A Detailed Comparison of Contraceptive Pills

Written by HMI

May 25, 2023

Oral contraceptives, often referred to as birth control pills, are among the most widely used methods of contraception. They are effective, affordable, and readily accessible. However, with a multitude of options available, it can be challenging to understand the differences and decide which is the right choice. This in-depth comparison will delve into the various types of contraceptive pills, outlining their mechanisms of action, advantages, disadvantages, and potential side effects.

Types of Contraceptive Pills

There are two primary types of contraceptive pills: combined oral contraceptives (COCs) and progestin-only pills (POPs), often called “mini-pills”.

  1. Combined Oral Contraceptives (COCs): COCs contain synthetic versions of two hormones produced naturally in the ovaries, estrogen and progesterone. These hormones prevent ovulation, thicken cervical mucus to inhibit sperm movement, and thin the lining of the uterus to reduce the likelihood of implantation if fertilization occurs.
  2. Progestin-Only Pills (POPs): POPs contain only synthetic progesterone. They primarily work by thickening cervical mucus and thinning the uterine lining. Some users may also experience suppression of ovulation, but this is not as consistent as with COCs.

Advantages and Disadvantages

Combined Oral Contraceptives

Advantages: COCs are over 99% effective when used correctly, making them a reliable form of contraception. They offer additional non-contraceptive benefits such as more regular, lighter, and less painful periods, and they can help with acne and premenstrual syndrome (PMS).

Disadvantages: COCs are less effective if not taken consistently at the same time every day. They do not protect against sexually transmitted infections (STIs), and there are potential health risks for certain groups, including women over 35 who smoke and women with certain medical conditions like uncontrolled high blood pressure or a history of blood clots.

Progestin-Only Pills

Advantages: POPs are a suitable alternative for those who cannot use estrogen, such as breastfeeding mothers, women over 35 who smoke, and women with certain health conditions. They also provide effective contraception, although they require very consistent use.

Disadvantages: Similar to COCs, POPs must be taken at the same time each day to be most effective, and they offer no protection against STIs. Some women may experience irregular bleeding patterns.

Side Effects

Combined Oral Contraceptives

Common side effects of COCs include nausea, breast tenderness, and changes in mood or libido. Most of these side effects subside after a few months as the body adjusts to the hormones. There’s also a slightly increased risk of more serious side effects like blood clots, heart attack, or stroke, especially in women with certain risk factors.

Progestin-Only Pills

Side effects of POPs can include irregular bleeding or spotting, headaches, breast tenderness, and changes in mood. As with COCs, these side effects often lessen after the first few months.


While both COCs and POPs are effective forms of hormonal contraception, they cater to different needs and health profiles. It’s crucial to have a thorough discussion with a healthcare provider to assess personal health history, lifestyle factors, and contraceptive needs when choosing the right pill. It’s also important to remember that while contraceptive pills are effective in preventing pregnancy, they do not provide protection against STIs. For those at risk, the use of condoms in conjunction with contraceptive pills is recommended.

Comparison of Brands

Different brands of contraceptive pills can have varying hormone levels, types of progestin, and dosing regimens. Here’s a closer look at some commonly used brands.

  1. COC Brands
    • Yasmin and Yaz: These brands contain drospirenone, a type of progestin, and ethinyl estradiol, a form of estrogen. These pills are known for reducing water retention and are often prescribed for women who suffer from acne or symptoms of premenstrual dysphoric disorder (PMDD). Rigevidon is also a very well know and widely used COC brand of pill.
    • Ortho Tri-Cyclen: This brand also contains ethinyl estradiol, combined with a different progestin, norgestimate. Ortho Tri-Cyclen is another brand often prescribed for women with acne, as it has been specifically approved by the FDA for this use.
  2. POP Brands
    • Cerazette: This brand uses desogestrel as its progestin. Unlike most other mini-pills, Cerazette does consistently prevent ovulation, making it slightly more effective than other POPs.
    • Micronor: This brand, which contains norethindrone, another type of progestin, is one of the most commonly prescribed POPs in the United States.
  3. Emergency Contraceptives: These include brands such as Ellaone and Levonelle, which are used to prevent pregnancy.

Factors to Consider

When choosing a contraceptive pill, several factors should be considered. These include personal health history, lifestyle, menstrual symptoms, plans for future pregnancy, and potential side effects. For example, women with a history of blood clots, stroke, or certain types of cancers should avoid COCs. Similarly, women who have difficulty remembering a daily pill might be better suited for a different form of contraception. Some women might also choose a particular pill to help manage heavy or painful periods or acne.

What to Expect When Starting the Pill

When starting any contraceptive pill, it’s normal to experience some side effects as the body adjusts to the hormones. Common side effects can include headaches, nausea, breast tenderness, weight changes, and mood swings. If side effects persist after a few months or are troubling, it’s important to talk to a healthcare provider. They may recommend a different brand or type of contraceptive pill.

Importance of Regular Check-ups

Regular check-ups with a healthcare provider are important for anyone using contraceptive pills. These visits are opportunities to discuss any side effects or problems with the pill and to check on health issues that might affect the safety of using the pill. They’re also a good time to review the correct use of the pill and the importance of using condoms to prevent STIs.


Choosing the right contraceptive pill can be a complex decision involving many factors. There are many options available, each with its pros and cons, so it’s essential to make an informed choice based on personal needs and medical history. It’s always recommended to consult with a healthcare provider to discuss the best option for reliable, safe, and comfortable contraception.

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