Definition: Combination pills are oral contraceptives that combine natural or synthetic estrogens and progestins, similar to the natural sex hormones (estrogen and progesterone) produced in a woman's body.
Also Known As: The pill; Combo Pills
Types of Combination Pills:
Combination birth control pills are categorized as monophasic, biphasic, or triphasic depending on whether the level of hormones stays the same during the first three weeks of the menstrual cycle or if it changes.Pack Size: Combo pills come in a one month supply. Combination pills are available in either 28-day or 21-day packs. Both versions have 21 active pills; these are the pills that include the hormones that prevent a woman from becoming pregnant.
28-Day Packs: In this type of pack, the last seven pills are known as reminder pills. They do not contain any hormones. These pills are taken during the fourth week, and their purpose is to help the woman maintain her routine of taking a pill everyday. Therefore, a woman will take a pill each day the 4 week cycle.
21-Day Packs:In this type of pack, the pills are taken for the first three weeks, and a woman takes nothing during the fourth week. She will start a new pack of pills eight days after the previous pack is completed.
24-Day Packs: There are two new combination pills, also available by prescription, that have 24 active days and only four placebo pills. These include:
- Yaz 28: the dosage regimen of YAZ is unique in that it contains 24 days of active therapy, followed by 4 days of placebo. This option may offer patients fewer hormone fluctuations than the traditional 21 days of active pills per 28 day cycle
- Loestrin 24 Fe: approved by the FDA in February 2006, was the first 24-day oral contraceptive approved in the US
Extended Cycle Pills:
- Seasonale, a new 'continuous dosage' product of ethinyl estradiol/levonorgestrel, can be taken continuously for 84 days and was FDA approved for routine contraception in September 2003. This regimen allows women to have less menstrual periods per year. This pill pack has have 77 active pills and 7 placebo pills
- Seasonique, is another continuous dosage contraceptive pill and was approved by the FDA in May 2006. Seasonique is similar to Seasonale in that ethinyl estradiol/levonorgestrel is taken continuously for 77 days; however, with Seasonique, the lfinal 7 days of the 3 month cycle contain low-dose ethinyl estradiol rather than placebo tablets
- In May 2007, the FDA gave approval for Lybrel, a low-dose continuous (taken all 365 days of the year) birth control pill meant to stop to a woman's monthly period
Women can check the package insert to find out exactly which hormones are present and at what dosages throughout the cycle.
Menstruation: A woman will usually have her period during the fourth week. The hormones contained in the active pills prevent pregnancy throughout the month, so even during the fourth week (regardless to whether she is taking reminder pills or no pills at all), a woman is protected against becoming pregnant. This does not apply to those on extended cycle pills.
How They Work:
They thicken the cervical mucus (the substance at the opening of the uterus) which makes it harder for sperm to reach and fertilize the egg. Combination pills also prevent a woman's body from ovulating during her monthly menstrual cycle.Progestin Hormones : All combination pills contain estrogen (typically: Ethinyl Estradiol). Additionally, there are typically 8 different types of progestin hormones found in these pills that mimic the natural hormone of progesterone. These include:
A Warning About Yasmin and Yaz 28: Unlike other combined pills, these 2 brands contain the progestin drospirenone which may increase potassium levels that could cause serious heart and other problems. These may not be the right method for you if you have ever had kidney, liver, or adrenal gland disease.Low Dose Combination Pills: Ethinyl estradiol is the type of synthetic estrogen found in oral contraceptives. The higher the number of micrograms of ethinyl estradiol leads to more potent effects of estrogen.
Low Dose Combination Pills:
These pills contain the lowest amount of estrogen (20 mcg ) plus one of the types of progestin. Brand names of this type of pill include:Regular Dose Combination Pills:
These pills contain 30–35 mcg estrogen plus one of the types of progestin. Brand names of this type of pill include:- Brevicon
- Demulen 1/35
- Desogen
- Femcon Fe
- Levlen
- Lo/Ovral
- Modicon
- Nordette
- Levora
- Loestrin
- Low-Ogestrel
- Necon 1/35
- Norinyl 1/35
- Ortho-Cept
- Ortho-Cyclen
- Ortho-Novum 1/35
- Ortho-Tri-Cyclen Lo
- Ovcon 35
- Seasona
- Yasmin
- Zovia 1/35E
Phasic Combination Pills:
These pills have changing levels of estrogen and progestin to more closely mimic the hormonal phases during a woman’s menstrual cycle. Brand names of this type of pill include:- Ortho-Tri-Cyclen Lo
- Jenest-28
- Ortho-Tri-Cyclen
- Cyclessa
- Triphasil
- Tri-Levlen
- Ortho-Novum 10/11
- Trivora
- Tri-Norinyl
- Estrostep Fe
- Ortho-Novum 7/7/7
