Oral contraceptives (birth control pills)
Most birth control pills contain 2 hormones
similar to the hormones that a woman’s
body normally makes. These hormones are
called estrogen (ethinyl estradiol) and
progestin (levonorgestrel). Birth control
pills come in different strengths of each
hormone and are sold under many different
brand names. Some of the brand names are
listed on the next page.
Usually, brands that contain a smaller
amount of both hormones are the safest
and work best for most women. These
“low dose” pills are found in Groups 1, 2, and 3.
To assure effectiveness and minimize spotting (small amounts of bleeding at
other times than normal monthly bleeding), take birth control pills at the same
time each day, especially with pills that have low amounts of hormones. If
spotting continues after 3 or 4 months, try one of the brands in Group 3. If there is
still spotting after 3 months, try a brand from Group 4.
As a rule, women who take birth control pills have less heavy monthly
bleeding. This may be a good thing, especially for women who are anemic. But if a
woman misses her monthly bleeding for months or is disturbed by the very light
monthly bleeding, she can change to a brand with more estrogen from Group 4.
For a woman who has very heavy monthly bleeding or whose breasts become
painful before her monthly bleeding begins, a brand low in estrogen but high in
progestin may be better. These pills are found in Group 3.
Women who continue to have spotting or miss their monthly bleeding when
using a brand from Group 3, or who became pregnant before while using another
type of pill, can change to a pill that has a little more estrogen. These “high dose”
pills are found in Group 4.
Women who are breastfeeding, or who should not use regular pills because of
headaches or mild high blood pressure, may want to use a pill with only
progestin. These pills in Group 5 are also called “mini-pills.”
Progestin only pills should be taken at the same time every day, even during the
monthly bleeding. Menstrual bleeding is often irregular. There is also an increased
chance of pregnancy if even a single pill is forgotten.
A Book for Midwives (2010)