Oral contraceptive pills, commonly known as "birth control pills" or "the pill," are hormonal medications taken daily to prevent pregnancy. There are two main types: combination pills containing both estrogen and progestin, and progestin-only pills (also called mini-pills). Combination pills are the most commonly prescribed and come in various formulations with different types and doses of hormones. When taken consistently and correctly, oral contraceptives are over 99% effective at preventing pregnancy, though typical use effectiveness is around 91% due to missed pills and other factors.

The primary mechanism of action of combination oral contraceptives involves suppression of ovulation by inhibiting the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. Additionally, these pills thicken cervical mucus to impede sperm penetration and thin the endometrial lining, making implantation less likely. Progestin-only pills primarily work by thickening cervical mucus and thinning the endometrium, with inconsistent ovulation suppression. The hormones in birth control pills are synthetic versions of naturally occurring estrogen and progesterone.

Beyond contraception, oral contraceptive pills offer numerous non-contraceptive health benefits. These include regulation of menstrual cycles, reduction in menstrual flow and cramping, decreased risk of ovarian and endometrial cancers, improvement in acne, reduction in symptoms of polycystic ovary syndrome (PCOS), and decreased risk of pelvic inflammatory disease. Some formulations are specifically FDA-approved for treating conditions such as acne, premenstrual dysphoric disorder (PMDD), or heavy menstrual bleeding.

The choice of oral contraceptive should be individualized based on patient factors including age, medical history, other medications, and personal preferences. Most women can safely use combination oral contraceptives, but certain conditions such as history of blood clots, stroke, heart disease, liver disease, or certain cancers may contraindicate their use. Progestin-only pills may be preferred for women who cannot take estrogen. Common side effects include nausea, breast tenderness, mood changes, and irregular bleeding, though these often improve within the first few months of use. Our thorough evaluation and ongoing monitoring ensure safe and effective use of oral contraceptives.