Low dose birth control: What is it and who is it for?

Hormonal birth control options use synthetic hormones to regulate your menstrual cycle. They help prevent pregnancy by preventing ovulation or altering the uterine lining.

There is a wide variety of hormonal contraceptives available, particularly for female birth control, including:

• Combined oral contraceptives (COCs): Contain a combination of estrogen and progestin hormones.
• Progestin-only pills (mini-pills): Suitable for those sensitive to estrogen.
• Contraceptive patch: The patches release hormones into the skin.
• Vaginal ring: Releases hormones that absorb through the vaginal lining.
• Injections: Provide progestin doses every 3 months.
• Implants: Implants under the skin provide long-term contraception.
• Hormonal intrauterine devices (IUDs): Release progestin directly into the uterus.

The best birth control option for you depends on your lifestyle, medical history, and personal preferences. For instance, whether you want to take a pill at the same time every day or prefer an implant or IUD to avoid a daily dose.

Some people experience hormonal side effects when on birth control. If you experience these side effects, consider asking a healthcare professional about low dose contraceptive options.

Low dose vs. high dose birth control

Hormonal birth control pills come in different doses. Low dose birth control pills contain lower levels of estrogen, progestin, or both than their higher dose counterparts.

Potential benefits of low dose birth control may include:

Fewer side effects

A 2016 literature review indicated that lower doses of estrogen may reduce the risk of:

• breast tension
• headaches
• nausea and vomiting
• water retention

These are side effects that some people may experience with other birth control options. If you experience any of these side effects, a lower-dose alternative might be worth trying.

Lower health complications

High doses of estrogen in combination birth control options may increase the chance of:

• embolism
• stroke
• high blood pressure
• heart attacks

Reducing estrogen doses or avoiding birth control methods that contain estrogen may reduce these health risks.

A 2016 cohort study that included almost 5 million women supported this. It concluded that combination birth control pills with 20 micrograms (mcg) of estrogen had fewer complications than those with 30 to 40 mcg.

Also, the 2016 review referenced earlier noted that lower dose options may have a reduced effect on insulin sensitivity and how your body metabolizes carbohydrates compared with high dose birth control. This means low dose birth pills may suit people with insulin resistance, prediabetes, or diabetes.

Is low dose birth control less effective?

The effectiveness of any birth control method, including low dose pills, depends on consistent and correct usage.

When taken as directed, low dose birth control pills can prevent pregnancy as effectively (98%) as higher dose birth control methods. This generally involves taking them at the same time every day.

Most low dose combination birth control pills come in packets containing 24 active pills and 4 placebo pills. This differs from regular dose birth control options, which often have 21 active pills and 7 placebo pills.

Types of low dose birth control methods

Different low dose birth control methods suit a variety of preferences and needs.

Common types include:

• Progestin-only pill (minipill): These pills contain a type of progestin hormone suitable for people who cannot tolerate estrogen or are nursing a baby.
  • Examples include norethindrone (Camila, Heather, Micronor).
• Combined oral contraceptives (COCs): These pills contain estrogen and progestin.
  • Popular examples include levonorgestrel ethinyl estradiol (Aviane, Alesse, Lessina).

In the United States, a new over-the-counter minipill option will become available without a prescription in 2024. Opill will contain 0.075 mcg of norgestrel, a type of progestin.

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Who should avoid low dose birth control methods?

Hormonal birth control, even low dose options, may not suit everyone.

For instance, a 2021 review noted that you might want to avoid estrogen-containing birth control if you:

• use tobacco
• have a body mass index (BMI) of 30 or more
• are 35 years of age or older

The review also noted that low dose minipills may result in more spotting and breakthrough bleeding (in between packets) for some people. If this is the case for you, you may benefit from an alternative.

Talk with a doctor or another healthcare professional for advice about the safest and most suitable birth control option for you.

Summary

Low dose birth control offers effective pregnancy prevention with potentially fewer side effects and health risks.

For instance, low dose options may reduce the chance of experiencing nausea, water retention, stroke, and high blood pressure.

However, low dose options containing estrogen may not suit everyone. Low dose progestin options could cause some users to experience breakthrough bleeding or spotting.

Ultimately, it’s best to consult a doctor for tailored advice to ensure you’re using the most suitable and safest option.

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