From the Guidelines
For young adults aged 18-30, combined oral contraceptives containing 20-30 mcg of ethinyl estradiol with newer progestins like norgestimate, desogestimate, or drospirenone are the best options, offering a balance of effectiveness with minimal side effects, as supported by the most recent evidence 1.
Key Considerations
- These formulations, such as Ortho-Cyclen, Sprintec (containing norgestimate), or Yaz/Yasmin (containing drospirenone), provide reliable contraception while minimizing common side effects like nausea, breast tenderness, and mood changes that can occur with higher estrogen doses or older progestins.
- It is essential to take one pill daily at the same time for maximum effectiveness (>99% with perfect use) 1.
- If side effects are experienced, it is recommended to allow 2-3 months for the body to adjust before considering alternatives.
- Individual responses to oral contraceptives can vary significantly, and what works well for one person may cause side effects in another.
- Regular follow-up with a healthcare provider is crucial to monitor for rare but serious complications like blood clots, especially if there are risk factors like smoking, high blood pressure, or migraines with aura 1.
Alternatives and Special Considerations
- Non-hormonal methods like copper IUDs or barrier methods are alternatives if hormonal contraceptives are not tolerated.
- For patients with specific conditions such as acne, combined oral contraceptives can have additional benefits, including anti-androgenic properties that can help treat acne 1.
- The choice of oral contraceptive should be based on the individual's health profile, preferences, and potential interactions with other medications, ensuring the best possible outcome in terms of morbidity, mortality, and quality of life.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Oral Contraceptives for Young Population
The best oral contraceptive with the least side effects for the general young population from 18-30 years old can be determined by considering the available evidence.
- Low-dose oral contraceptives, such as those with 20 micrograms of ethinyl estradiol, have been shown to have fewer side effects and comparable cycle control to higher-dose pills 2.
- Drospirenone/ethinyl estradiol, a unique oral contraceptive formulation, has been found to have a favorable side effect profile and provides non-contraceptive health benefits, such as improving acne, menstrual pain, and premenstrual dysphoric disorder (PMDD) 3.
- The choice of oral contraceptive should be based on individual patient factors, including medical history, lifestyle, and personal preferences, as well as the discussion of risks and benefits with a clinician 4, 5.
Types of Oral Contraceptives
- Combined oral contraceptive pills (COCs) are the most commonly used form of prescription contraceptives among adolescents in the United States 5.
- Progestin-only pills (POPs) are another option, with certain types of progestins having more potent antiandrogenic properties and being more effective in treating acne, hirsutism, and polycystic ovary syndrome 5.
Safety and Efficacy
- Oral contraceptives are a safe method of birth control, with the overall risks of taking oral contraceptives being much less than the risks of pregnancy 6.
- The risk of death from oral contraceptive use for teenagers is virtually nil, and the benefits of oral contraceptives outweigh the risks, particularly those of pregnancy 6.