There are 2 hormones in birth control pills:

  1. Estrogen – higher doses will increase the risk for blood clots but will also help with breakthrough bleeding or lower doses will also.
  2. Progesterone – causes 2 types of side effects Androgenic (acne), and progestin – higher progestin activity = less chance of bleeding.

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.