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Birth control pills have long been the preferred contraceptive method for many women, as they prevent pregnancy with an efficacy rate of up to 99% when used correctly. However, contraceptive pills have side effects and may not be suitable for some women, especially in certain health conditions. So, what are the different types of birth control pills? And what are the best birth control pills available at the pharmacy?

How Do Birth Control Pills Work?

Birth control pills prevent pregnancy through the hormones they contain, which perform the following:

• Inhibiting or reducing ovulation: Preventing the release of eggs from the ovary.

• Thickening cervical mucus: Creating a barrier that prevents sperm from passing through and eventually reaching the egg.

• Thinning the uterine lining (endometrium): So that if an egg is fertilized, it cannot attach to the lining and grow.

Types of Birth Control Pills

Birth control pills are not a single type; rather, they are divided into two main categories: Combination Pills and Progestin-Only Pills (POPs). Below is a detailed breakdown of these types:

1. Progestin-Only Pills (The Mini-Pill)

These contain only progestin and do not contain estrogen. They prevent pregnancy in a manner similar to combination pills, but they primarily work by increasing the thickness of the cervical mucus, making sperm penetration more difficult.

2. Combination Birth Control Pills

These are the most commonly prescribed. They contain synthetic versions of the female hormones estrogen (ethinyl estradiol) and progesterone (progestin). Combination pills prevent pregnancy by stopping the ovaries from releasing an egg and causing changes in the uterine lining that make it unsuitable for a fertilized egg to implant and grow.

Combination pills may contain the same dose every day or varying doses in stages, classified as follows:

• Monophasic: Contains the same dose every day.

• Biphasic: One dose for the first half of the cycle and another for the second half.

• Triphasic: One dose for the first 5–7 days, a second dose for the next 5–9 days, and a third dose for the final 5–10 days.

Based on their common usage patterns, combination pills are further divided into:

• Conventional Packs: Usually contain either 21 active pills and 7 inactive (placebo) pills, or 24 active pills and 4 inactive pills. Withdrawal bleeding occurs once a month while taking the inactive pills.

• Extended-Use Pills: When a doctor recommends taking active pills and skipping inactive ones for longer than the usual 21 days. When you take a break from the hormones, "withdrawal bleeding" typically occurs.

• Continuous-Use Pills: Similar to extended-use, but there is no break from the hormones; they are taken for a year or more. Usually, withdrawal bleeding does not occur with this method.

Success Rate of Birth Control Pills

The efficacy of oral contraceptive pills is approximately 99% when taken as directed. This requires taking them regularly and correctly at the same time every day.

Benefits of Birth Control Pills

While the primary goal is preventing pregnancy, these pills offer other benefits, which is why doctors may prescribe them for conditions such as:

• Endometriosis.

• Menorrhagia (Heavy menstrual bleeding).

• Severe menstrual cramps.

• Irregular menstrual cycles.

• Ovarian cysts.

• Premenstrual Syndrome (PMS).

• Premenstrual Dysphoric Disorder (PMDD).

Side Effects of Birth Control Pills

Contraceptive medications are not without side effects. The most common is breakthrough bleeding or spotting, especially when first starting the pills—this is more common with progestin-only pills but can also occur with combination pills. Other potential side effects include:

• Acne.

• Breast tenderness or enlargement.

• Brown or black skin patches (melasma).

• Changes in appetite.

• Changes in menstrual flow.

• Stomach upset.

• White vaginal discharge.

• Weight loss or gain.

• Unusual hair growth.

Contraindications for Combination Birth Control Pills

Combination pills are not suitable for all women. They are not recommended for smokers over the age of 35, or for those with certain medical conditions, such as:

• Blood clotting disorders.

• A history of blood clots or strokes.

• Breast cancer.

• Diabetes with kidney, eye, nerve, or blood vessel complications.

• Liver disease.

• Kidney disease.

• Heart disease.

• Lupus with antiphospholipid antibodies.

• Migraine with aura.

• Uncontrolled hypertension (high blood pressure).

• Vascular diseases.

Contraindications for Progestin-Only Pills

Similarly, progestin-only pills may not be suitable, particularly in cases of:

• Breast cancer.

• High blood potassium levels (specific to Drospirenone).

• Liver cancer.

Best Birth Control for Breastfeeding Mothers

It is essential to speak with a physician before starting birth control if you have recently given birth or are breastfeeding. Due to the increased risk of blood clots in the first few weeks postpartum, progestin-only pills are recommended over combination pills.

Progestin-only pills are safe to take during breastfeeding, whereas combination pills are generally not recommended as they may slightly affect the mother's milk supply.

The Best Birth Control Pills from the Pharmacy

Aljawaher Almotamayza pharmacies provide a variety of birth control pills, including prescription medicines. However, consulting a physician is recommended to determine the right option and correct usage for you:

1. Reguelon (21 Tablets)

Reguelon 21 tablets is a combination pill containing ethinyl estradiol and desogestrel.

2. Postinor (2 Tablets)

Postinor 2 tablets is an emergency contraceptive containing levonorgestrel, which mimics natural progesterone.

3. Navela Tablets

Navela 1 Tablet tablets is an emergency contraceptive (1 tablet) containing 1.5 mg of levonorgestrel. It prevents approximately 84% of expected pregnancies if taken within 72 hours of unprotected intercourse.

4. Gynera (21 Tablets)

Gynera 21 Tablets is a combination pill containing a blend of female hormones, also used to regulate the menstrual cycle.

5. Cerazette (75 mg, 28 Tablets)

Cerazette 75 Mg 28 Tablets is a progestin-only pill containing desogestrel, taken for 28 consecutive days.

6. Yaz Plus (28 Tablets)

contains synthetic estrogen and progestin, plus Levomefolate Calcium (a form of Vitamin B). It is used for contraception, treating moderate acne, and improving folate levels.