Birth Control Pills: Types and Effectiveness

Birth control pills are popular and effective oral contraceptives that millions of women worldwide use to prevent unwanted pregnancies. When taken correctly and consistently, birth control pills are highly effective at preventing pregnancy.

With so many different types of birth control pills in the market, it can be overwhelming to choose the right one. This informational guide will explore the types of pills available, how they work, and any potential side effects.

Whether you are considering starting birth control pills or simply want to learn more about this form of contraception, this guide has everything you need to know.

What Are Birth Control Pills?

Birth control pills are oral contraceptives containing synthetic versions of hormones that work together to prevent pregnancy if used correctly.

The pill can also be used as a treatment option for menstrual disorders, endometriosis, and acne. They may also reduce the risk of ovarian or uterine cancer.

What Are the Types of Birth Control Pills?

A range of contraceptive pills is available. Let us take a closer look at each type.

Combination pills

These pills contain a combination of synthetic oestrogen and progestin hormones that reduce the risk of pregnancy by preventing ovulation and creating unfavourable cervical and uterine environments to obstruct fertilisation.

1. Monophasic pills

• These tablets are combination pills that contain the same dose of hormones in each active pill and are used in 1-month cycles. Thus, they are also known as monophasic or single phase.
• Monophasic pills come in packs of 21 days with a 7-day break (21/7) where either no pill or a placebo is taken, which results in a withdrawal bleed. An alternative would be the 24/4 regimen with four days of placebo or low-dose oestrogen.

2. Phasic pills

• Phasic pills contain different doses of oestrogen and progestin for a 1-month cycle meant to mimic hormonal fluctuations during the menstrual cycle. 

3. Extended-cycle pills

• This type of tablet is designed to be taken for up to 3 months (84/7), after which there will be a 7-day interval with either a placebo or no pills. 
• The usage of extended-cycle pills results in periods occurring only four times a year. However, it is common to notice spotting or bleeding in between.

Progestin-only pill

Also called a "minipill", this oral contraceptive option is meant to be used by those who cannot or prefer not to use contraceptives with oestrogen. The main progestins are norethindrone and drospirenone. 

A pack of progestin-only pills contains 28 pills, and it is essential to take one pill daily within a specific timeframe. Depending on the type of progestin-only pill you are prescribed, the required timing is either a 3-hour window or a 12-hour window. It is crucial to take the pill consistently at approximately the same time each day to ensure its effectiveness.

Progestin-only pills prevent pregnancy by:

• Suppressing ovulation.
• Inhibit sperm migration.
• Thinning the endometrium.
• Thickening cervical mucous.

How Effective Are Birth Control Pills?

When taken correctly and consistently daily, birth control pills are excellent at preventing unwanted pregnancy. In addition, consistency is critical to reducing the chances of hormonal fluctuations.

One tip for maintaining consistency is using a tracker, such as a birth control app, to schedule reminders.

Note that some medications can interfere with the effectiveness of contraceptive pills, such as:

• Antibiotic (Rifampin).
• Antiseizure medications (carbamazepine, phenytoin, barbiturates,topiramate, felbamate, oxcarbazepine or primidone).

What Are the Side Effects of Birth Control Pills?

Like all medications, birth control pills can cause side effects in some women. However, several women also report experiencing no symptoms at all.

The most common side effects of birth control pills include the following:

• Nausea
• Headaches
• Breast tenderness
• Irregular or sporadic bleeding or spotting
• Amenorrhea (absence of menstruation)
• Mood changes 
• Worsening of migraines
• Weight gain

Although rare, some risks include:

• Deep vein thrombosis
• High blood pressure
• Stroke
• Heart attack
• Breast and cervical cancer

Your doctor may recommend switching to a different birth control pill if the side effects have not ceased after a few months.

What Are Other Benefits of Birth Control Pills?

In addition to preventing pregnancy, birth control pills have several other benefits for women.

Some of the benefits of birth control pills include:

• Treating acne.
• Alleviating premenstrual syndrome (PMS) symptoms.
• Minimising the risk of infections in the ovaries, fallopian tubes, or uterus.
• Reducing the risk of endometrial and ovarian cancer.
• Preventing anaemia (iron deficiency).

What Are the Most Asked Questions About Birth Control Pills?

1. Do birth control pills affect mood?

Some women may experience mood changes while taking birth control pills, including symptoms such as depression, anxiety, or irritability.

2. Do birth control pills cause weight gain?

Most of the available research on the relationship between weight gain and birth control pills is inconclusive. However, the hormones in birth control pills can cause fluid retention, leading to temporary weight gain. This is usually short-term and goes away on its own.

3. Can I take birth control pills when breastfeeding?

Breastfeeding women can safely use certain types of birth control pills. A progestin-only pill is safe to be used when breastfeeding.

4. Can birth control pills cause infertility?

No, birth control pills do not cause infertility. Both women who use and do not use the pill have equal chances of conceiving. Taking birth control pills only puts your fertility on pause to prevent pregnancies.

5. Can birth control pills make you miss your period?

Yes, the pill can make you miss your period or have lighter periods. This is due to the alterations of hormones, which can affect the menstrual cycle. However, missing a period while on the pill does not necessarily indicate pregnancy. Here are a few factors that can contribute to a missing period:

• Strenuous exercise.
• Continuous birth control pills.
• Changes in diet.
• Stress.
• Health conditions or illness.

6. Do birth control pills cause fibroids to grow?

Fibroids are benign (non-cancerous) growths in the uterus that can cause painful periods, pelvic pain, and other symptoms.

Some studies suggest that hormonal factors, such as oestrogen and progesterone, may influence the growth of fibroids. However, more research is required for a conclusive result.

Make an Appointment at Pantai Hospitals

Birth control pills are a reliable method of contraception. While there are some common concerns regarding their usage, such as weight gain and missed periods, it is important to note that these side effects are usually mild and temporary. 

If you have questions or concerns about birth control pills, talk to your doctor, who can provide guidance and recommend the best form of contraception based on individual needs.

Get in touch with us to book an appointment with our team of gynaecologists today, or find out more about our Obstetrics and Gynaecology Services at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.