Like jeans, birth control preference is not one size fits all (unless you happen to find yourself in Sisterhood of the Travelling Pants). Your friend’s current brand may just not work for you. That’s why it is important to be patient when first starting out on birth control; you may need to try out a few pills before you find your perfect match. Just like shopping for jeans, this may take some time. Contraceptive methods come in many forms, including the ring and the patch, but the most common is oral contraception—aka “the pill.”
Doctors typically suggest waiting 2-3 months after starting birth control to properly evaluate how your body has adjusted to the pill, but in this lead-up time you may experience a variety of symptoms including:
- Sore breasts
- Changes in your period
If you don’t feel back to your normal self after this trial period, talk to your doctor about trying a different brand or method of contraception. That being said, this transition period should not be a painful experience. If your symptoms are too disruptive during this trial period consult with your doctor immediately and come up with a new plan. Using a contraceptive product is supposed to solve problems, not create new ones. Birth control - like jeans - takes some time to adjust to, but you wouldn’t keep wearing stiff jeans after they’re supposed to be broken in, would you?
When first starting a new birth control pill, not all symptoms are quite as obvious. Many worry about the effects that the pill, and the changing hormones it induces, will have on their mood. One of the most commonly reported reasons for stopping birth control is dramatic changes in mood or an increase in depressive symptoms. While researchers have yet to find a direct link between the pill and general moodiness or induced depression, there is evidence that suggests some of the hormones birth control pills utilize can influence brain function . When looking at different pill options, keep an eye out for options that contain estradiol or estradiol valerate. Both of these hormones have recently been shown to reduce mood changes while on the pill.
It’s also important to mention that not all side effects of the pill are bad. Some are quite great, actually! The pill can:
- Prevent pregnancy (with 99% effectiveness if taken properly)
- Regulate menstruation (particularly useful for those with heavy/irregular periods)
- Decrease PMS symptoms
- Improve hormonal acne
- Help manage endometriosis
There are two main types of birth control pills: the combination pill and the mini pill. Both must be taken at the same time every day to be effective.
- Combination pill: contains estrogen and progestin
- The doses of each hormone vary amongst pill options. Those who are more sensitive to fluctuating hormones may want to look for a pill with a lower dose of estrogen; in the typical 10-35 microgram (μg) range look for a dosage closer to 10. If you’re worried about spotting and breakthrough bleeding you want to look for a pill at the top end of the estrogen range.
- Important to note: Most users who choose low-dose pills experience fewer side effects
- Pills typically come in monthly packs with 21 active pills and 7 inactive pills. This time period can be extended with an extended-cycle product. Bleeding will occur on days you take an inactive pill—this is known as withdrawal bleeding and occurs due to dropping hormone levels (which is also what causes a normal period).
- Mini pill: only contains progestin
- The progestin dose will be lower in these pills than in any combination pill.
- All pills are active, but you may still get your period on the mini pill. It is very normal for your period to be irregular when first starting with it, and for breakthrough bleeding and spotting to occur. The amount of bleeding varies greatly from person to person.
- The mini pill is ideal for candidates who have been advised by doctors to not use contraception containing estrogen, including those with high blood pressure, previous blood clots, those who are currently breastfeeding, or a smoker after age 35.
Within each category of pills, there are a variety of options available on the market. The key physiological difference between the two pills is that the combination pill prevents ovulation (when ovaries release the egg), but most mini pills do not. While combination pills have a wider room for error—if you take the pill every day it’s fairly effective—mini pills must be taken at roughly the same time every day for proven pregnancy prevention. Consider your schedule and if you will realistically be able to incorporate this routine before choosing a pill.
Obviously, the positives of the birth control pill you’re using must outweigh the negatives. We recommend tracking your symptoms throughout the trial period to get a better sense of how your body is responding to the pill until you find your perfect fit. And while you’re trying out different pills please remember almost half of women report going off the pill within a year citing intolerable side effects. So no, you’re not going crazy, you’re probably just on the wrong pill.
And, by the way, don’t settle on that uncomfortable pair of jeans either.