Birth control pills

Combination pill

The combination pill is an oral contraceptive pill used by millions of women to prevent pregnancy. When used correctly, it is one of the most reliable contraception methods available. Most commonly referred to as “the pill,” many women also take it to help ease menstrual cramps, regulate their menstrual cycle, and control responses associated with fluctuating hormone levels, such as acne.

The pill contains both estrogen and progestin, and it is taken for 21 days with a 7-day break. Some brands will also include placebo pills or iron supplements during the week-long break. This is to help you keep the routine of taking a daily pill and to help you replenish any iron lost through your menstruation.

After a consultation with a healthcare professional, most women will be offered the combination pill as it is highly tolerable, easy to take, and widely available.

Mini pill

The mini pill is an alternative oral form of birth control that contains only progestin. It also goes by another name, the progestin-only pill (POP).

It is more tolerable than other oral contraceptives, especially for women who have experienced side effects from the combination pill in the past.

Other groups of women who can't use the combination pill will be able to use the mini pill, including those who:

• smoke and are 35 or older
• are very overweight
• are taking certain medications
• have certain medical conditions

Before you order contraceptives from Speedy Health, you should have first been prescribed by your regular doctor. However, if you are unsure whether the mini pill or combination pill is better for you, you can ask your doctor for a consultation.

Combination pill

Regardless of the brand, all combination pills (containing estrogen and progestin) work in the same way.

The synthetic hormones they contain prompt your body to react in ways that reduce the chance of conception.

1. First - the hormones stop your ovaries from releasing eggs, in turn preventing ovulation. With no eggs released, there is nothing for sperm to fertilize.
2. Second - the mucus in the neck of your cervix thickens. This makes it harder for sperm to enter and find an egg.
3. Third - the lining of the uterus thins, which makes it very unlikely a fertilized egg could ever implant.

As you can see, the combination of effects makes it virtually impossible (99%) for pregnancy to occur. However, it is still possible in rare circumstances and if the pill is taken incorrectly.

The combination pill cannot protect you against sexually transmitted infections (STIs). Instead, you should use barrier contraceptives such as condoms.

You can take the combination pill at any point of your cycle. If taken on the first to fifth day of your period, it will be immediately effective. If it is taken outside this timeframe, then additional barrier contraception will be required for the first week or two before you are fully protected.

Mini pill

The mini pill has very similar actions to the combination pill. It shares one of the hormones with the combination pill, progestin (a synthetic version of “progesterone”). However, it does not contain estrogen.

Like the combination pill, the mini pill thickens the cervical mucus in the neck of the womb to stop sperm from entering as easily. It also thins the lining of the womb so that fertilized eggs don't implant.

Where conventional mini pills and combination pills differ is in how they affect ovulation. Most mini pills do not stop ovulation, which means your body will still produce eggs (though it is exceptionally difficult for them to make contact with sperm). However, there are newer versions, called desogestrel pills, which do prevent ovulation.

Despite having two and not three modes of action, the mini pill is still more than 99% effective.

Again, no oral birth control will protect you from sexually transmitted diseases (STDs).

Combination pill

With oral combined contraceptives, one pill must be taken at the same time daily for 21 days of the month, followed by a 7-day break.* During this break, you will experience breakthrough bleeding. However, you will still be fully protected throughout if you have been taking the pill correctly.

After the 7-day break, you should begin the next pack following the same rules and continue this cycle until you no longer wish to use a hormonal contraceptive method.

There are some combination pill brands that differ from the usual 21-day method. These brands contain 28 pills. The additional 7 pills will either be placebos or iron supplements, for example, Isibloom or Junel Fe 24, respectively.

*Some brands will require you to take a pill for 24 days, followed by 4 days of taking a placebo.

Mini pill

Unlike the combination pill, the mini pill should be taken once daily at the same time for the full 28 days of your cycle. There is no seven-day break, and you should start your next pack straight after the last. This does make it easier to remember as you are taking the tablets more often and you won't be delayed in starting the new pack.

It is important that you take the mini pill as close to your usual time as possible daily as this can influence its effectiveness as mentioned above.

When starting the pill, pick a time of the day that is most convenient for you. Most women find taking them the first thing in the morning or last thing at night to be the easiest. If started on the first to fifth day of your period, the mini pill will be effective straight away, unless your menstrual cycle is typically shorter than 23 days.

If you have a short menstrual cycle, or start the POP pill outside this five-day window, you will not be protected for the two days after. Do not have unprotected sex during this time.

What if I forget to take a pill?

Clearer instructions will be included with your medication - please consult these for more guidance. If you ever have any doubt about using any contraceptive, you should speak with your doctor.

For the combination pills, if you are one day late in taking a pill, take the missed dose as soon as you remember. Continue the pack as normal. If you have missed two or more doses, continue with the last missed pill and use barrier methods (e.g., condom) until you have started the next pack after the 7-day break.

For the mini pill, it will depend on the particular version. Some pills must be taken within a 3-hour timeframe and others a 12-hour timeframe. If you remember within these timeframes, take the pill as normal. If you are more than 3 or 12 hours late, take the last missed pill as soon as you remember and carry on as normal (even if you have to take two pills at once). You should use barrier protection for the next 48 hours. After that, you should be protected.

Both the combined and mini pill share a number of side effects as they work in a very similar way in the body.

The following is not a complete list of reactions, just the most common.

Combination pill:

• acne
• fluid retention
• headaches
• spotting (metrorrhagia)
• nausea
• weight gain

Mini pill:

• breast abnormalities
• mood changes
• headache
• decreased libido
• menstrual cycle irregularities
• nausea
• skin reactions
• weight gain

Every woman will react differently to each type of contraceptive, as well as the specific brand. There are so many options available and there will be an ideal pill for you. If you find you experience unpleasant side effects, contact your doctor or gynecologist and ask about alternatives.

You should always inform your healthcare provider of any conditions you have or medications you are taking before starting any hormonal birth control. They will use this information to decide what pill is best. For example, if you have a history of heart attacks or heart disease, medications that raise your blood pressure, such as certain birth control pills, may not be recommended. Likewise, if you have a history of cancers, especially endometrial or ovarian cancer, certain pills will be dangerous for you.

Blood clots

One of the effects of estrogen is that it makes your blood clot more easily. This means that if you are taking the combination pill, which contains synthetic estrogen, you are at a slightly increased risk of blood clots.

The chance of one occurring is very small, however, your doctor will assess other risk factors before prescribing. Your diet and weight, whether or not you smoke, and a history of blood disorders and high blood pressure will affect if the combination pill is suitable for you.

The POP does not contain estrogen, so will most likely be offered if the combination pill is deemed unsuitable.

You should be aware of the symptoms of blood clots - pain and numbness in the limbs, difficulty breathing and coughing (including coughing blood. If you experience any of these while on the pill, seek immediate medical attention.

Cancer complications

Both the mini pill and the combination pill have been linked to cases of breast cancer and cervical cancer and conditions (e.g., ovarian cysts). Again, the increase in cases is slight, and there is debate as to whether the increase is due to more reported symptoms coming from more frequent doctor checkups rather than the medications themselves.

If you notice any changes to your breasts, such as lumps or unusual breast tenderness, you should inform your doctor ASAP.

Speedy Health offers a large variety of oral contraceptives. Your regular doctor should first prescribe a pill for you to use before you order one online from us. We will also ask you to complete a short online consultation. This will only take a few minutes and is to allow our doctors to make sure the selected contraceptive is safe for you to use.

Currently, Speedy Health sells the following pills:

• Norethindrone
• Yaz
• Sprintec
• Yasmin
• Tri-Lo-Sprintec
• Isibloom
• Aviane
• Lo Loestrin Fe
• Junel Fe 24
• Junel Fe 1/20

All of these contraceptives are FDA-approved and widely prescribed by doctors across the country. Click on the names to learn more about them.