Low Estrogen Birth Control Options

Birth control pills are hormonal contraceptives. They are one of the most commonly used birth control methods by women in the US. The Centers for Disease Control and Prevention (CDC) estimates that over 12% of women between the ages of 15 and 49 years who use contraception take birth control pills. One of the options in hormonal birth control pills is low estrogen birth control. Please continue reading to learn more about this and other forms of birth control pills.

What are progesterone-only and combination birth control pills?

Below are two types of oral contraceptive pills available. Both the combination pills and progestin-only pills are hormonal oral birth control pills. However, the combination pills and progestin-only pills differ in the type of hormones they contain:

Combination birth control pill — containing synthetic estrogen, synthetic progesterone, and progestin. Combination pills are available in conventional 28-pill packs as well as extended cycle packs. Each pack contains a varying number of active pills and inactive pills. Each pack contains a varying number of active pills and inactive pills.
Progestin-only pills (POP) — also called the mini pill. POP is available as a 28-day pack with no hormone-free pills; each pack contains 28 active pills. As mentioned, a progestin-only pill contains progesterone as a single active ingredient. Unlike the combination pills, progestin-only pills don’t have the 7-day of inactive pills.

How do birth control pills work?

Most birth control pills contain estrogen and progesterone hormones. Progestin-only pills contain only progesterone.

Both estrogen and progesterone send signals to the pituitary gland in the brain to stop releasing hormones that cause ovulation. This means when you take birth control pills, no egg is released from the ovary, and no egg is available for sperm to fertilize.

In addition, progesterone thickens the cervical mucus, which can help prevent sperm from reaching an egg. It also thins the lining of the uterus, making it more difficult for a fertilized egg to be implanted.

With correct and consistent use, birth control pills are 99% effective in preventing pregnancy.

What is low-dose birth control?

The first oral contraceptives introduced half a century ago contained high doses of estrogen, approximately 100-150 micrograms (mcg) per pill. Later, regular birth control pills with 50 mcg of estrogen were introduced. However, even these higher-dose pills are rarely used today. Therefore, if you are interested in low-dose oral birth control, both combination pills and progestin-only pills have low-dose options for you to choose from.

Most combination birth control pills contain lower doses of estrogen ranging from 10 to 30 mcg. Examples of low-dose combination pills include Aviane, Levora, Ortho-Novum, Yasmin, and others.

Low-dose pills that contain only progestin have 35 mcg of progestin. Examples of low-dose progestin-only pills include Camila, Heather, Jolivette, and Errin.

Which birth control has the lowest estrogen content?

Pills that contain only 10 mcg of the hormone estrogen are called ultra-low dose or very low dose birth control pills. An example is Lo Loestrin Fe which contains 10 mcg of ethinyl estradiol (estrogen) and 1 mg of norethindrone acetate (progesterone) along with 10 mcg of ferrous fumarate (iron).

What is low estrogen birth control for?

Low-dose combination birth control and progestin-only birth control are primarily used to prevent pregnancy.

However, there are non-contraceptive health benefits of taking birth control, such as to relieve menstrual pain, irregular menstruation, fibroids, and endometriosis-related pain.

The FDA has also approved specific brands of combination birth control pills to treat acne.

Very low-dose birth control pills are sometimes prescribed during perimenopause. Women in their 40s who are still having menstrual periods can still get pregnant, and these pills protect from unwanted pregnancy. They also help to regulate heavy and irregular periods.

Though there is some data regarding hormonal birth control’s role in reducing the risk of ovarian and uterine cancer; however, the risk of breast cancer is slightly increased for both progestin-only and combination birth control pills.

Is birth control with low estrogen better?

Combination birth control pills that contain low estrogen have several advantages:

Over 99% effective in preventing unwanted pregnancy with perfect use
Approximately 93% effective in pregnancy prevention with typical use
A lighter menstrual period
A more regular menstrual cycle
Less severe premenstrual syndrome (PMS) and menstrual cramps
Protective effect against pelvic inflammatory disease (PID), an infection of reproductive organs such as the uterus, fallopian tubes, and ovaries
Reduced risk of ovarian cysts as well as certain types of cancer such as ovarian cancer, endometrial cancer, and colorectal cancer.

However, there are some risks associated with taking low-estrogen birth control:

Side effects such as sore breasts, headaches, weight gain, nausea, vomiting, depression, anxiety, and reduced libido
Higher risk of blood clots, heart attack, and stroke, especially in women over the age of 35 years who are smokers or have a history of blood clots, high blood pressure, or heart disease
Increased risk of breast cancer. Though, the overall risk is low

If you cannot take combination pills due to certain health issues or other risk factors, your provider may offer a progestin-only oral contraceptive pill.

What are the side effects of Lo Loestrin Fe?

The most common side effects of Lo Loestrin Fe birth control are nausea, vomiting, headache, menstrual cramps, spotting between menstrual periods, breast tenderness, and weight changes. Ultra-low-dose birth control pills are less likely to cause side effects than standard birth control pills because they contain lower doses of hormones.

Wrapping up

Choosing the right birth control pill can be overwhelming. By reading about low-estrogen birth control options and educating yourself about the choices available, you are now in a better position to discuss low-dose birth control pills and other birth control methods with your healthcare provider.

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