Combination birth control pills are a reliable form of contraception that's easily reversed. Fertility can return to normal almost immediately after stopping the pills. Other, noncontraceptive benefits of these pills include:
- 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 iron-deficiency anemia
- Relief from premenstrual syndrome (PMS)
- Shorter, lighter and more-predictable periods or, for some types of combination pills, fewer periods yearly
- Better control of monthly cycle and a reduction in hot flashes for women nearing menopause (perimenopause)
Combination birth control pills come in different mixtures of active and inactive pills, including:
Conventional pack. The most common type 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.
You take a pill every day and start a new pack when you finish the old one (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 typically contain 84 active pills and seven inactive pills. Bleeding generally occurs only four times a year during the seven days you take the inactive pills.
A 365-day pill also is available. You take this pill every day at the same time. For some women, periods stop altogether. For others, periods become significantly lighter.
Continuous-dosing and extended-cycle pills might provide additional benefits of suppressing menstruation, such as:
- Prevention and treatment of excessive bleeding related to uterine fibroids
- Prevention of menstrual migraines
- Reduction in menstruation-associated worsening of certain conditions, including seizures
- Relief from pain related to endometriosis
Combination birth control pills aren't appropriate for everyone, however. Your health care provider might suggest you take another form of birth control if you:
- Are in the first month of breast-feeding
- Are older than 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
Nov. 15, 2017
- Hatcher RA, et al. Combined (estrogen & progestin) contraceptives. In: Managing Contraception 2017-2018. 14th ed. Tiger, Ga.: Bridging the Gap Foundation; 2017.
- 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. 29, 2017.
- Martin KA. Overview of the use of estrogen-progestin contraceptives. https://www.uptodate.com/contents/search. Accessed Sept. 29, 2017.
- Stewart M, et al. Choosing a combined oral contraceptive pill. Australian Prescriber. 2015;38:6.
- Martin KA. Risks and side effects associated with estrogen-progestin contraceptives. https://www.uptodate.com/contents/search. Accessed Sept. 29, 2017.
- Hatcher RA, et al. Combined oral contraceptives (COCs). In: Contraceptive Technology. 20th edition. New York, N.Y.: Ardent Media Ltd.; 2011.
Combination birth control pills