Birth Control Pills (Oral Contraceptives): Drug Facts, Side Effects and Dosing

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Birth Control Pills (Oral Contraceptives) List of Names and S >

  • What are birth control pills, and how do they work (mechanism of action)?
  • Do I need a prescription for birth control pills?
  • Birth control pill side effects
  • What is the dosage for birth control pills, and how do I take them?
  • List and types of birth control pill generic and brand names
  • Are birth control pills safe to store in hot or cold weather?
  • Which drugs or supplements interact with Oral Contraceptives, Birth Control Pills?
  • Are birth control pills safe to take if I’m breastfeeding?

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What are birth control pills, and how do they work (mechanism of action)?

Oral contraceptives (birth control pills) are medications that prevent pregnancy. They are one method of birth control. Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin or progestin alone. Combinations of estrogen and progestin prevent pregnancy by inhibiting the release of the hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland in the brain. LH and FSH play key roles in the development of the egg and preparation of the lining of the uterus for implantation of the embryo. Progestin also makes the uterine mucus that surrounds the egg more difficult for sperm to penetrate and, therefore, for fertilization to take place. In some women, progestin inhibits ovulation (release of the egg).

There are different types of combination birth control pills that contain estrogen and progestin that are referred to as “monophasic,” “biphasic,” or “triphasic.”

  • Monophasic birth control pills deliver the same amount of estrogen and progestin every day.
  • Biphasic birth control pills deliver the same amount of estrogen every day for the first 21 days of the cycle. During the first half of the cycle, the progestin/estrogen ratio is lower to allow the lining of the uterus (endometrium) to thicken as it normally does during the menstrual cycle. During the second half of the cycle, the progestin/estrogen ratio is higher to allow the normal shedding of the lining of the uterus to occur.
  • Triphasic birth control pills have constant or changing estrogen concentrations and varying progestin concentrations throughout the cycle. There is no evidence that bi- or triphasic oral contraceptives are safer or superior to monophasic oral contraceptives, or vice versa, in their effectiveness for the prevention of pregnancy.

Do I need a prescription for birth control pills?

Yes, you need a prescription from a doctor or other health care professional for oral contraceptives.

Birth control pill side effects

The most common side effects of the birth control pills include nausea, headache, breast tenderness, weight gain, irregular bleeding, and mood changes. These side effects often subside after a few months’ use. Scanty menstrual periods or breakthrough bleeding may occur but are often temporary, and neither side effect is serious. Women with a history of migraines may notice an increase in migraine frequency. On the other hand, women whose migraines are triggered by fluctuations in their own hormone levels may notice improvement in migraines with oral contraceptive use because of the more uniform hormone levels during oral contraceptive use. Uncommonly, oral contraceptives may contribute to increased blood pressure, blood clots, heart attack, and stroke. Women who smoke, especially those over 35, and women with certain medical conditions, such as a history of blood clots or breast or endometrial cancer, may be advised against taking oral contraceptives, as these conditions can increase the adverse risks of oral contraceptives.

What is the dosage for birth control pills, and how do I take them?

Many of the birth control pills come in easy-to-use dispensers in which the day of the week or a consecutive number (1, 2, 3, etc.) is written on the dispenser with a corresponding tablet for each day or number.

For example, some Ortho-Novum dispensers are labeled “Sunday” next to the first tablet. Thus, the first tablet is to be taken on the first Sunday after menstruation begins (the first Sunday following the first day of a woman’s period). If her period begins on Sunday, the first tablet should be taken on that day.

For birth control pills that use consecutive numbers, the first tablet (#1) is taken on the first day of the menstrual period (the first day of bleeding). Tablet #2 is taken on the second day and so on.

Still other packages instruct women to begin on day five of the cycle. For such products, women count from day one of their menstrual cycle (day one is the first day of bleeding). On the fifth day, the first tablet is taken. Tablets then are taken daily.

Most birth control pills are packaged as 21-day or 28-day units. For 21-day packages, tablets are taken daily for 21 days. This is followed by a seven-day period during which no birth control pills are taken. Then the cycle repeats.

For the 28-day units, tablets containing medication are taken for 21 consecutive days, followed by a seven-day period during which placebo tablets (containing no medication) are taken.

Newer formulations with 24 days of hormone pills and only four days of placebo pills are now available, as are continuous or extended-cycle oral contraceptive regimens, in which only active hormone pills are taken. Extended-cycle preparations include seven-day intervals of placebo pills to be taken approximately every three months.

Women just starting to take birth control pills should use additional contraception for the first seven days of use because pregnancy may occur during this period.

If women forget to take tablets, pregnancy may result. If a single tablet is forgotten, it should be taken as soon as it is realized that it is forgotten. If more than one tablet is forgotten, the instructions that come with the packaging should be consulted, or a physician or pharmacist should be called.

List and types of birth control pill generic and brand names

List of examples of oral contraceptives of different brands and categories:

MONOPHASIC PRODUCTS
BRAND NAME(S) ESTROGEN PROGESTIN
Alesse-28 ethinyl estradiol levonorgestrel
Apri ethinyl estradiol desogestrel
Aviane ethinyl estradiol levonorgestrel
Brevicon ethinyl estradiol norethindrone
Demulen 1/35-21
Demulen 1/35-28
Demulen 1/50-21
Demulen 1/50-28
ethinyl estradiol ethynodiol diacetate
Desogen ethinyl estradiol desogestrel
Genora 1/35 ethinyl estradiol norethindrone
Genora 1/50 mestranol norethindrone
Levlite 28 ethinyl estradiol levonorgestrel
Levlen 21
Levlen 28
ethinyl estradiol levonorgestrel
Levora 0.15/30-21
Levora 0.15/30-28
ethinyl estradiol levonorgestrel
Loestrin 21 1/20
Loestrin 21 1.5/30
Loestrin FE 1/20
Loestrin FE 1.5/30
ethinyl estradiol norethindrone acetate
Lo-Ovral 28
Ovral 28
ethinyl estradiol norgestrel
Low-Ogestrel 28
Ogestrel 0.5/50-28
ethinyl estradiol norgestrel
Microgestin 1/20
Microgestin 1.5/30
Microgestin FE 1/20
Microgestin FE 1/5/30
ethinyl estradiol norethindrone acetate
Modicon ethinyl estradiol norethindrone
Necon 0.5/35-21
Necon 0.5/35-28
Necon 1/50-21
Necon 1/50-28
Necon 1/35-21
Necon 1/35-28
ethinyl estradiol norethindrone
Nordette 28 ethinyl estradiol levonorgestrel
Norinyl 1/50 mestranol norethindrone
Norinyl 1/35 ethinyl estradiol norethindrone
Nortrel 0.5/35
Nortrel 1/35
ethinyl estradiol norethindrone
Ortho-Cept ethinyl estradiol desogestrel
Ortho-Novum 1/35 ethinyl estradiol norethindrone
Ortho-Novum 1/50 mestranol norethindrone
Ortho-Cyclen ethinyl estradiol norgestimate
Ovcon 50
Ovcon 35
ethinyl estradiol norethindrone
Tri-Norinyl 28 ethinyl estradiol norethindrone
Yasmin 28 ethinyl estradiol drospirenone
Zovia 1/50E
Zovia 1/35E
ethinyl estradiol ethynodiol diacetate
BIPHASIC PRODUCTS
BRAND NAME(S) ESTROGEN PROGESTIN
Jenest 28 ethinyl estradiol norethindrone
Mircette ethinyl estradiol desogestrel
Necon 10/11-21
Necon 10/11-28
ethinyl estradiol norethindrone
Ortho-Novum 10/11 ethinyl estradiol norethindrone
TRIPHASIC PRODUCTS
BRAND NAME(S) ESTROGEN PROGESTIN
Estrostep 21
Estrostep FE
ethinyl estradiol norethindrone
Ortho-Novum 7/7/7 ethinyl estradiol norethindrone
Ortho Tri-Cyclen
Ortho Tri-Cyclen LO
ethinyl estradiol norgestimate
Tri-Levlen 21
Tri-Levlen 28
ethinyl estradiol levonorgestrel
Tri-Norinyl 28 ethinyl estradiol norethindrone
Triphasil 28 ethinyl estradiol levonorgestrel
Trivora 28 ethinyl estradiol levonorgestrel
24-4 PREPARATIONS (24 days of hormone pills and 4 days of placebo pills)
Yaz ethinyl estradiol drospirenone
Lo Estrin 24-4 ethinyl estradiol norethindrone acetate
EXTENDED-CYCLE PREPARATIONS
Seasonale ethinyl estradiol levonorgestrel
Seasonique ethinyl estradiol levonorgestrel
PROGESTIN-ONLY PRODUCTS
BRAND NAME(S) ESTROGEN PROGESTIN
Micronor norethindrone
Nor-QD norethindrone
Ovrette norgestrel

Previous contributing medical author: Carolyn Janet Crandall, MD, MS, FACP

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