How we select a pill for you to start on, and how we select the pill you should continue on is a very complicated topic. Choosing the right pill for you, however, has certain key elements. Typically women think of the pill for contraception, but it’s an excellent strategy to ward off many problems.
1. Contraceptive protection is quickly established and very effective. Virtually all oral contraceptives have been thought to have identical effectiveness. If you take the pills faithfully, ovulation is suppressed, and failure rates are quite rare. Based on published data, about 2-3 women out of a hundred taking the pill for a year will become pregnant. Pills from the 70s and 80s that have published rates of only 1 person in a hundred getting pregnant is based on old studies. We have had a bit of pregnancy rate drift in the past few years, and women today have higher pregnancy rates than we used to in the past (obesity?). So, in truth gynos don’t assign pills based on effectiveness, they will all work for you!
2. Pills are very safe, and lower dosages are even safer. Since the 1970s safety has driven most of the dosing and type of hormone changes in the pill, and safety is always the first concern. Again, all birth control pills are extraordinarily safe and few women cannot take OCs. But safety is enhanced by selecting the lower doses. There are medical conditions that your gyno will have to consider when offering you a pill: hypertension, diabetes, migraines and blood clotting disorders are the most important considerations when selecting the type and dosage of birth control pill.
3. Health benefits are a very important consideration. Non-contraceptive benefits should now drive many birth control pill decisions for you and your gyno. One of the first concerns is cycle control, and control of menstrual cramps. Another important concern is PCOS effects. Another important concern is prevention of gynecologic cancers and ovarian cysts. Prevention and treatment of endometriosis. Are you suffering from PMS, acne or heavy bleeding? Hair loss and unwanted hair growth from PCOS can be protected against by being on oral contraceptive pills.These medical concerns can be addressed by selecting the right pill for you. However it has to be the right pill. ‘Mini” pills, also called progesterone only pills, will not protect against acne or hirsuitism.
4. Fertility preservation including STD protection. Prevention of tubal infection (also called salpingitis) both helps prevents tubal pregnancy and helps you to be more fertile. Likely you will get fewer fibroids.
5. Health concerns you and your gyno may want to discuss. A new concern is one for bone health, as we have had lower dosages of the pill, we may need to think in terms of slightly higher doses for some young teens as they are accruing bone mass. Side effects are our second concern. If you don’t like the pills you are taking you won’t stay on them, and you may be at risk for unplanned pregnancy. Side effects can also be managed, and pill switching is sometimes necessary.
Call for an appointment if you want to discuss! 217-356-3736