From the Guidelines
The oral birth control options with the least amount of hormones are the mini-pill (progestin-only pill) and ultra-low-dose combined pills. The mini-pill contains only one hormone (progestin) at a low dose and includes brands like Micronor, Nor-QD, and Camila, typically containing 0.35 mg of norethindrone 1. Ultra-low-dose combined pills contain both estrogen and progestin but at minimal levels, such as Lo Loestrin Fe (10 mcg ethinyl estradiol) or Alesse/Aviane (20 mcg ethinyl estradiol) 1. These options are particularly suitable for women who experience side effects from higher hormone doses or have contraindications to higher estrogen levels, such as those with a history of blood clots, migraines with aura, or who are breastfeeding (mini-pill only).
Some key points to consider when choosing between these options include:
- The mini-pill must be taken at the same time each day for maximum effectiveness (within a 3-hour window), while combined pills offer a slightly larger timing window 1.
- Lower hormone doses may reduce side effects like nausea, breast tenderness, and headaches, but might increase the risk of breakthrough bleeding 1.
- Effectiveness remains high (91-99%) when taken correctly, though the mini-pill may be slightly less effective than combined formulations 1.
- It is essential to counsel patients on strategies to promote daily adherence, such as cell phone alarms and support from a family member or partner, to minimize the risk of missed pills and maintain effectiveness 1.
Overall, the choice between the mini-pill and ultra-low-dose combined pills should be based on individual patient needs and medical history, with consideration of the potential benefits and risks of each option 1.
From the FDA Drug Label
For any particular estrogen/progestogen combination, the dosage regimen prescribed should be one which contains the least amount of estrogen and progestogen that is compatible with a low failure rate and the needs of the individual patient. New acceptors of oral contraceptive agents should be started on preparations containing 0.035 mg or less of estrogen.
Oral birth control options with the least amount of hormones are those containing 0.035 mg or less of estrogen. The specific products are not listed in the provided drug label, but the general guideline is to use the lowest possible dose formulation that is effective.
- Low-dose oral contraceptives are recommended for new acceptors and for women who require a low-hormone option.
- The goal is to minimize exposure to estrogen and progestogen while maintaining a low failure rate and meeting the individual patient's needs 2.
From the Research
Oral Birth Control Options with the Least Amount of Hormones
- Progestin-only pills (POPs) are a type of oral birth control that contains only progestin, making them a good option for those looking for a lower-hormone birth control method 3.
- Examples of low-dose oral contraceptives include norethindrone acetate 1.0 milligram and ethinyl estradiol 10 micrograms, which reduces estrogen exposure by almost half compared to other oral contraceptives 4.
- Triphasic oral contraceptives, such as those containing levonorgestrel or norethindrone, are also available and may have lower hormone levels than monophasic options 5, 6.
Comparison of Hormone Levels in Different Oral Birth Control Options
- A study comparing two triphasic oral contraceptives found that the levonorgestrel triphasic had a lower incidence of intermenstrual bleeding than the norethindrone triphasic 5.
- Another study compared a triphasic norgestimate/35 micrograms ethinyl estradiol oral contraceptive to a monophasic norethindrone acetate/20 micrograms ethinyl estradiol oral contraceptive and found that the triphasic option had better cycle control and user satisfaction 6.
Progestogen-Only Pills as a Low-Hormone Option
- Progestogen-only pills are a popular choice for women who prefer a low-hormone birth control method, with 6% of women in the UK using this type of contraception 7.
- These pills are often referred to as the "mini-pill" and are a good option for women who are ineligible for or choose not to use combined oral contraceptives 3.