Oral Contraceptives: Benefits, Side Effects, and How They Work

Introduction: Key Points About Oral Contraceptives

Oral contraceptives, commonly referred to as birth control pills, are medications designed to prevent pregnancy. These pills contain hormones that regulate the menstrual cycle and inhibit ovulation. In addition to contraception, they may be prescribed to address conditions such as acne, irregular periods, and hormonal imbalances. When taken as directed, oral contraceptives are generally safe and highly effective. If you have any questions about starting or switching birth control, our healthcare providers are available for telemedicine consultations.

Medications in the Oral Contraceptive Drug Class

Below is a list of commonly prescribed oral contraceptives, including both brand names and their generic equivalents:

1. Alesse (Levonorgestrel and Ethinyl Estradiol)
2. Aviane (Levonorgestrel and Ethinyl Estradiol)
3. Beyaz (Drospirenone and Ethinyl Estradiol)
4. Cryselle (Levonorgestrel and Ethinyl Estradiol)
5. Desogen (Desogestrel and Ethinyl Estradiol)
6. Diane-35 (Cyproterone and Ethinyl Estradiol)
7. Drospirenone and Ethinyl Estradiol (Yasmin)
8. Estrostep Fe (Norethindrone and Ethinyl Estradiol)
9. Femcon Fe (Norethindrone and Ethinyl Estradiol)
10. Junel Fe (Levonorgestrel and Ethinyl Estradiol)
11. Loestrin Fe (Norethindrone and Ethinyl Estradiol)
12. Lutera (Levonorgestrel and Ethinyl Estradiol)
13. Microgestin Fe (Norethindrone and Ethinyl Estradiol)
14. Mircette (Desogestrel and Ethinyl Estradiol)
15. NuvaRing (Etonogestrel and Ethinyl Estradiol)
16. Ortho-Cyclen (Norgestimate and Ethinyl Estradiol)
17. Ortho Tri-Cyclen (Norgestimate and Ethinyl Estradiol)
18. Seasonale (Levonorgestrel and Ethinyl Estradiol)
19. Sprintec (Norgestimate and Ethinyl Estradiol)
20. Syeda (Levonorgestrel and Ethinyl Estradiol)
21. TriNessa (Norgestimate and Ethinyl Estradiol)
22. Yasmin (Drospirenone and Ethinyl Estradiol)
23. Yaz (Drospirenone and Ethinyl Estradiol)

The generic name refers to the active ingredients in the medication, while the brand name is the name given by the manufacturer. The generic name is listed in parentheses.

How Oral Contraceptives Work

Oral contraceptives primarily work by preventing ovulation, which means they stop the ovaries from releasing an egg each month. These pills contain synthetic versions of estrogen and progestin (or just progestin in some cases). In addition to preventing ovulation, these hormones thicken cervical mucus, making it more difficult for sperm to reach the egg, and thin the uterine lining, reducing the chances of a fertilized egg implanting.

There are two main types of oral contraceptives: combination pills, which contain both estrogen and progestin, and progestin-only pills. Combination pills, such as Alesse and Yasmin, are the most commonly prescribed. Progestin-only pills, often called the “mini-pill,” are recommended for women who cannot take estrogen due to conditions like high blood pressure or a history of blood clots.

Benefits of Oral Contraceptives

When taken correctly, oral contraceptives are over 99% effective at preventing pregnancy. Beyond contraception, they offer several additional benefits, such as regulating menstrual cycles, reducing menstrual cramps, and improving acne. Many women also use them to manage conditions like polycystic ovary syndrome (PCOS) or endometriosis. Oral contraceptives are often favored over other forms of hormonal birth control because they are easy to use, reversible, and provide health benefits beyond pregnancy prevention.

If you’re considering oral contraceptives or are unsure which type is best for you, our telemedicine providers are here to help. Schedule a consultation today to explore your options and make an informed decision.

Potential Side Effects of Oral Contraceptives

As with any medication, oral contraceptives can cause side effects. While many people tolerate birth control pills well, it’s important to be aware of potential side effects, especially if you’re new to this form of hormonal birth control. Below is a list of common and less common side effects, along with their estimated occurrence rates. If you experience any side effects, particularly severe ones, consult your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to discuss your symptoms and explore alternative options.

Common Side Effects (Occurring in >1% of Users)

1. Nausea: Affects approximately 10-30% of users, especially during the first few months. Taking the pill with food or at bedtime may help alleviate nausea.
2. Breast tenderness: Occurs in about 10-20% of users. This typically improves after the first few months of use.
3. Headaches: Reported by 10-15% of users. If you have a history of migraines, particularly with aura, your risk may be higher. Speak to your healthcare provider if headaches worsen or become severe.
4. Breakthrough bleeding or spotting: Affects 10-15% of users, especially during the first few cycles. This usually resolves as the body adjusts to the hormone levels.
5. Mood changes: Around 5-10% of users report mood swings or depressive symptoms. If you have a history of depression or anxiety, you may be at higher risk. Discuss any mood changes with your provider.
6. Weight changes: Some users (about 1-5%) may experience slight weight gain or loss, often due to fluid retention rather than fat gain.

Less Common Side Effects (Occurring in <1% of Users)

These side effects are less common but may still occur. If you experience any of the following, contact your healthcare provider:

1. Changes in libido
2. Skin changes (e.g., acne or darkening of the skin)
3. Vaginal discharge or dryness
4. Changes in contact lens tolerance
5. Blood pressure changes

Severe Side Effects

Although rare, oral contraceptives can cause serious side effects. These include:

1. Blood clots (Deep Vein Thrombosis or Pulmonary Embolism): The risk of blood clots is higher in women who smoke, are over 35, or have a history of clotting disorders. Symptoms include leg pain, swelling, shortness of breath, or chest pain. Seek immediate medical attention if you experience these symptoms.
2. Stroke or heart attack: This risk is higher in smokers, women over 35, and those with high blood pressure or a history of cardiovascular disease. Symptoms include sudden weakness, confusion, chest pain, or difficulty speaking.
3. Liver problems: In rare cases, oral contraceptives can cause liver tumors or jaundice (yellowing of the skin or eyes). If you notice these symptoms, contact your healthcare provider immediately.

If you experience any of these severe side effects, stop taking the medication and seek medical help right away. You can also schedule a telemedicine appointment with one of our providers to discuss your symptoms and next steps.

Drug to Drug Interactions with Oral Contraceptives

Oral contraceptives can interact with other medications, potentially reducing their effectiveness or increasing the risk of side effects. It’s essential to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some common drug interactions with birth control pills include:

Antibiotics (e.g., Rifampin): This medication may decrease the effectiveness of oral contraceptives, increasing the risk of unintended pregnancy.

Anticonvulsants (e.g., Phenytoin, Carbamazepine): These drugs can reduce the effectiveness of birth control pills by speeding up hormone metabolism.

HIV medications (e.g., Ritonavir): Certain HIV treatments may interfere with the effectiveness of oral contraceptives.

St. John’s Wort: This herbal supplement can reduce the effectiveness of birth control pills by accelerating hormone breakdown.

Antifungal medications (e.g., Griseofulvin): These medications may also reduce the effectiveness of oral contraceptives.

If you are taking any of these medications, it’s important to consult your healthcare provider about alternative contraception methods or adjustments to your current regimen. Our telemedicine providers are available to help you navigate these interactions and ensure your birth control remains effective.

Precautions and Contraindications for Oral Contraceptives

Oral contraceptives are not suitable for everyone. Certain medical conditions and lifestyle factors can increase the risks associated with these medications. Before starting birth control pills, it’s crucial to discuss your full medical history with your healthcare provider. Below are some key precautions and contraindications to consider:

Precautions When Using Birth Control Pills

Smoking: Women who smoke, particularly those over 35, are at a higher risk of serious cardiovascular side effects, such as blood clots, stroke, and heart attack. Smokers are strongly encouraged to consider alternative contraception methods.

High blood pressure: Oral contraceptives can raise blood pressure, so women with hypertension should be closely monitored while using them.

Migraines: If you experience migraines, especially with aura, you may be at an increased risk of stroke when using oral contraceptives. It’s important to discuss this with your provider before starting the pill.

Diabetes: Women with diabetes, particularly those with vascular complications, should use oral contraceptives cautiously, as they may increase the risk of cardiovascular problems.

Contraindications for Oral Contraceptives

Oral contraceptives should not be used by women with the following conditions:

1. A history of blood clots or clotting disorders
2. A history of stroke or heart attack
3. Uncontrolled high blood pressure
4. Severe liver disease or liver tumors
5. Known or suspected breast cancer or other hormone-sensitive cancers
6. Pregnancy

If you have any of these conditions, your healthcare provider can help you explore alternative birth control options. You can schedule a telemedicine consultation with one of our providers to discuss your options and ensure you choose the safest method for your health.

Conclusion: Making Informed Decisions About Oral Contraceptives

Oral contraceptives are a widely used and effective form of birth control, but like all medications, they come with potential side effects, drug interactions, and precautions. It’s important to be aware of these risks and consult with a healthcare provider before starting or changing your birth control method. Our telemedicine providers are available to guide you through the process, answer any questions, and help you make the best decision for your health and lifestyle.

If you are considering oral contraceptives or have concerns about your current birth control, don’t hesitate to schedule a telemedicine appointment with one of our providers today. We are here to support you in making informed decisions about your reproductive health.

James Kingsley

Learn More