Combination Birth Control Pills: Types, Benefits, And Side Effects

Combination pills

What Are Combination Pills?

Combination birth control pills come under the category of oral contraceptives. These have a composition of two primary female hormones – estrogen and progestin. The medication is 99% effective in preventing an unwanted pregnancy. It has other health benefits as well apart from contraception.

In this post, we will discuss the uses of combination pills, types, hormone levels, preparation beforehand, things to avoid, precautions, and side effects.

How Do Combination Birth Control Pills Work?

Combination birth control pills stop the ovaries from releasing an egg. The medicine also alters the cervical mucus. The cervical mucus becomes thick and sticky. This prohibits the sperm from reaching the egg. Thus, fertilization does not happen. It also sheds or things out the endometrium lining of the uterus.

The fertilized egg, if any, due to thinning of the endometrial, does not cause implantation. All these processes keep you from not conceiving. There are different types of oral contraceptives containing estrogen and progestin. Some contain varying doses of these hormones.

Then there are the extended-cycle pills or continuous-dosing. This type of combination oral contraceptive reduces the number of periods you get annually. So, if you want to know the right option of a combination birth control pill for you, then read on further.

Benefits Of Combination Pills

This type of contraceptive has a high success rate. Also, this method of contraception is reversible. If you want to conceive, then you can stop taking the combination birth control pills (you might face some temporary side effects thoguh). Your fertility will return to normal almost immediately after stopping the dosage. Here are few other benefits of this medication:

  • Prevent an unwanted pregnancy
  • Relief from PMS (premenstrual syndrome)
  • Lessen acne
  • Reduce the risk of endometrial and ovarian cancer
  • Reduction in hot flashes for females during perimenopause
  • Reduce the risk of ovarian cysts, ectopic pregnancy, and benign breast disease
  • Gives you control over the monthly cycle
  • Less heavy menstrual bleeding gave iron-deficiency anemia or uterine fibroids
  • Less severe dysmenorrhea (menstrual cramps)
  • More predictable, lighter, and shorter periods
  • Fewer periods every year if you choose certain types of combination pills
  • Reduction in production of androgen caused by PCOS (polycystic ovary syndrome)

Types of Combination Pills

The estrogen and progestin combination birth control pills have active as well as inactive pills. Here are the variants:

1. Conventional Pack

This is the most commonly prescribed birth control. This pack has 21 active pills containing the hormones. There are also 7 inactive pills. These are placebo medicines and have no hormones in them. You have to take an active pill every day at the same time for 21 days.

Then you may take an inactive pill per day. After you finish with the 28-day course, start with a new pack. You can also get a 24-active pill pack. It also has 4 inactive pills. Such a type of medication is a shortened pill-free interval pack.

Bleeding usually happens every month. The bleeding is more likely to occur in the week when you take the last 4 inactive pills.

2. Continuous Dosing or Extended Cycle

As the name suggests, you have to take the combination birth control pills for a longer period than 21 or 28 days. This combination birth control pill pack has 84 active pills and 7 inactive pills. You can expect withdrawal bleeding only 4 times in the year. The bleeding happens in the 7 days when you are on the placebo pills.

There is also a 365-day contraceptive pill pack. Here, you have to consume the tablet at the same time every day. Here, you may get lighter periods. For some, the bleeding stops altogether. The extended cycle or continuous dosing can prohibit you from conceiving.

But it also has other health benefits of suppressing menstruation. And these are:

  • Prevention of menstrual migraines
  • Treatment and prevention of excessive bleeding caused by uterine fibroids
  • Relief from endometriosis pain
  • Lessening of periods related to worsening of health, such as seizures

Also Read: Types Of Birth Control Pills

What Are the Hormone Levels in Combination Pills?

The combination birth control pills are categorized on the basis of hormone dose:

  • Monophasic: Here, each active pill has the same amount of progestin and estrogen.
  • Biphasic: Here, the active pills come with two combinations of progestin and estrogen.
  • Triphasic: Here, the active pills comprise three combinations of both hormones. In certain types, the level of progestin is higher. In some, the dose of progestin may remain the same, while that of estrogen may increase.

How to Prepare Yourself for Combination Pills?

You can avail yourself of most of the combination birth control pills over-the-counter. However, you can also request a prescription from your healthcare provider. The doctor will check your medical history, blood pressure, weight, and medicines you take, allergies if any, etc.

  • He/she will also enquire about your preferences for contraceptive
  • And note down your concerns about preventing pregnancy
  • Then the doctor may prescribe a low dose of combination pills
  • This will come with minimum side effects
  • It will also restrict the occurrence of a pregnancy

The amount of estrogen on oral contraceptives is as low as 10 mcg (micrograms) of Ethinylestradiol. But the same is sometimes up to 30 mcg. It is important to know that low-dose medicines may cause more breakthrough bleeding than the ones with higher estrogen content.

When to Avoid Combination Oral Contraceptive?

The combination birth control pills are excellent for health and contraceptive. But it may not be the best alternative for everyone. The doctor may suggest another form of birth control if you:

  • Are older than 35 and smoke
  • Have problems related to diabetes such as neuropathy, retinopathy, nephropathy
  • Have migraines with aura
  • Have a history of cardiovascular disease or stroke
  • Are in the initial month of breastfeeding
  • Have uncontrollable high blood pressure
  • Have a record of breast cancer
  • Have liver tumor or disease
  • Past record of or present pulmonary embolism or deep vein thrombosis
  • Face unexplained uterine bleeding
  • Have a chance of prolonged immobilization given a major surgery

What Are the Precautions for Combination Contraceptive Pills?

Before you use combination birth control pills, here are the precautions to maintain:

  • Know when is the right to start with the first pack
  • You may start on the first Sunday after menstrual bleeding
  • Or, you can start on a Sunday itself
  • Pick a comfortable time for the pill intake
  • You need to take the tablet every day but at the same time
  • It is advisable not to miss a dose
  • If you miss a dose, then consume one more pill as soon as you remember
  • If you miss more than one dose, then look for missed dose information
  • It is better to avoid smoking when on oral contraceptives
  • Do not start with inactive pills until done taking the entire course of active pills

Side Effects Of Using Combination Pills

Here are the temporary and common side effects of combination birth control pills:

  • Nausea
  • Headaches
  • Bloating
  • Breast tenderness
  • Breakthrough bleeding or spotting
  • Slightly high blood pressure

The above-mentioned effects fade away with time. When your body adjusts to the dose, these issues do not affect you anymore. These are more noticeable in the initial 3 months. But with continued use, the discomfort may not impact you altogether.

Sometimes, however, combination pills can lead to serious conditions. These occur especially due to an interacting health problem or medication, or intolerance to dosage. Some of the serious effects that rare occurrence, include:

  • If you smoke, then the higher risk of stroke and heart attacks
  • Gallbladder disease
  • Liver disorder
  • Blood clots in legs

Here are a few warning signs for combination birth control pills. If you notice any of these signs, contact your doctor immediately:

  • Depression, severe mood swings, seizures
  • Chest pain, breast lump
  • Signs of pregnancy or two missed periods
  • Difficulty with speech or speaking
  • Severe allergic reaction on the skin
  • Pain in abdomen
  • Fainting
  • Severe leg swelling or pain
  • Worsening or new headache
  • Yellowish discoloration of skin or jaundice
  • Eye problems such as loss of vision, double or blurred vision

Final Thoughts

Combination birth control pills are one of the most effective in preventing unplanned pregnancy. As you can understand by the above information, it also has other uses and benefits for health. So, you may consider taking this type of oral contraceptive. You may go ahead with this medication after consulting with your doctor.


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