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Oral contraceptives come in a variety of formulations. The main division is between combined oral contraceptive pills, containing both estrogen and progesterone, and progesterone only pills (mini-pills). Combined oral contraceptive pills also come in varying types, including varying doses of estrogen, and whether the dose of estrogen or progesterone changes from week to week. more...

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Combined oral contraceptive pills

All contain the estrogen ethinyl estradiol, although in varying amounts, and one of a number of different progesterones. They are taken for 21 days with then a 7 day gap during which a withdrawal bleed (often, but incorrectly, referred to as a menstrual period) occurs. These differ in the amount of estrogen given, and whether they are monophasic (only one dose of estrogen and progesterone during the 21 days) or multiphasic (varying doses).

Monophasic

These are given as 21 tablets of estrogen and progesterone, followed by 7 tablets of placebo. Different formulations contain different amounts of estrogen and progesterone:

  • 20 mcg estrogen
    • 0.1 mg levonorgestrel (Alesse®, Levline®)
    • 1 mg norethindrone acetate (Loestrin 1/20®Fe)
  • 30 mcg estrogen
    • 0.15 mg levonorgestrel (Levlen®, Levora®, Nordette®)
    • 0.3 mg norgestrel (Lo-Ovral®)
    • 0.15 mg desogestrel (Desogen®, Organon; Ortho-Cept®, Ortho-McNeil)
    • 1.5 mg norethindrone acetate (Loestrin® 1.5/30)
    • 3.0 mg drospirenone (Yasmin®)
  • 35 mcg estrogen
    • 0.25 mg norgestimate (Ortho-Cyclen®)
    • 0.4 mg norethindrone (Ovcon-35®, Warner Chilcott)
    • 0.5 mg norethindrone (Modicon®, Brevicon®)
    • 1 mg norethindrone (Ortho-Novum 1/35®, Necon®, Norethin®, Norinyl 1/35®)
    • 1 mg ethynodiol diacetate (Demulen 1/35®, Zovia 1/35E®)
  • 50 mcg estrogen
    • 0.4 mg norethindrone (Ovcon-50®, Warner Chilcott))
    • 1 mg norethindrone (Necon 1/50®, Norinyl 1/50®, Ortho-Novum 1/50®, Ovcon-50®)
    • 0.5 mg norgestrel (Ovral®)
    • 1 mg ethynodiol diacetate (Demulen 1/50®, Zovia 1/50E®)

Multiphasic

  • Desogestrel 0.15 mg and ethinyl estradiol 0.02 mg x 14 tablets, followed by ethynil estradiol 0.01 mg x 2 tablets, followed by 5 tablets of placebo (Kariva®, Barr Laboratories; Mircette®, Organon)
  • Desogestrel 0.1 mg ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.125 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.15 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by 7 tablets of ferric oxide (Cyclessa®, Organon; Velivet®, Barr Laboratories)
  • Norethindrone 0.5 mg and ethinyl estradiol 0.035 mg x 7 tablets, followed by 0.75 mg of norethindrone and 0.035 mg of ethinyl estradiol x 7 tablets, followed by 1 mg of norethindrone and 0.035 of ethinyl estradiol, followed by 7 tablets of placebo (Ortho-Novum 7/7/7®)
  • Norethindrone 0.5 mg and 0.035 mg of ethinyl estradiol x 10 tablets, followed by 1 mg norethindrone and 0.035 ethinyl estradiol x 11 tablets, followed by 7 tablets of placebo (Ortho-Novum 10/11®)

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Emergency Oral Contraception
From Population Reports, 12/1/98

What is it? Certain oral contraceptives (OCs) or similar pills taken after unprotected sex to prevent pregnancy.

Why? A woman had sex--willingly or not--without contraception, and she wants to avoid pregnancy.

How to take emergency OCs? In 2 doses: First dose as soon as possible but no later than 72 hours after unprotected sex. Second dose 12 hours after first dose.

Which pills? See table at right.

How much protection? Seems to prevent 3 of every 4 pregnancies that would otherwise occur. Less effective than most other family planning methods. Should not be relied on routinely.

How does it work? Mainly prevents release of the egg. (Does NOT disrupt existing pregnancy.)

Side effects? Nausea (upset stomach)--To avoid, eat after taking the pills. Vomiting--If you vomit within 2 hours after taking pills, repeat the dose. Otherwise, do not take extra pills. They will not make the method more effective, but they may increase nausea.

Special counseling needs? Be supportive, as always. Don't judge. If sex was forced, the woman may need medical care. Also, she may need special counseling if sex was unwanted (offer referral if appropriate).

Help her consider her future need to avoid STDs and pregnancy. She can start any contraceptive method at once.

This table tells how many pills to take, by formulation:

COPYRIGHT 1998 Department of Health
COPYRIGHT 2004 Gale Group

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