How Your Gyno Picks Your Birth Control Pill

How we select a pill for a patient. Virtually all oral contraceptives have been thought to have  identical effectiveness. If you take the pills faithfully, ovulation is suppressed, and failure rates are quite rare. Based on published data, about 2-3 women out of a hundred taking the pill for a year will become pregnant. Pills from the 70s and 80s that have published rates of only 1 person in a hundred getting pregnant is based on old studies. We have had a bit of pregnancy rate drift in the past few years, and women today have higher pregnancy rates than we used to in the past (obesity?). So, in truth gynos don’t assign pills based on effectiveness, they will all work for you! Since the 1970s safety has driven most of the dosing and type of hormone changes in the pill, and safety is always the first concern. Again, all birth control pills are extraordinarily safe and few women cannot take OCs. But safety is enhanced by selecting the lower doses. Non-contraceptive benefits drive many pill decisions for you and your gyno. Are you suffering from PMS, acne or heavy bleeding? These medical concerns can be addressed by selecting the right pill for you. Side effects are our second concern. If you don’t like the pills you are taking you won’t stay on them, and you may be at risk for unplanned pregnancy. Side effects can also be managed, and pill switching is sometimes necessary.


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