Birth Control Pills
Sometimes referred to as: oral contraceptives, OCPs
Interview between:
Jamila Schwartz, MD
Nora Lansen, MD
The pill—like all other forms of hormonal contraception—works by inducing a steady-state hormone level. This consistent level of hormones suppresses ovulation, which normally occurs after an undulating pattern of fluctuating hormones. Ovulatory suppression thereby prevents pregnancy.
Cases Per Year (US)
Approximately 10 million women take birth control pills.
General Frequency
15.9% of women of reproductive age take birth control pills.
Risk
Low.
Context
Why are birth control pills important? Why should we care?
Close to half of all pregnancies in the U.S. are unintended; birth control pills are an easy method of prevention (which is important for all sorts of reasons). They are safe and effective for most women.
How might you decide if the pill is the right approach?
It’s almost always a matter of patient preference. All hormonal contraception works by suppressing ovulation, so it’s just the method that differs.
Women might prefer the pill because they want to take a medicine orally and don’t want to have a procedure, which they would need with long-acting reversible contraception (LARC), such as an IUD. Or they may prefer the pill because the estrogen it contains has benefits (like skin improvement), which non-estrogen methods don’t have.
But all forms of hormonal contraception—the pill, the patch, the ring, the shot, the progestin IUD, and the implant—are all just as effective. The best-acting non-hormonal form of reversible contraception is the copper IUD (which works just as well as the progestin-containing IUD).
Are there medical conditions or other factors that affect the decision?
Some women have predisposing health concerns that make estrogen use unsafe (e.g., migraine with aura, uncontrolled high blood pressure, cigarette smoking). For those who can’t safely take the traditional birth control pill, there are other great options, including the mini-pill (progestin only), an IUD (none of them have estrogen), or the implant.
How do you choose the right pill for someone?
Although there are many brand names for the pill, the differences among them are very slight: Some have a tiny bit less estrogen (or none altogether), while others have varying types of progestin.
For most people, these differences don’t have any impact. However, for some, a dose adjustment might cause a noticeable change. For instance, if a woman is experiencing breakthrough bleeding with a low-dose pill, one with a higher dose of estrogen could eliminate that unpredictable bleeding.
Benefits
Risks
When to Use
Useful Links
Connect with our physicians
Jamila Schwartz, MD and Nora Lansen, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Birth Control Pills or any of the many other conditions we treat.
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