Most combination pills have an estrogen and a progesterone derivative.
Two of the most common ‘mini pill’ or those with just progesterone has been those containing only 35 micrograms of norethindrone.
Mini pills are for people who cannot take estrogen, are breastfeeding, or just want to avoid taking estrogen.
There now is a mini pill with just drospirenone, a relatively newer contraception hormone that is a bit more likely to be anti-androgen (anti-male hormone). It has been used for PMS and water retention, as well as being less likely to cause weight gain.
How we select a which for you to start on, and how we select the pill you should continue on is a very complicated topic, but here are some concepts to discuss with your gyno about whether a mini pill is best for you.
Contraceptive protection is quickly established and very effective. Virtually all oral contraceptives have been thought to have identical effectiveness. Combination pills are more effective than progesterone only pills.
Pills are very safe, and lower dosages are even safer. There are medical conditions that your gyno will have to consider when offering you a pill: hypertension, diabetes, migraines, urinary tract infections, sexual function, and blood clotting disorders are the most important considerations when selecting the type and dosage of birth control pill.
Health benefits aside from the obvious control of getting pregnant on the pill are a very important consideration. Non-contraceptive benefits should now drive some 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 with northethindrone, will not reliably protect against acne or hirsutism, but the newest mini pill with drospirenone (Slynd brand name) are anti-androgenic and can be helpful with these condintions.
Fertility preservation including STD protection. Prevention of tubal infection (also called salpingitis) both helps prevents tubal pregnancy and helps you to be more fertile.
It is rare for women on combination pills to have breakthrough bleeding, but about 50% of women on progesterone only pills will have break through bleeding.
There are more drug interactions with other medications with the use of pills like Slynd which has drospirenone vs pills with only norethindrone like Camila, so that is something to work closely with your gynecologist on.
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