From the Guidelines
The best combination birth control is typically a combined hormonal contraceptive containing both estrogen and progestin, such as combined oral contraceptive pills (COCPs), the vaginal ring (NuvaRing), or the contraceptive patch (Xulane), which offer 91-99% effectiveness when used perfectly, as supported by the most recent study 1.
Key Considerations
- Combined hormonal contraceptives contain both estrogen and a progestin, and are available in various formulations, including COCPs, the transdermal contraceptive patch, and the vaginal contraceptive ring 1.
- These methods work by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining to prevent implantation.
- The effectiveness of combined hormonal contraceptives can be as high as 91-99% when used perfectly, with additional benefits like reduced menstrual pain, lighter periods, and improved acne.
Important Factors to Consider
- Individual needs, such as convenience, remembering daily pills, hormonal sensitivities, and medical history, should be taken into account when choosing a combination birth control method.
- Consulting with a healthcare provider is essential for finding the most suitable method, as they can help determine the best option based on a person's specific needs and health status.
- The American College of Rheumatology recommends discussing use of emergency contraception with all patients, including those with SLE or positive aPL, because risks of emergency contraception are low compared to those of unplanned pregnancy 1.
Special Considerations
- In fertile women with RMD who have neither SLE nor positive aPL, the American College of Rheumatology strongly recommends use of effective contraceptives, such as hormonal contraceptives or IUDs, over less effective options or no contraception 1.
- For patients with SLE, progestin-only or IUD contraceptives are recommended over combined estrogen-progestin contraception, especially in those with moderate or severe disease activity, including nephritis 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Combination oral contraceptives prevent pregnancy primarily by suppressing ovulation. Levonorgestrel and ethinyl estradiol tablets are a birth control pill (oral contraceptive) used by women to prevent pregnancy. The best combination birth control is not explicitly stated in the provided drug labels.
- The labels provide information on how combination oral contraceptives work and the instructions for taking Levonorgestrel and ethinyl estradiol tablets, but they do not compare the effectiveness of different combinations.
- The labels do mention that Levonorgestrel and ethinyl estradiol tablets are a type of birth control pill, but they do not provide a direct comparison to other combinations. Based on the information provided, no conclusion can be drawn about the best combination birth control 2, 2, 2.
From the Research
Effectiveness of Birth Control Methods
- The most effective birth control methods are long-acting reversible contraceptives, such as intrauterine devices (IUDs) and subdermal implants, with failure rates of less than 1% per year 3.
- Oral contraceptive pills are the most commonly used reversible method of contraception, but have a higher failure rate of 4% to 7% per year 3.
- The effectiveness of a birth control method also depends on user adherence and continuation 3.
Noncontraceptive Benefits of Birth Control
- Hormonal contraceptives can improve medical conditions associated with hormonal changes related to the menstrual cycle, such as acne, endometriosis, and premenstrual dysphoric disorder 3, 4, 5.
- Drospirenone/ethinyl estradiol, a specific type of oral contraceptive, has been shown to be effective in treating premenstrual dysphoric disorder (PMDD) and moderate acne vulgaris 4, 5.
- The combination of ethinylestradiol 20 µg and drospirenone 3 mg has demonstrated significant antiandrogenic and antimineralocorticoid effects, resulting in lower rates of adverse events such as fluid retention 5.
Factors to Consider When Choosing a Birth Control Method
- Optimal contraceptive selection requires patient and clinician discussion of the patient's tolerance for risk of pregnancy, menstrual bleeding changes, other risks, and personal values and preferences 3.
- Patients should consider their individual needs and medical history when choosing a birth control method, as some methods may be more suitable than others 3, 4, 5.