control altogether.

Here are a select few of the progestin-only pills available in the US market.

  • Errin
  • Nor-QD
  • Camila
  • Ortho-Micronor

How can choosing the right birth control pill be easier?

Choosing a birth control pill doesn’t have to be as stressful as it seems. Hopefully this guide has led you in the right direction towards figuring out type of pill would fit best with your lifestyle. But remember, it’s important for you to include a doctor in this decision-making process.

That’s where the convenient Lemonaid Health mobile app comes in. The US-based, US-licensed nurse practitioners and doctors at Lemonaid Health are available for a mobile visit to help you decide on your birth control pill.

Here’s how a birth control visit works:

  1. Download and open the Lemonaid mobile app. Select the birth control service and start your visit.
  2. Select whether you know which pill (or patch or ring!) you want or whether you need help choosing a pill.
  3. Choose the pill you want, and answer the health questions.

To wrap up your visit, you’ll enter your pharmacy and payment information. One of Lemonaid Health’s knowledgeable nurse practitioners or doctors will start a mobile visit with you to review your medical history, confirm your prescription, and if safe and appropriate it will be prescribed, and you’ll be done!

Just pick up your prescription from the pharmacy or, if you selected the mail-order option, wait for it to be delivered to you!

Get started with your private, mobile Lemonaid visit today.

Get started


Lemonaid. Frequently Asked Questions: Birth Control. Accessed online August 30, 2018 at

Mayo Clinic. Birth Control. Accessed online August 29, 2018 at