Understanding Combination Birth Control Pills
Combination birth control pills are a form of hormonal contraception that contains two types of hormones: a synthetic estrogen, typically ethinyl estradiol, and a progestin. These pills work together to prevent pregnancy through several mechanisms:
- Preventing Ovulation: The consistent dose of hormones suppresses the surge of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are necessary to trigger ovulation (the release of an egg from the ovary).
- Thickening Cervical Mucus: The progestin component thickens the mucus in the cervix, creating a barrier that makes it more difficult for sperm to travel into the uterus and reach an egg.
- Thinning the Uterine Lining: The hormones also thin the endometrium, the lining of the uterus, making it less receptive to a fertilized egg if one were to implant.
For many years, birth control pills contained high doses of estrogen (up to 150 mcg), which were associated with significant side effects. Over time, doses were reduced to minimize these risks while maintaining effectiveness. Pills with a 35 mcg estrogen dose are now considered a 'regular' dose, situated between older high-dose pills and modern low-dose (20 mcg) and ultra-low-dose options.
Monophasic vs. Multiphasic Pills with 35 mcg Estrogen
Combined oral contraceptives are available in different formats, primarily classified as monophasic or multiphasic, which affects the hormone distribution throughout the cycle.
Monophasic 35 mcg Pills
These pills deliver the same amount of estrogen ($35 ext{ mcg of ethinyl estradiol}$) and progestin in each active pill. This consistent hormone level can lead to predictable, regular periods. Examples include:
- Ortho-Novum 1/35 (and generics like Norethindrone and Ethinyl Estradiol 1/35)
- Necon 1/35
- Sprintec (and generics like Norgestimate and Ethinyl Estradiol 0.25/35)
- Zovia 1/35E
Multiphasic (Triphasic) 35 mcg Pills
Multiphasic pills vary the dose of one or both hormones during the 21 days of active pills to more closely mimic the natural hormonal cycle. This approach was originally intended to reduce side effects but evidence has shown limited benefit over monophasic pills. An example is Ortho Tri-Cyclen, where the ethinyl estradiol dose remains at 35 mcg, but the progestin dose changes weekly.
Specific Brands of Birth Control with 35 mcg Estrogen
Several birth control pills currently on the market contain $35 ext{ mcg of ethinyl estradiol}$. These differ primarily in the type and dose of the progestin they contain.
- Norethindrone-based: Alyacen 1/35, Cyclafem 1/35, Dasetta 1/35, Necon 1/35, Nortrel 1/35, and Pirmella 1/35 are all examples of monophasic pills that pair norethindrone with 35 mcg of ethinyl estradiol.
- Norgestimate-based: Monophasic pills like Ortho-Cyclen, Previfem, and Sprintec utilize norgestimate in combination with 35 mcg of ethinyl estradiol.
- Desogestrel-based: Ortho-Cept is an example of a monophasic pill containing desogestrel and $35 ext{ mcg of ethinyl estradiol}$.
Benefits and Considerations of 35 mcg Estrogen Pills
Birth control pills with 35 mcg of estrogen are a viable option for many women, but like all medications, they come with a balance of benefits and potential side effects.
Potential Benefits
- Cycle Regulation: Helps to regulate menstrual cycles, making periods more predictable.
- Reduced Menstrual Symptoms: Often leads to lighter, shorter, and less painful periods, which can be beneficial for women with heavy or painful menstrual bleeding.
- Reduced Acne: Some formulations are effective at managing and reducing acne.
- Lowered Cancer Risk: Studies show that long-term use of combined oral contraceptives can lower the risk of ovarian and endometrial cancers.
Potential Considerations
- Breakthrough Bleeding: While 35 mcg pills offer more estrogen than low-dose options, some women may still experience spotting or bleeding between periods, particularly during the first few months.
- Side Effects: Common side effects can include nausea, headaches, breast tenderness, bloating, and mood changes.
- Serious Risks: The estrogen component can increase the risk of serious side effects like blood clots, heart attack, and stroke, especially for women who smoke and are over 35 years old.
- Progestin Variations: The different progestins used with 35 mcg of estrogen can have varying effects on individuals. A healthcare provider can help determine the best combination for specific needs.
Comparison of 35 mcg Estrogen Birth Control Pills
| Pill (Generic) | Progestin Type | Estrogen Dose | Phasic Type | Notes |
|---|---|---|---|---|
| Ortho-Novum 1/35 | Norethindrone | $35 ext{ mcg}$ | Monophasic | Regulates periods, reliable dose |
| Sprintec | Norgestimate | $35 ext{ mcg}$ | Monophasic | Can help with acne, widely available |
| Ortho-Cyclen | Norgestimate | $35 ext{ mcg}$ | Monophasic | Consistent hormone levels |
| Ortho Tri-Cyclen | Norgestimate | $35 ext{ mcg}$ | Triphasic | Progestin dose increases weekly |
| Necon 1/35 | Norethindrone | $35 ext{ mcg}$ | Monophasic | Generic option, consistent dose |
| Zovia 1/35E | Ethynodiol diacetate | $35 ext{ mcg}$ | Monophasic | Combination of two hormones |
Conclusion
Pills containing 35 mcg of ethinyl estradiol represent a standard dosage for combined oral contraceptives, offering an effective method of pregnancy prevention and other health benefits like regulated cycles and reduced acne. Multiple brands are available, distinguished primarily by their progestin component, and come in both monophasic and multiphasic formats. While generally safe, these pills carry potential side effects and risks, which necessitate a thorough discussion with a healthcare provider. Choosing the right birth control depends on individual medical history, lifestyle, and how one's body responds to hormones. For further information and a detailed guide on oral contraceptives, you can consult sources like the Cleveland Clinic.
