What Makes Low-dose Birth Control Different from Other Hormonal Contraceptives?
Hormonal birth control products are some of the most popular and effective contraceptive methods used in the U.S. Not only can they protect women from an unwanted pregnancy, but they can also improve their quality of life, regulate hormonal imbalances, and give women freedom and choices that their female ancestors never had. Since the pill was invented and marketed in 1960, new hormonal birth control methods have become more accessible and inexpensive for women.
Generally, hormonal birth control products are considered safe for most women. But they do come with risks. Fortunately, there are many different kinds of hormonal and also non-hormonal contraceptives that women can try before finding one that’s right for their needs and lifestyle.
How does the birth control pill work?
Before one can fully appreciate what makes low-dose contraceptives different than other forms of birth control, it’s crucial to understand how the birth control pill works in the first place.
The female reproductive system operates under a cycle of rising and falling estrogen, progesterone, and androgen hormones. At the beginning of the cycle, hormones steadily increase until the ovary is triggered to release an egg. Once this happens, hormones influence the uterus to grow an endometrial lining in preparation of a fertilized egg. If an egg is not fertilized within about ten to fourteen days after ovulation, the endometrium is shed, resulting in a menstrual period.
The pill disrupts the rising and falling of reproductive hormones, preventing the ovary from releasing an egg. Instead of a rise and fall of hormones, the pill introduces a steady dose of synthetic estrogen and progesterone hormones. The endometrium is not signaled to grow to prepare a fertilized egg, and when women who take the pill have a menstrual period, it’s not really a period because ovulation did not occur. Monthly bleeding on the pill is referred to as withdrawal bleeding.
Naturally occurring estrogen in the female reproductive cycle is produced in the ovaries. Estrogen helps the uterus grow the lining that is responsible for implantation of a fertilized egg.
When the pill was first introduced in the 1960s, the pills contained around 100 micrograms of synthetic estrogen, called ethinyl estradiol. High doses of synthetic estrogen can cause many side effects, including a significantly increased risk of blood clot formation and other issues. Since the introduction of the pill in the 1960s, estrogen levels have been decreased.
Most birth control pills in 2019 contain a mix of synthetic estrogens and progesterone hormones. Estrogen levels in today’s pills are around 30 to 35 micrograms. There are still higher dose pills on the market that contain approximately 50 micrograms. Some pills contain only 20 micrograms of estrogen, or even lower as in the case a pill called Lo Loestrin Fe that contains only ten micrograms of synthetic estrogen. While there is still a risk of blood clots when taking combination birth control pills, the risk is substantially lower with pills that contain 30 micrograms of estrogen and lower.
Today, most birth control pills are considered low dose, whether they contain a combination of synthetic estrogen and progesterone, or are progesterone only pills. The birth control ring and the birth control patch contain similar amounts of estrogen as low-dose combination pills. The ring releases around 15 micrograms of synthetic estrogen into the body every day for 21 days.
The birth control patch delivers 20 micrograms of synthetic estrogen every day for seven days before the patch is changed. However, the body absorbs a higher dose of estrogen from the patch than the pill because when using the patch, the hormones are directly absorbed into the bloodstream and able to bypass the liver’s filtering functions. Therefore, women who have increased risk factors for blood clots should not take the birth control patch.
Are low-dose birth control pills still effective?
Yes, with typical use, low-dose birth control pills are still 92% effective against preventing unintended pregnancy. Combination pills which contain a low dose of estrogen and progesterone hormones can be taken as generics or brand name. Both types have the same amount of effectiveness. The most popular brand name, low-dose combination pills are:
In most cases, women will take 21 days of active pills followed by a seven-day break where only placebo pills are taken. It is during this seven-day break that a withdrawal bleed will occur. However, it is safe for women to take birth control pills to prevent monthly bleeding for months or years if needed.
Low-dose progesterone-only pills are also 92% effective with typical use. Brand names of synthetic progesterone-only pills include:
Low-dose progesterone only pills are also called minipills, and each monthly pack contains 28 active pills. But it is critical that women who are on the minipill take it at the exact same time every day for it be the most effective. Combination pills give women slightly more leeway as far as what time of day she needs to take the pill for it to be effective. Minipills must be taken on a strict schedule, though. Doctors often prescribe the minipill for women who are breastfeeding or are in perimenopause. Women who cannot tolerate synthetic estrogens can safely take minipills.
However, it’s critical that women understand that up to 40% of women who take the minipill will continue to ovulate. The minipill prevents pregnancy by making the uterus inhospitable to implantation.
Women who are over 35, who smoke, or have a family or personal history of blood clots should steer clear of synthetic estrogens. But the minipill may be safe for women with these risk factors to use to prevent pregnancy and regulate hormones. If you’re curious about what type of hormonal birth control can work for you, sign up with Pandia Health today. Doctors are standing by to assist you with your birth control needs.
The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.