What are the pros and cons of combination pills?

Pros

  • Decreased risk of ovarian and endometrial cancers
  • Improvement in acne
  • Less severe menstrual cramps (dysmenorrhea)
  • Possible positive effect on bone mineral density
  • Reduction in androgen production caused by polycystic ovary syndrome
  • Reduction in heavy bleeding (menorrhagia) and related anemia
  • Relief from premenstrual syndrome (PMS)
  • Shorter, lighter and more predictable periods, or fewer or no periods
  • Avoidance of risks associated with pregnancy, such as greater risk of blood clots, higher rates of ectopic pregnancy and increased nausea and breast tenderness (though some of these risks occur with birth control pills, they are much less severe than with pregnancy)

Cons

  • No protection against sexually transmitted infections, including HIV
  • Increased risk of heart attack and stroke
  • Increased risk of blood clots, with a slightly greater risk of blood clots linked to certain types of progestin used in the pill (though the overall effect of progestin type on blood clot risk is small)
  • Side effects such as irregular bleeding, bloating, breast tenderness, nausea, depression, weight gain and headache

What are the pros and cons of the minipill?

Pros

  • Can be taken if you have health problems, such as a high risk of heart disease, blood clots, high blood pressure or migraines
  • Can be used during breast-feeding
  • Offers a quick return to fertility if you hope to get pregnant
  • Avoidance of risks associated with pregnancy, such as greater risk of blood clots, higher rates of ectopic pregnancy, and increased nausea and breast tenderness (though some of these risks occur with birth control pills, they are much less severe than with pregnancy)

Cons

  • No protection against sexually transmitted infections, including HIV
  • Potentially less effective than combination birth control pills
  • Must be taken at the same time every day (taking the minipill more than three hours later than usual means backup birth control will be needed for at least two days)
  • Side effects such as irregular menstrual bleeding, ovarian cysts, decreased libido, headache, breast tenderness, acne, weight gain, depression and hirsutism
  • Slightly increased risk that if pregnancy occurs it will be ectopic — the fertilized egg implants outside the uterus.

What's the bottom line?

You have many options for birth control. If you choose to take birth control pills, work with your health care provider to decide which type of birth control pill is right for you.

Jan. 22, 2015 See more In-depth