How to Choose the Least Worst Birth Control Pill

Because every mode of contraception comes with drawbacks

Sarah E. Hill
Elemental
Published in
6 min readOct 31, 2019

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Illustration: Luyi Wang

WWhen I first went on the birth control pill, I was a passive observer in the process: My doctor gave me a prescription, I filled it, and I didn’t ask any questions. I knew almost nothing about the medication, what was in it, or why it was being chosen for me. It’s not like I was being irresponsible or my doctor was being secretive; it’s more like — that’s just the way it went. You got the birth control pill you got, often without really understanding why. But there’s reason to believe this might be changing.

In an age of increased interest in health and wellness, women are demanding more transparency when it comes to the things they put in their bodies. We want to know what’s in our food—think of that viral image of “what Nutella is actually made of.” Earlier this year, the NPD Group reported that more consumers are seeking out beauty products that are free from ingredients like sulfates, phthalates, and gluten. And just this month, New York became the first state to require menstrual-product manufacturers to disclose the ingredients in pads and tampons.

That’s just the way it went: You got the pill you got, often without really understanding why. But there’s reason to believe this might be changing.

But what about birth control pills? There are close to 100 different formulations of the pill, which can make the question itself feel overwhelming. It doesn’t have to be. Familiarizing yourself with some of the basics of birth control ingredients and their known side effects can make you a participant in — rather than a recipient of — your birth control strategy. This will enable you to work together with your doctor to find the pill that will allow you to feel most at home in your own body.

Here are the questions to ask your doctor so you’ll understand more about the birth control you’re taking and how it makes you feel.

What’s in it?

The first step is to find out what hormones are in your pill. The majority of birth control pills out there are combination pills containing synthetic estrogen…

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Sarah E. Hill
Elemental

Research Psychologist and Author of “This is Your Brain on Birth Control” (available on Amazon now).