Most hormonal birth control is categorized into two main types: combination pills, which contain both estrogen and a progestin, and progestin-only pills, also known as "minipills". Therefore, any birth control pill that is not a minipill contains estrogen, most commonly in the form of ethinyl estradiol.
How Combination Birth Control Pills Work
Combination birth control pills use a synthetic version of estrogen (ethinyl estradiol) and a synthetic progestin to prevent pregnancy through several mechanisms:
- Inhibiting ovulation: The hormones suppress the brain's signals to the ovaries, preventing the release of an egg each month.
- Thickening cervical mucus: The presence of hormones makes the mucus in the cervix thicker and stickier, creating a barrier that makes it difficult for sperm to reach the egg.
- Thinning the uterine lining: The hormones cause the lining of the uterus to become thinner, making it difficult for a fertilized egg to implant.
These combined effects make combination pills highly effective when taken correctly.
Types of Combination Birth Control Pills
Combination pills are further classified based on the dosage of hormones they deliver throughout the cycle. Your healthcare provider can help you determine the best option based on your needs and health history.
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Monophasic Pills: These pills contain the same fixed amount of estrogen and progestin in each active pill of the pack. This provides a consistent hormone dose every day, which can sometimes lead to fewer side effects like mood changes.
- Examples of monophasic pills include Sprintec, Lutera, and Yaz.
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Multiphasic Pills: These pills have varying amounts of estrogen and/or progestin throughout the active pills in the pack, designed to mimic the body's natural hormonal cycle. There are several types:
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Biphasic: The dose changes once during the cycle.
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Triphasic: The dose changes three times during the cycle.
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Quadriphasic: The dose changes four times during the cycle.
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Examples of multiphasic pills include Ortho Tri-Cyclen Lo and Cyclessa.
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Extended or Continuous Cycle Pills: These regimens contain more active pills and fewer, or no, placebo pills, allowing users to have fewer or no periods throughout the year. While safe and effective, they may be associated with more breakthrough bleeding initially.
- Examples include Seasonale and Amethyst.
Estrogen Content and Dosage Levels
Modern combination birth control pills contain significantly lower doses of estrogen compared to earlier formulations, which has led to a reduction in side effects. The typical estrogen component is ethinyl estradiol, and dosages generally fall into a few categories:
- Low-Dose Pills: Contain 20 micrograms of ethinyl estradiol. Examples include Lo Loestrin Fe and Alesse.
- Regular-Dose Pills: Contain 30-35 micrograms of ethinyl estradiol. Many standard combination pills fall into this category.
- High-Dose Pills: Contain 50 micrograms or more, and are less common today.
Combination Pill Comparison
| Feature | Monophasic | Multiphasic | Extended/Continuous Cycle |
|---|---|---|---|
| Hormone Dosage | Consistent dose of estrogen and progestin throughout all active pills. | Varying doses of estrogen and/or progestin over the cycle. | More active pills and fewer or no placebo pills. |
| Period Frequency | Monthly withdrawal bleed during placebo week. | Monthly withdrawal bleed, designed to mimic natural cycle. | Reduces or eliminates periods, such as having only four periods per year. |
| Potential Side Effects | May offer more stable hormone levels and fewer mood swings. | Could cause side effects from fluctuating hormones, such as mood changes. | May cause initial breakthrough bleeding, which often subsides. |
| Benefit | Simplicity and consistency in dosing. | More closely mimics natural hormonal patterns. | Convenience of fewer periods and may alleviate related symptoms. |
Potential Side Effects and Benefits of Estrogen-Containing Pills
Estrogen-containing pills offer numerous benefits beyond contraception, but also carry potential side effects and risks.
Benefits
- More predictable periods: Regulates irregular cycles.
- Lighter, shorter, or less painful periods: Can help manage heavy or painful menstrual bleeding and related anemia.
- Reduced PMS symptoms: Helps minimize premenstrual syndrome and premenstrual dysphoric disorder.
- Clearer skin: Often improves acne and reduces unwanted hair growth by balancing hormones.
- Lowered cancer risk: Reduces the risk of ovarian, uterine, and colorectal cancers.
Side Effects
- Physical: Common but usually temporary side effects include nausea, headaches, bloating, breast tenderness, and spotting between periods.
- Cardiovascular risks: Rare but serious risks include an increased risk of blood clots, stroke, and heart attack, especially in smokers over 35.
- Mental/Emotional: Some individuals report mood swings or changes in libido.
Conclusion
When asking which birth control pill has estrogen in it?, the answer is all "combination" pills. These pills combine estrogen with a progestin and are available in several forms, including monophasic, multiphasic, and extended-cycle varieties, each with different dosing schedules and benefits. For those who need or prefer to avoid estrogen due to health risks or side effects, progestin-only pills offer an alternative. The right choice of birth control is a personal decision that should be made in consultation with a healthcare provider who can assess your medical history and specific needs.
For More Information
- CDC - Combined Hormonal Contraceptives: https://www.cdc.gov/contraception/hcp/usspr/combined-hormonal-contraceptives.html
