Types of Oral Contraceptives

Ever wondered what type of oral contraceptives are out there? 

Well, here's the facts! A brief overview on active ingredients, side effects, benefits and more!

Currently there are three oral contraceptives available for purchase either by Rx or over the counter (OTC). The most commonly used oral contraceptive is Combined Oral Contraceptives (COCs). Less commonly used are Progestin-Only Pills (POPs) and Emergency Contraceptive Pills (ECPs). Lets take a deeper look into what this means.  

Active Ingredients: two low doses of natural hormones,  progestin and estrogen

Action: prevent the release of eggs from the ovaries, thereby hindering ovulation

Effectiveness: Highly user dependent, meaning how you take COC's will chance its effectiveness against pregnancy. These pills are daily, and require consistency. Within the first year of use, 7/100 women become pregnant, however, with no mistakes in use, the risk decreases to less than 1 in 100 women

Protection against STIs: None 

Benefits: As a prescription drug, use of COC's are controlled by the woman and can be stopped at any time without doctors approval. COC's don't interfere with sex-life and are moderately attainable as they rarely require preliminary testing for a prescription. 

Side effects: When taking COC's you might experience irregular, lighter or less frequent bleeding, headaches, dizziness, nausea, mood swings, weight variability, and acne. However, this affects are very dependent on the woman and will change from person-to-person. 

Active Ingredients: a low dose of natural progestin, this form of oral contraceptives is primarily for breastfeeding women

Action: thickens cervical mucus which blocks sperm from fertilization, and disrupts the menstrual cycle, preventing the release of eggs from the ovaries, thereby hindering ovulation

Effectiveness: Similar to COCs, POPs are also highly user dependent, requiring consistency in daily pill dosing. Missing pills increases the risk of pregnancy drastically. Within first year of use, only 1/100 breastfeeding women become pregnant, but with no mistakes, this decreases to less than 1/100. In women not actively breastfeeding, this risk increases to 7/100 pregnancies within the first year and less 1/100 with consistency.

Protection against STIs: None   

Benefits: As a prescription and OTC drug, use of COC's are controlled by the woman and can be stopped at any time without doctors approval. COC's don't interfere with sex-life and are readily accessible in drug stores, pharmacies, and online. The main benefit of POPs is that it can be taken while breastfeeding, as it does not interfere with milk-supply and does not harm the baby or the mother. 

Side effects: When taking POPs you might experience irregular, lighter, more or less frequent bleeding, headaches, dizziness, nausea, mood swings, weight variability, and acne. However, these affects are very dependent on the woman and how they are breastfeeding as this will change from person-to-person

Active Ingredients: ECPs can be of the three combinations   

1. Levonorgestrel or Ulipristal acetate only 
2. Progestin-only pills with levonorgestrel or norgestrel
3. COCs with estrogen and a progestin - levonorgestrel, norgestrel or norethindrone)

Action: prevent or delay the release of eggs from the ovaries, thereby hindering ovulation

Effectiveness: prevents pregnancy after unprotected sex up to 5 days after, the sooner the more effective and highly dependent on the ingredients. ECPs DO NOT work if the person is already pregnant

Protection against STIs: None 

Benefits: Can be used as needed by the woman and especially necessary to avoid pregnancy if sex was forced. ECPs reduce the need for abortion and are also available OTC at drug stores, pharmacies and online for purchase.

Side effects: When taking ECPs you might experience irregular, lighter, more or less frequent bleeding 1-2 days after taking an ECP. Monthly bleeding afterwards might come sooner or later than expected. This also might lead to headaches, dizziness, vomiting and nausea as well.

Let us know what oral contraceptives you have tried and your experience in the comments below! For more information please visit the link below to the Family Planning Handbook for Providers.

            (1) Huff, M. B. (2009). Family Planning: A Global Handbook for Providers. Journal of Pediatric and Adolescent Gynecology, 22(2), 135–135. Link.