Why it's doneBy Mayo Clinic Staff
Combination birth control pills are a reliable form of contraception that is also easily reversed. Fertility may return to normal almost immediately after stopping combination birth control pills. Combination birth control pills have noncontraceptive benefits as well, such as:
- Decreased risk of ovarian and endometrial cancers, ectopic pregnancy, ovarian cysts, benign breast disease
- Improvement in acne
- Less severe menstrual cramps (dysmenorrhea)
- Reduction in androgen production caused by polycystic ovary syndrome
- Reduction in heavy menstrual bleeding due to uterine fibroids and other causes, as well as a reduction in related iron deficiency anemia
- Relief from premenstrual syndrome (PMS)
- Shorter, lighter and more predictable periods or, for some types of combination pills, fewer periods each year
- Better control of monthly cycle and a reduction in hot flashes for women in perimenopause
Combination birth control pills come in different mixtures of active and inactive pills, including:
- Conventional pack. The most common type of combination birth control pills contains 21 active pills and seven inactive pills. Formulations containing 24 active pills and four inactive pills, known as a shortened pill-free interval, also are available. A pill is taken every day and a new pack is started when the previous pack is completed (every 28 days). Bleeding occurs every month during the week when you take the last four to seven inactive pills.
Continuous dosing or extended cycle. These combination birth control pills typically contain 84 active pills and seven inactive pills. Bleeding generally occurs only four times a year during the week when you take the inactive pills.
A 365-day pill is also available. This pill is taken every day at the same time. For some women, periods stop altogether. For others, periods become significantly lighter.
Continuous dosing or extended cycle pills may provide additional benefits of suppressing menstruation, such as:
- Prevention and treatment of excessive bleeding related to uterine fibroids
- Prevention of menstrual migraine
- Reduction in the menstruation-associated worsening of certain conditions, including seizures and asthma
- Relief from pain related to endometriosis
Combination birth control pills aren't appropriate for everyone, however. Your health care provider may suggest another form of birth control instead of combination birth control pills if you:
Aug. 13, 2015
- Are in the first month of breast-feeding
- Are older than age 35 and smoke
- Have poorly controlled high blood pressure
- Have a history of or current deep vein thrombosis or pulmonary embolism
- Have a history of stroke or heart disease
- Have a history of breast cancer
- Have migraines with aura
- Have diabetes-related complications, such as nephropathy, retinopathy or neuropathy
- Have liver disease
- Have unexplained uterine bleeding
- Will be immobilized for a prolonged period due to major surgery
- Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media; 2011:249.
- Martin KA, et al. Overview of the use of estrogen-progestin contraceptives. http://www.uptodate.com/home. Accessed Aug. 19, 2014.
- Frequently asked questions. Contraception FAQ185. Combined hormonal birth control: Pill, patch and ring. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Combined-Hormonal-Birth-Control-Pill-Patch-and-Ring. Accessed Sept. 4. 2014.
- Martin KA. Risks and side effects associated with estrogen-progestin contraceptives. http://www.uptodate.com/home. Accessed Aug. 19, 2014.
- Laughlin-Tommaso SK (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 22, 2014.