Low-dose birth control: Effectiveness, risks, and side effects

For some people, low-dose pills may cause fewer side effects and offer more health benefits than higher-dose pills. Some low-dose pills contain both estrogen and progestin, while others contain only progestin.

In this article, learn about the oral types of low-dose birth control. We also cover the risks and side effects of this type of medication.

Types

Most birth control pills contain a combination of estrogen and progestin.

Progestin is a synthetic form of the natural hormone progesterone. Together, the two hormones regulate the menstrual cycle and prevent pregnancy.

Low-dose birth control pills come in two forms. Combination pills use both estrogen and progestin, but provide lower doses of estrogen than traditional pills. Progestin-only pills only contain synthetic progesterone.

Combination low-dose birth control

Combination pills contain 10–35 micrograms (mcg) of estrogen, while higher-dose pills contain 50 mcg or more.

Doctors rarely prescribe high-dose combination pills because the low-dose pills work just as well and cause fewer side effects. Numerous brands and generic forms of combination pills are available.

Some combination pill brand names include:

• Ortho-Novum
• Yaz
• Yasmin
• Aviane
• Apri
• Levlen

People usually take 21 active pills followed by either a 7-day break or 7 pills without hormones. They will usually get their period during the week without hormones.

Low-dose birth control may be a better option for people who experience intolerable side effects from high doses of estrogen.

Low-dose birth control also offers some health benefits, including:

• a more regular menstrual cycle
• reduced symptoms of endometriosis
• milder symptoms of perimenopause
• lower risk of some cancers, including ovarian cancer
• reduced risk of ovarian cysts
• smaller chance of ectopic pregnancy

The minipill can also be beneficial for people who cannot take traditional pills containing estrogen.

Risks

Low-dose combination birth control should be just as effective as birth control containing higher estrogen levels.

It is essential to take birth control pills at the same time each day and not miss a dose. Failing to take the pills at the same time can increase the risk of pregnancy. This risk is higher with minipills.

Low-dose birth control poses fewer health risks than birth control that uses high levels of estrogen. This is because high doses of estrogen are more likely to cause side effects.

Estrogen slightly increases the risk of heart health issues and may raise blood pressure. Very rarely, it can cause a blood clot to form in a vein, usually in the leg, which is called deep vein thrombosis (DVT).

The blood clot can break loose and travel to other areas of the body, potentially causing a life-threatening embolism.

The risk of estrogen-related cardiovascular health problems is higher in people who:

• smoke
• are over the age of 35
• have a family history of blood clots
• have been diagnosed with heart disease
• have other risk factors for heart disease, such as obesity or high blood pressure

People who use low-dose birth control are less likely than those using high-estrogen pills to experience heart health issues.

The long-term use of hormonal birth control may slightly increase a person’s risk of certain cancers, including breast and cervical.

However, some research shows that the risk of cervical cancer in people who use birth control drops after 10 years of use. It is also worth noting that the risk of ovarian cancer is lower in people who have used birth control.

Some other risks of low-dose birth control include:

• insulin resistance
• depression
• weight gain
• cholestasis and some other forms of liver disease

The risk of developing these issues depends on many factors, including lifestyle and family medical history. So it is important to discuss the risks and benefits of oral contraceptives with a healthcare provider.

Side effects are common with all hormonal birth control pills, although some people report fewer side effects with progestin-only pills.

The most common side effects include:

• changes in sleep
• headaches
• nausea
• vomiting
• diarrhea
• bleeding between periods, especially initially
• sore breasts
• changes in libido

Many people find that the side effects disappear after a few months as the body adjusts to the new hormones.

When to switch birth control methods

Finding the right form of birth control is a process of trial and error. Many people find that hormonal birth control reduces the pain of period cramps and regulates the menstrual cycle.

However, it is common to have to try several different types or brands of pill before finding one with manageable side effects. Some people find that they are not able to tolerate hormonal birth control in any form.

Many non-hormonal options are available, including the copper intrauterine device (IUD), condoms, a diaphragm, and spermicidal lubricants. If people are interested in permanent contraception, they can discuss surgical options with a doctor.

People can also speak to a doctor about switching birth control types whenever the side effects feel intolerable, or the risks seem too large.

Switching birth control type might be beneficial for people who are:

• continuing to experience side effects that are no better after 2–3 months
• having side effects that are unbearable or interfere with daily functioning
• living with a medical condition, such as lupus, liver disease, or cardiovascular disease, that may worsen the side effects of birth control
• smoking while using hormonal birth control
• having migraines while using birth control, especially those with aura

Takeaway

Numerous safe and effective options can prevent pregnancy. Hormonal contraceptives are about 91 percent effective with typical use, which is imperfect. With perfect use, they are more than 99 percent effective.

People who want to avoid pregnancy may wish to consider adding a backup method of contraception, such as condoms.

The most suitable birth control method may vary as a person ages or experiences changes to their health or hormonal levels. Monitoring side effects is especially vital for people who use birth control for reasons other than preventing pregnancy.

It is best to talk to a doctor about all birth control options. It is essential to be clear about any side effects and to raise any queries or concerns.

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