What’s the Best Birth Control Pill? How to Pick a Birth Control Brand That’s Right for You

Birth control pills are a common option for contraception. When taken properly, they can be very effective at preventing unplanned pregnancies in both teens and adults. There are many options available, which may make it difficult to choose a pill that’s right for you.

Here, we’ll discuss the different types of birth control pills available and the pros and cons of each. This way, you can decide which type or brand of birth control pills might be best for you. And if you decide the pill isn’t right for you, see this birth control guide, which includes information about other birth control methods.

How do birth control pills work?

The hormones used in birth control pills are estrogen and progestin. Estrogen and progestin do three things to prevent pregnancy:

• They prevent ovulation (egg release from the ovary).

• They form a thick plug of cervical mucus at the uterus opening, or the cervix, to prevent sperm from entering the uterus.

• They cause the lining of the uterus to thin out. This prevents a fertilized egg from properly implanting in the uterus.

Progestin alone can do all three functions on its own. But it doesn’t consistently stop ovulation. Adding estrogen improves ovulation prevention, making the pill more effective. 

But there are some things to be aware of with estrogen-containing pills:

• Depending on your health and medical history, estrogen may raise your risk for certain medical complications like stroke or blood clots.

• Medical professionals like to start with a low dose of estrogen because of these risks. But lower doses of estrogen can make breakthrough bleeding or spotting more likely.

EXPERT PICKS: WHAT TO READ NEXT

• Access to birth control pills: Did you know that in some places you don’t need to see a doctor to get the pill? Follow these steps to get birth control from your local pharmacist.

• Guide to birth control pills: Our experts have you covered on all things related to the pill. Learn about types, how they work, and side effects.

• Is it safe to delay your period while on hormonal birth control? Using the pill, patch, or ring can help you safely control when you get your period.

What are the different types of birth control pills?

There are two main types:

• Combination pills contain both estrogen and progestin.

• Progestin-only pills are also referred to as the “minipill.”

Let’s take a look at the pros and cons of each below. We’ve also included the lowest GoodRx price available for each type of pill at certain pharmacies. All pricing is for one pack of pills, unless otherwise specified.

Combination pills

Most birth control pills fall into this category. The dose of estrogen and progestin can change throughout the month/pack.

Monophasic pills 

These are the most common type of birth control pills. They provide a steady dose of hormones typically for 21 days, followed by 7 inactive (“placebo”) pills that don’t contain any hormones. These inactive pills are included to help you stay on track, so you know when to start your next pack. It’s common to experience bleeding similar to menstruation while taking them.

• Pros: Helps lighten or shorten the menstrual cycle and reduces cramps

• Cons: Can cause changes to menstrual cycles, missed periods, and breakthrough bleeding or spotting

• Examples: Aviane ($19.32), Junel Fe 1/20 ($10.68), Apri ($10.72)

Biphasic pills 

These come in packs containing three sets of pills at different doses, which you take in this order: You start with 21 active pills that contain both hormones. Next, you take 2 inactive pills. Finally, you take 5 pills that contain only estrogen. 

• Pros: Reduces the likelihood of menstrual changes and breakthrough bleeding

• Cons: Higher chance of side effects like headaches and bloating than monophasic pills

• Examples: Azurette ($14.30), Viorele ($31.73)

Triphasic pills 

These provide changing doses of estrogen and progestin throughout the month, similar to what the body does naturally. The most common pattern is 7 days of one strength, 7 days of another strength, 7 days of a third strength, and then 7 days of inactive pills.

• Pros: Very low chance of menstrual changes and breakthrough bleeding

• Cons: Most likely to cause side effects, like mood changes and headaches

• Examples: Tri-Previfem ($23.37), Necon 7/7/7 ($14.56)

Quadriphasic pills 

These contain four different strengths of hormones, also intended to mimic hormones throughout a cycle. Estrogen gradually decreases in strength throughout the month, and progestin increases.

• Pros: Side effects and breakthrough bleeding are least likely.

• Cons: Missed pills are very hard to correct, which means that women are more likely to get pregnant by accident if they miss a dose.

• Examples: There’s only one brand available, and it may not be an affordable option for everyone — Natazia. ($239.44)

Extended cycle pills 

These are designed to deliver hormones for 84 days so women only have 4 periods a year. They usually come as monophasic pills (a steady dose of hormones that doesn’t change) but there are a few biphasic options as well.

• Pros: Good option if you want fewer periods (for personal or health reasons) or want to adjust your periods for life events

• Cons: Greater likelihood of breakthrough bleeding or spotting

• Examples: Jolessa ($26.18), camrese ($29.14)

Continuous cycle pills

These are similar to extended cycle pills except there are no inactive pills at all.

• Pros: Virtually eliminates menstrual periods and reduces cramps

• Cons: Extremely likely to cause breakthrough bleeding or spotting. Plus, the lack of a period can also make it difficult to know if an unintended pregnancy has happened.

• Examples: There’s only one generic available — Amethyst. ($20.70)

Progestin-only pill

This is commonly referred to as the “minipill.” It provides a steady dose of progestin throughout the month. It doesn’t contain estrogen, most brands have no inactive pills, and you don’t take a break between packs. The exception is Slynd, a brand-name pill that has four inactive pills in a 28-day pack.

• Pros: This is the safest choice for smokers, especially smokers over the age of 35, women with a history of strokes or heart problems, and breastfeeding women.

• Cons: The minipill is generally unforgiving — you must take it at the exact same time every day. If you miss a dose by 3 hours or more, you’re very likely to have breakthrough bleeding, and there’s a risk of pregnancy. Slynd is the only minipill that has a 24-hour missed pill window. The minipill doesn’t have a generic version available yet, so affordability can be an issue.

• Examples: Camila ($21.77), Jencycla ($16.27), norethindrone ($9.00). Opill ($49.99 for 3 packs) is the first FDA-approved, over-the-counter pill. It’s also an example of a progestin-only pill.

How to choose the best birth control pill by name

In general, birth control pill brands can be a bit confusing if you don’t know what you’re looking for. But sometimes, their names offer clues. For example:

• Loestrin provides a lower amount of estrogen compared to many other brands.

• Tri-Previfem and Tri-Sprintec are triphasic pills.

• With Seasonale and Seasonique, women get only four periods a year (once every season).

• Junel 1/20 contains 1 mg progestin and 20 mcg estrogen.

• Necon 7/7/7 increases the strength of hormones every 7 days in a pack.

• The “Fe” in the name, such as with Junel Fe 24, means that the pill includes a small amount of iron (symbol Fe) in the inactive pills of the pack. This can help prevent temporary anemia in women who become iron-deficient during their menstrual period. 

What are the side effects of birth control pills?

Side effects from the pill are common, regardless of the type. Minipills are more likely to cause bleeding irregularities than combination pills, but otherwise they are pretty similar. Contrary to popular belief, birth control pills don’t usually cause weight gain.

The good news is side effects tend to improve or resolve after a few months of use. But if side effects remain a problem, speak with your healthcare team. They may recommend switching types or brands, or trying an alternative to the pill. Each person responds differently to hormones and different dosages, so a trial-and-error period may be necessary.

How do healthcare professionals decide which birth control pill to prescribe?

Before determining which birth control pill might be the best option for you, your prescriber will need to know your medical history. This is because estrogen may not be safe for everyone. So their recommendations can depend on:

• Your age

• What your menstrual cycle is like

• Other medical conditions like diabetes, hypertension, lupus, or migraines

• Any history of blood clots, or breast or uterine cancer

• Whether you’re breastfeeding or have any hormone-related issues, like acne or premenstrual dysphoric disorder (PMDD)

The best birth control pill for you is the one that will be the most effective with the least amount of risk based on your medical history.

Frequently asked questions

Why trust our experts?

Written by:

Andrea Kemp, MD, MPH

Dr. Kemp is an accomplished board-certified physician with over 25 years of clinical experience. She completed medical school and residency training in obstetrics and gynecology in Cincinnati, Ohio.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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