Combination birth control pills contain two hormones, estrogen and progestin, that work together to prevent pregnancy. There is only one kind of estrogen (ethinyl estradiol) used in all hormonal birth control methods, although the amount of estrogen ranges across the brands. The biggest factor that differentiates the various birth control brands is the kind of progestin. It is hard to compare the effects of progestin across birth controls, because between two with the same amount of progestin the potency can vary greatly due to the kind of progestin.

Combination Birth Control Pills: Progestin

There are eight kinds of progestin. Within each category of progestin there are many brands, often with options of monophasic and multiphasic.

• Monophasic pills contain a consistent level of hormones in all the active pills and as a result are less likely to cause side effects from the fluctuating hormones.
• Multiphasic pills contain differing doses of hormones in the active pills, which are further differentiated by biphasic and triphasic. Multiphasic pills are thought emulate the body’s natural menstrual cycle and contain fewer hormones when the doses are averaged over the course of a cycle.

Benefits and risks differ between progestin types and even between brands utilizing the same kind of progestin.

Progestin is a synthetic form of progesterone, which is something a woman’s body naturally creates. Due to the synthetic (man-made) nature of progestin, the various kinds of progestin have been introduced and Food and Drug Administration approved at different times and, thus, fall into different “generations.” The generation refers to how long it has been on the market, first generation having been available the longest and so on. There is research indicating that newer third and fourth generations of progestin carry more risk of blood clots than the previous. There are more details on that claim below, but for the best information you should do research and consult with your healthcare provider.

For more in-depth information on which type of progestin and corresponding brand might work for you, see below. Hormones affect all women differently, so these general guidelines may not apply to every woman.

Progestin Types & Pills

Desogestrel
Monophasic: Apri, Desogen, Kariva, Mircette, Ortho-Cept, Reclipsen, Solia
Multiphasic: Cesia, Cyclessa, Velivet
Non-pill Methods: NuvaRing, Implanon

Drospirenone
Monophasic: Ocella, Yasmin, Yaz, Beyaz
Multiphasic: Gianvi

Ethynodiol Diacetate
Monophasic: Demulen, Zovia

Levonorgestrel
Emergency Contraceptives: Plan B, Plan B One Step, Next Choice
Monophasic: Alesse, Aviane, Lessina, Levlen, Levora, Lutera, Lybrel, Nordette, Portia, Sronyx
Multiphasic: Enpresse, Levlite, Tri-Levlen, Triphasil, Trivora
Extended Cycle Pills: Jolessa, LoSeasonique, Quasense, Seasonale, Seasonique
Non-pill Methods: Mirena (IUD)

Norethindrone
Mini Pill: Aygestin, Camila, Errin, Jolivette, Nor-QD, Nora-Be, Ortho Micronor
Monophasic: Aranelle, Balziva, Femcon Fe, Jenest-28, Junel 1.5/30, Junel Fe 1/20, Microgestin, Modicon, Necon, Ortho-Novum, Ovcon 35, Tilia FE, Zenchent
Multiphasic: Nortel, Tri-Norinyl, Tri-Legest Fe

Norethindrone Acetate
Monophasic: Loestrin 1/20 Fe, Loestrin 1.5/30
Multiphasic: Estrostep Fe

Norgestimate
Monophasic: Mononessa, Ortho Cyclen, Previfem, Sprintec
Multiphasic: Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Tri-Previfem, Tri-Sprintec, Trinessa
Non-pill Methods: Ortho Evra (the Patch)

Norgestrel
Mini Pill: Orvette
Monophasic: Cryselle 28, Low-Ogestrel, Ogestrel, Ovral, Lo/Ovral