How do I Choose the Best Contraceptive Pill?

Choosing the best contraceptive pill is a highly personal decision based on the unique characteristics of each individual woman and her body. Since all pills must be proven to prevent pregnancy to a specific standard, choosing the best pill goes beyond choosing an effective one. Learning the distinguishing characteristics of each type of pill available is the best way to start narrowing down options.

One of the most common characteristics women look for in a contraceptive pill is the effect it will have on menstruation cycles. Women who choose traditional packs that contain three weeks of “active” pills and one week of “inactive” pills can expect to follow a normal menstruation schedule of one week of bleeding per month. For women who experience painful periods, or simply do not wish to menstruate so often, extended cycle packs of contraceptive pills, which contain more “active” pills than conventional packs, will reduce the number of times per year a woman menstruates. Both conventional and extended cycle pill packs prevent pregnancy to the same degree, and consist of “combination” pills.

“Combination” pills are made with two types of hormones, estrogen and progestin. Contraceptive pills that are labeled as low-dose pills are usually “combination” pills and are often selected by women who experience heavy side effects with regular-dose pills. While choosing lower-dose pills can relieve side effects such as moodiness and weight gain, they can be associated with intermittent, unpredictable bleeding between scheduled periods. For some women, this inconvenience is justified by a decrease in other unpleasant side effects, but the choice is highly personal.

Many doctors hesitate to prescribe combination pills for women with a history of, or an elevated risk for, conditions such as migraine headaches, blood clots, or other circulatory issues. Women who smoke cigarettes or are breast-feeding are also discouraged from using a combination contraceptive pill. If any of these circumstances describe your lifestyle, an alternative contraceptive pill may be a better option.

Non-combination pills that only contain progestin, not estrogen, are also available. Progestin-only pills generally provide contraception methods for women who are unable to take combination pills due to circulatory problems or because they are breast-feeding. Unfortunately, progestin-only pills are associated with a higher risk of accidental pregnancy, and must be taken at precisely the same time every day for the best chance of reducing this risk. Combination pills should also be taken around the same time each day, but the time frame is stricter for progestin-only pills. Side effects such as weight gain, moodiness, and decreased sex drive are also more commonly reported by women taking progestin-only pills.

Perhaps the most important thing to remember when choosing the best contraceptive pill for your needs is that, while certain predictions can be made, how a pill will actually affect you is difficult to pin down. Many women carefully assess their lifestyles, preferences, and medical histories with their doctors before choosing a pill, only to later discover that it was not the best match. Selecting an initial pill and then switching to different options until a good fit is found is very common.