Choosing the Right Birth Control Pill

The birth control pill is a reliable and convenient contraceptive choice. The decision to go on the pill or minipill is often an easy one for women, but choosing a pill can be confusing. Below, we share information that will help you make the right choice.

Combination pill vs. minipill

There are two categories of birth control pills: the combination pill (also called the pill) and the progestin-only pill (also called the minipill).

Combination Pills

Combination pills contain synthetic estrogen and progestin. Most types of combination pills include a mixture of active pills (contain hormones) and inactive pills (placebos). Some allow your period to occur every month, some four times a year, and some stop bleeding entirely. Your period occurs during the week you take the inactive pills. You can choose to skip the inactive pills if you want to skip your period.

In addition, some combination pills contain the same amount of estrogen and progestin in each active pill while others change the amount once or multiple times per pack. There are also low-dose options, which are good if you're sensitive to estrogen.


The minipill only contains synthetic progestin, and all the pills are active. Unlike the combination pill, you can't choose to skip your period on the minipill, though it may be irregular.

The minipill is the only birth control pill option for women who can't take synthetic estrogen.

How birth control pills work

Before you choose between the combination pill and the minipill, first learn how they work.

Combination pills prevent pregnancy by:

  • Stopping ovulation
  • Thickening cervical mucus to stop sperm from meeting an egg
  • Thinning the lining of the uterus, which prevents implantation of an embryo

Combination pills only have a 0.3 percent failure rate when taken every day.

The minipill sometimes stops ovulation, but it mainly prevents pregnancy by:

  • Thickening cervical mucus to stop sperm from meeting an egg
  • Thinning the lining of the uterus to prevent implantation of an embryo

It also has only a 0.3 percent failure rate when taken as directed. You must take the minipill around the same time every day for it to work.


Working with your healthcare provider

Before writing your prescription, your healthcare provider will need to know your medical history. It's important to provide this information because birth control pills can affect some pre-existing conditions and interact with medications. Your healthcare provider will use this information to help you choose the right pill for you.

Find an OBGYN near you who can help with birth control and a variety of other women's health needs throughout your life.


​Dr. Young is a member of the American Medical Association and the American College of Obstetrics and Gynecology and is committed to staying up to date on the newest research and practicing evidence-based medicine.