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What is Emergency Contraception and How Does it Work?

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team 70% of people with uteri between the ages of 15 and 44 are at risk of unintended pregnancy. Because the average childbearing person only has two children in their life, she will have to spend almost 30 years of her life […]

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Breastfeeding and Birth Control

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team Is it Safe to Use Birth Control While Breastfeeding? TLDR: Yes, it is safe to use birth control while breastfeeding. However, depending on which method, it may decrease your milk supply. Getting pregnant soon after giving birth can be incredibly difficult […]

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Natural Family Planning

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team What Is Natural Family Planning or Fertility Awareness Method? The average American woman only wants to have two children in her lifetime. Children are a significant time, money, and emotional investment. Despite the massive strides women have made to obtain equality, […]

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Birth Control And Pregnancy

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team What You Need to Know About Birth Control and Pregnancy The average woman in the U.S. wants to have two children. To accomplish this goal, she spends only about 3 years of her life: pregnant, in the postpartum period, or attempting […]

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Family Planning: When to Stop Birth Control

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team 97% of women of reproductive age in the U.S. will use a form of birth control at some point in their lives. While hormonal contraceptives offer numerous health benefits for women, hormonal birth control is incredibly useful for preventing unwanted pregnancy. […]

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Obamacare, Medicare and Birth Control

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team What You Need to Know About the Affordable Care Act (aka Obamacare), Birth Control/Contraceptive Coverage Before Congress passed the Affordable Care Act (ACA), health insurance providers were not required to cover any form of birth control under U.S. law. At the […]

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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.

Progesterone ONLY  methods such as the IUD with hormone, implant, shot, and Progesterone Only Pills are safe. copper IUD and condoms are safe.

For combined contraceptives such as the combined oral contraceptive pill cOCPs or the birth control patch (Xulane), the birth control ring (NuvaRing elyrng) if it is MILD pulmonary Stenosis, it is safe per this paper

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TLDR: Yes. we can get you dienogest via the birth control pill Natazia in the US.

Dienogest is the progestin in Qlaira (NOT available in the US) and Natazia (yes, we have this in the US).

Unfortunately, Qlaira is NOT available in the US. However, there is Natazia which is the same.
It is VERY expensive though. $245-$285 if you don’t have insurance. And unlikely that most insurance will cover it.
Also, it has so many phases and our team prefers monophasic. Watch this video

  • 2 dark yellow tablets each containing 3 mg estradiol valerate
  • 5 medium red tablets each containing 2 mg estradiol valerate and 2 mg dienogest
  • 17 light yellow tablets each containing 2 mg estradiol valerate and 3 mg dienogest
  • 2 dark red tablets each containing 1 mg estradiol valerate
  • 2 white tablets



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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.”

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short answer: No.

long answer: anything is possible and some people have long periods. But 14 days would be unusually long.

If it happens again, then time to see your doctor for a work up, you might have Von Willebrand’s disease which is “the most common bleeding disorder” found in 1/100 people according to the CDC. Learn more here


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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.


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Seasonale, Seasonique, Loseasonique all contain the SAME active ingredients = levonorgestrel and ethinyl estradiol.
Seasonale and Seasonique each have 84 days of 0.15 mg/30 mcg levonorgestrel/ethinyl estradiol.
However, Seasonique then goes into 7 days with 10 mcg of ethinyl estradiol vs. Seasonale which has 7 days of sugar/placebo/bleeding pills.

Loseasonique is the same as seasonique except that it only has lower hormones = levonorgestrel/ethinyl estradiol 0.1 mg/20 mcg for 84 pills.

Loseasonique, Amethia Lo, Camreselo, Lojaimiess are all the SAME active ingredients, SAME dosage.
Seasonique, Amethia, Camrese, Daysee, Simpesse, Ashlyna, Jaimiess are all the SAME active ingredients, SAME dosage.
Seasonale, Introvale, Jolessa, Quasense are all the SAME active ingredients, SAME dosage.


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So birth control pills are in different colors because they want you to choose their “brand” – the brand can be generic or name brand. Name brand is more expensive because they are the original.

Also, some packs have 4 different colors, some have 2, some have more. If there are 2 color pills. usually the 3 weeks of 1 color are the active pills and the 1 week of the other are the sugar/placebo/bleeding week pills.


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The best birth control if you don’t want to have children are in order from best/most to least effective:

The birth control implant (Nexplanon ®) 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 that never wants children, it’s better for the one with the testicles to get a vasectomy than the one with the uterus to have that person’s 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 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 5-7 yr IUD with hormone fails 1/1000.

The implant fails 1/1000.

Vasectomy fails 1.5/1000.

Tubal ligation/women’s sterilization fails 5/1000

Copper IUD fails 8/1000

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 effectiveness or what’s the best birth control for you in our resources.

updated 11.5.20 sy


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You can stop the pill or another form of hormonal birth control at any time, just know that your “period” will come and that you will no longer be protected against pregnancy. To find more information click here and if you are stopping birth control because you are planning family check out this link too.