These answers are for general informational purposes only and are not a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.
Any birth control pill is good for acne. However, some may be better than others. At Pandia Health, ‪the ONLY #WomenFounded #WomenLed #DoctorLed birth control delivery company‬, we suggest desogestrel, drosperinone (if you can drink 8 glasses of water a day), or norgestimate are best for acne. We’ve found that levonorgestrel and norethindrone are not as good for acne.
It depends on your risk of getting pregnant if you are not on the pill. If you can use a condom or abstain from vaginal intercourse for 4 to 6 weeks before the surgery, then please do STOP the birth control pill, birth control patch, birth control ring 4 to 6 weeks before a surgery.
A paper from 1988 shows: that research from the 1970s (when women were on HIGHER doses of estrogen) that 0.19% of women on the pill versus 0.035% NOT on the pill got a deep vein thrombosis after surgery. Other studies showed: 4.6% of patients who underwent gynecological operations for benign disease, 0 of 99 patients who underwent various abdominal operations, and 20% in 33 patients who had emergency appendectomies had a thrombosis.
From the American College of Obstetrics and Gynecology in 2018: “No trials exist to demonstrate a reduction in postsurgical VTE with preoperative discontinuation of hormone therapy, and this practice should not be routinely recommended. In women using combined oral contraception, prothrombotic clotting factor changes persist 4–6 weeks after discontinuation, and risks associated with stopping oral contraception a month or more before major surgery should be balanced with the very real risk of unintended pregnancy. It is not considered necessary to discontinue combination oral contraceptives before laparoscopic tubal sterilization or other brief surgical procedures. In current users of oral contraceptives who have additional risk factors for VTE having major surgical procedures, heparin prophylaxis should be considered.”
There are 40 different formulations out there of the birth control pill. There are usually 3 different levels of estrogen (10 mcg, 20mcg, 30mcg, we do NOT recommend less than 30mcg for anyone under 30 years old. Too low of estrogen is NOT good for your bone health/density. See our youtube video ) and 8 different progesterones. So NOTE which progesterone and what level estrogen and find a doctor willing to try different ones and work with you.
Pandia Health has birth control expert doctors. If you are in California, Texas, Florida (and soon other US states), we’d be happy to help.
Otherwise, many people do well on norgestimate, desogestrel, drosperinone as the progestin. So perhaps cycle through those with your doctor.
The best birth control if you don’t want to have children are in order from best to least effective:
The birth control implant (Nexplanon ®, Implanon ®  works better than tubal ligation! Some women do GREAT on it. Some women have a lot of random breakthrough bleeding (BTB).
The IUD with hormone (Mirena ®, Liletta ®, Kyleena ®, Skyla ®) are very well tolerated because it is low dose and progesterone only. 30% of women who go on Mirena and Liletta have no periods. yay! 70% get lighter periods. Kyleena and Skyla are more likely to continue to have periods.
Then comes, Tubal ligation and then copper IUD in terms of efficacy at preventing pregnancy.
If you like the birth control ring (Nuvaring ® or its generics), now there is a 1 year ring. You could just put it in and leave it in for a year!!
Know that there are 40 different birth control pills with estrogen and progesterone. so if you didn’t like 1 then there are 39 other formulations of the birth control pill you could try.
If you are in a long term heterosexual relationship, it’s better for the one with the testicles to get a vasectomy than you to have your tubes tied. Vasectomy is more effective and less invasive than tubal ligation. Tubal ligation is invasive! they have to poke 3 holes in your abdomen, blow it up with gas. and it’s NOT as effective as the implant/IUD with hormone! and NOT as effective as vasectomy.
If your doctor is an ob/gyn or even if they are not, you can cite the ACOG committee opinion https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Ethics/Sterilization-of-Women-Ethical-Issues-and-Considerations it says:
“It is ethically permissible to perform a requested sterilization in nulliparous women and young women who do not wish to have children. A request for sterilization in a young woman without children should not automatically trigger a mental health consultation. Although physicians understandably wish to avoid precipitating sterilization regret in women, they should avoid paternalism as well.”
The IUD with hormone fails 1/1000.
Tubal ligation/women’s sterilization fails 5/1000
The implant fails 1/1000.
Vasectomy fails 1.5/1000.
The birth control ring, the birth control patch, and the birth control pill fail 7/100, though the ring and patch, should have a theoretical lower failure rate because you have fewer chances of forgetting/messing up. The ring has 13 chances a year of messing up, the patch 52 times and the pill 365 times.
You can read more about birth control efectviness or what’s the best birth control for you in our resources.
There are 2 hormones in birth control pills:
Norgestimate does not have a higher dose estrogen  and it’s known for breakthrough bleeding.
Zovia/Demulen has a 50mcg estrogen version and it has a higher progestin effect so will most likely stop the breakthrough bleeding
Medications such a Vyvanse and other ADHD meds rev up the liver and eat up the estrogen and other hormones in birth control so people on those meds sometimes need higher estrogen.
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