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Combined Pill
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This page was medically reviewed by Ms Laurenmarie Cormier, Nurse Practitioner on August 02, 2022. Next review due on August 01, 2024.
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    Combined Pills: Here's what we've got.
    Apri

    Apri

    Desogestrel, ethinyl estradiol

    Pill with a "regular" estrogen dose. Very similar to Isibloom and Viorele.

    • Starting from CAD93.00
    Aviane

    Aviane

    Levonorgestrel, ethinyl estradiol

    The same active ingredients as Lutera. A birth control pill you take every day.

    • Starting from CAD93.00
    Yasmin-blister

    Yasmin

    Drospirenone and Ethinyl Estradiol

    Well known pill that reduces PMS symptoms and can help to make your periods more regular.

    • Starting from CAD108.00
    Yaz

    Yaz

    Drospirenone and Ethinyl Estradiol

    Like Yasmin but in a lower dose. 28 day pill you take without a break.

    • Starting from CAD127.00
    Loestrin Fe

    Loestrin

    Norethindrone Acetate and Ethinyl Estradiol

    The combined pill with a low amount of estrogen. You can choose to take it with or without a pill-free break.

    • Starting from CAD180.00
    Portia

    Portia

    Levonorgestrel and Ethinyl Estradiol

    Safest category pill that reduces heavy bleeding. Same hormone mix as Aviane and Lutera but a higher dose.

    • Starting from CAD92.00
    Seasonique

    Seasonique

    Levonorgestrel and Ethinyl Estradiol

    Extended cycle pill that comes in a larger pack.

    • Starting from CAD263.00

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    Nurse Practitioner
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    Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

    What are combined birth control pills?

    They’re pills that combine two hormones: estrogen and progestin. These hormones affect how and when your body prepares for pregnancy.

    There are several different types of combined birth control pill and they’re all just about equally effective at preventing pregnancy. However, some contain higher doses of hormones than others, or use different types of progestin and estrogen. This means one pill might be ideal for easing specific PMS symptoms, while another pill works great for women who are extra-sensitive to hormones.

    It can feel a bit overwhelming, so we’re here to help.

    How does the combined pill work?

    The combined pill works in three ways to prevent pregnancy. Here’s the big one: it stops ovulation. That’s when your ovary releases an egg, and it happens once a month. Each egg has the chance to become fertilized, leading to pregnancy. If fertilization doesn’t happen, the lining of your womb breaks down and the whole thing happens again next cycle (lots of fun, we know).

    Because the combined birth control pill stops ovulation, your chances of becoming pregnant are significantly reduced.

    The combined birth control pill also protects you by making the mucus in your cervix thicker. “Thick mucus” isn’t something you normally want to hear but in this case, it’s great news. When it’s thicker, sperm have a much harder time reaching the egg.

    The pill also makes your uterine lining thinner. This lining builds throughout the month and then breaks down during your period. When you’re using birth control, the lining doesn’t build in the same way. And so the period you have while taking the pill should be lighter and more manageable.

    Which birth control pills are combined pills?

    Any that contain two active ingredients, a progestin and an estrogen. To find out if your pill is a combined pill, just check the active ingredients.

    In the leaflet that comes with your pill, the ingredients should be clearly listed at the top underneath the name of the drug. For combined pills you should see two ingredients, front and center, that are progestin and estrogen.

    With Loestrin, for example, the active ingredients are norethindrone acetate and ethinyl estradiol. This pill is clearly stated as a progestin-estrogen combination.

    We offer a range of combined birth control pills, so there’s plenty of choice for you. But if you can’t take combination pills, for any reason, it’s important to share this with us for your safety.

    Reference Popover #ref1
    Reference Popover #ref2
    Medically reviewed by
    Ms Laurenmarie Cormier
    Nurse Practitioner
    on August 02, 2022.
    Meet Laurenmarie  
    Laurenmarie
    This page was medically reviewed by Ms Laurenmarie Cormier, Nurse Practitioner on August 02, 2022. Next review due on August 01, 2024.

    How we source info.

    When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

    How effective are combined birth control pills?

    There are two ways of measuring how effective pills are at preventing pregnancy. One way is according to perfect use. This means you take the pill exactly as you should, every day, without making a mistake. The level of effectiveness of the combined oral birth control pill when taken like this is over 99%. So in a whole year, fewer than 1 in 100 women taking the combined birth control in that time will become pregnant.

    The other way is typical use. This is when you take the pill but make realistic errors, such as forgetting the occasional pill or taking it late. It’s 91% effective when taken like this, which means about 9 in 100 women taking it over a year will become pregnant.

    The best way to make sure the pill is effective then is to follow the instructions as closely as you can when you take it.

    When to start taking the combined pill

    It depends on whether you’re taking the pill for the first time, coming back after a break, or switching from a different type of birth control. If you’re using the pill for the first time, you can start on any day.

    When you start using the pill on the first day of your period, you’re protected from becoming pregnant immediately — so you don’t need to worry about using a condom. You’ll also be protected immediately if you start taking the pill before the fifth day of your period.

    If you start using the pill after the fifth day of your cycle, you won’t be protected right away. Use a back-up birth control method (like condoms) for seven days while the pill starts to work.

    Another option is the Sunday start approach. If you start taking the pill on the first Sunday after your period begins, you avoid withdrawal bleeding on a weekend (if you want to skip having your period on a weekend, this is the way to go).

    When to start the combined pill if you’re already on birth control

    You shouldn’t leave a gap when you’re switching from one birth control method to the combined pill. If you’re already taking a hormonal birth control pill, start your new prescription the day after you finish your last pill.

    If you’re using a transdermal patch like Xulane, start the pill a day before you’re due to take off the patch. If you’re using the vaginal ring, start the pill a day before you’re set to take out the ring.

    If you normally have the Depo-Provera injection, you can start taking your pill up to 15 weeks after your last shot.

    And if you have an IUD (copper or hormonal), you should begin your combined birth control pill pack a week before having your IUD removed.

    Reference Popover #ref3

    Are all combined pills the same?

    No. While all birth control pills have the same effectiveness (so over 99% when they’re used correctly), some pills contain variations of the same hormone, or higher or lower doses of hormones than others. It may be that you’re more sensitive to progestin (or estrogen) in the combined pill for instance, and so you’ll be better off taking a particular pill that restricts the number of side effects you get.

    If you’re more sensitive to progestin for example, combined pills like Portia are the safest, and the least likely to trigger side effects. And if you’re more sensitive to estrogen, combination pills such as Yasmin should offer you the best protection from side effects.

    How do I know which is the best combined pill for me?

    Unless you’ve tried a few different pills and found one that works well for you, there’s a good chance that you won’t know which is the best option. Finding the right combination pill for you can involve some trial and error. And our bodies can change over time, so what was effective before might not suit you as well now. A consultation with our clinician will help you to narrow down your options.

    Besides your sensitivity to hormones in pills and whether you’re prone to certain side effects, there are other factors that may play a role in identifying the right pill for you too. If you’re looking for a pill that can also help with acne, for example, the likes of Yasmin are thought to be particularly strong choices. But at the same time, you may be at a slightly higher risk of getting a blood clot with those, so the pros and cons of specific pills also need to be taken into account.

    In short then, we can help you to pick out the best (and safest) combined pills for you by weighing these things up, using your health background as the basis.

    Combined pill: FAQ

    Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

    Should I take Seasonique or Seasonale?

    Answer:
    Seasonique comes with 84 pills with 0.15mg of levonorgestrel and 0.03mg of ethinyl estradiol, and 7 pills with 0.01mg of ethinyl estradiol.

    Seasonale is very similar, containing 84 pills with 0.15mg of levonorgestrel and 0.03mg of ethinyl estradiol, and 7 inactive pills with no hormone.

    The difference might seem minimal, but if you’ve taken Seasonale before and had menstrual symptoms around the time of your inactive pill week, Seasonique may be a better option for you.

    Is Seasonique similar to any other birth control pills?

    Answer:
    Seasonique is essentially the same pill as Indayo.

    Although Seasonique contains the same hormones at the same dose as this pill, it’s made by a different manufacturer, so the appearance of the pills, the packaging and the price may be different.

    How is Seasonique different from other birth control pills?

    Answer:
    Seasonique is an extended cycle pill, meaning that all of the pills in the pack contain active ingredients, while most of the other birth control options have 7 inactive pills at the end of each month. Instead, Seasonique had 7 single hormone pills at the end of each three consecutive months.

    Studies have shown that extended cycle pills are slightly more effective, but the difference is minimal and not enough to place extended cycle pills above all others.

    How effective is Seasonique?

    Answer:
    Seasonique is a very effective form of birth control, with an effectiveness rate above 100% if taken correctly. But like with every birth control pill, the effectiveness can lower if you miss a pill or more during your cycle, or if you regularly take the pill later than you should, leaving the interval between pills higher than 24 hours. To make sure that you get the most out of your birth control, you should set an alarm on your phone to ring at the same time every day, and always carry the pills with you to make sure that you take them at the right time, even if you’re not at home when the alarm rings.

    Do I need a prescription for Seasonique?

    Answer:
    Yes, you need a prescription to get Seasonique, or any other birth control pill. This is to make sure that a clinician checks whether it’s safe or not for you to take birth control, and also to assess which options would be better for your specific health needs and circumstances.

    Why should I buy Seasonique online with Treated?

    Answer:
    Picking the right birth control pill can be a difficult task with so many options available. Here at Treated, we are aware of this, so our aim is to make the process as straightforward as possible for you. You just need to answer a few questions about your health and our clinicians will give you a list of medication recommendations based on your health needs and circumstances.

    Once we find the right pill for you, all you need to do is choose a delivery frequency and your first package will be with you in less than a week. We’ll stay in touch to make sure that you’re getting everything you want out of your pill, and if you aren’t, we will recommend a different option for you to try.

    Will I get breast growth with Tri-Sprintec?

    Answer:
    It’s possible. “Breast issues” were reported in 8% of women using the combined pill in clinical trials according to the US National Library of Medicine. However, side effects such as these usually pass after a few months of use.

    Talk to a doctor if you experience breast swelling, pain or tenderness that persists. And speak to a doctor immediately if you experience any changes in breast tissue (such as a lump).

    Why should I buy Tri-Sprintec with Treated?

    Answer:
    Getting a birth control prescription through Treated is easy and fast. After a consultation with a licensed doctor, you’ll pick how often you want to receive your refills and we’ll get our preferred pharmacy to fill your prescription and pop it in the mail. It’s all online — no awkward phone calls or annoying trips to the pharmacy. Try us out today and start your consultation.

    Does Tri-Sprintec cause weight gain?

    Answer:
    Around 2.5% of the women who take Tri-Sprintec or another combined birth control pill say their weight changes, but it’s not known how much of this is due to the pill versus the circumstantial factors of everyday life. There isn’t very much evidence to suggest that the combined pill causes weight gain (or weight loss).

    If you do find that your weight fluctuates when taking Tri-Sprintec, let a doctor know. They may be able to do something to help.

    Does Tri-Sprintec cause depression?

    Answer:
    Combined birth control pills like Tri-Sprintec contain hormones which can cause mood swings, especially right after being introduced to your body. This happens to approximately 3.8% of women. If you feel depressed or find that mood swings persist when taking Tri-Sprintec, speak to a doctor.

    Can I skip a period with Tri-Sprintec?

    Answer:
    Yes, but you should check with the doctor first, because it involves a slightly different way of taking the pill.

    To skip your period on the combined pill, you start the next month’s pack after taking three weeks of active pills. With Tri-Sprintec, this means you skip the week of white inactive pills and go immediately from the blue pills to the next month’s light gray pills. This isn’t the “official” way of taking Tri-Sprintec, so check with your doctor before skipping any pills.

    How is Tri-Lo-Sprintec different?

    Answer:
    There is a Tri-Sprintec Lo dosage for women who have a slight estrogen sensitivity. The pills are very similar, but the active pills in Tri-Lo-Sprintec have a little less estrogen. Women who use Tri-Sprintec but get mild estrogenic side effects may be recommended the “Lo” version by a doctor instead.

    Estrogenic side effects are symptoms like nausea, swollen or tender breasts, or heavy menstrual bleeding.

    Can you take Tri-Sprintec for acne?

    Answer:
    Yes, Tri-Sprintec can help with acne. It has been approved as an acne treatment by the FDA, but only for women who also need birth control. So if you want to treat acne but can’t take the combined pill for any reason (or don’t need birth control), you should speak to a doctor about an alternative.

    What is the generic name for Tri-Sprintec?

    Answer:
    Tri-Sprintec generics (read: pills with the same ingredients) include Ortho Tri-Cyclen, TriNessa, Tri-Previfem, Tri-Linyah, Tri-Estarylla, Tri-Femynor, Tri-VyLibra and Norg-EE.

    These pills should work in the same way and be just as effective as Tri-Sprintec. The main differences will be the packaging, how the pills look, who manufactures them (Tri-Sprintec is made by Teva) and normally the price.

    Tri-Sprintec is probably the most well-known name for this pill, but Tri-Estarylla is a little cheaper.

    What do Tri-Sprintec pill colors mean?

    Answer:
    The different color pills in the pack correspond with different phases. The gray pills are taken on days 1 through 7 of your cycle, the light blue pills on days 8 through 14, the blue pills on days 15 through 21 and the white pills on days 22 through 28.

    The gray, light blue and blue pills are all active pills (containing hormones). Tri-Sprintec white pills are inactive (spacer or reminder pills) and are there to help you keep track of when to start your next pack.

    Do I need a prescription for Sprintec?

    Answer:
    Sprintec is not available over the counter. Hormonal birth control isn’t suitable for all women, so you have to talk with a medical professional to make sure Sprintec is safe for you to use.

    Potential side effects that occur when using Sprintec could have a significant impact on your health. When you use hormonal birth control, you should have check-ups with our clinician to make sure it’s still the right choice for you.

    Why should I buy Sprintec online with Treated?

    Answer:
    At Treated, our clinicians can consider your medical history to recommend the right birth control option for you to choose. Talk to us about your specific needs and we’ll help you to find the right option.

    Once you have your prescription, you can access our aftercare service, where we want to know about any issues you’re having with the medication and any changes in your health in general. We’re here every step of the way.

    Is there more than one Sprintec dosage?

    Answer:
    Sprintec itself is only available in one dosage. But there are other versions that have different levels of hormones, including Tri-Sprintec and Tri-Lo-Sprintec. These are phasic pills, where the levels of hormones change throughout the course of the month. Phasic pills work well for women who are trying to control menstrual symptoms. The physician can help you settle on the right version of Sprintec during your consultation.

    If you feel like you need a pill with a lower dose because Sprintec is causing you persistent or unwanted side effects, then it’s easy to switch pills with Treated. Just log in to your account and let our clinician know you’re thinking about changing. They can then go through the options available for you to choose from.

    Are Sprintec and Estarylla the same pill?

    Answer:
    In clinical terms, Estarylla and Sprintec are the same pill. Estarylla is manufactured by Sandoz, while Sprintec is manufactured by Teva. Sprintec has the exact same hormones and in the exact same amounts.

    If you used to take Estarylla and found it helpful, but haven’t been able to find a replacement pill, Sprintec might be a good option for you.

    Is there any evidence for the Sprintec pill and weight gain?

    Answer:
    While weight gain has been recorded as a possible side effect for Sprintec and combined pills, there is little evidence to support it. In other words, it’s possible to experience weight gain when taking Sprintec, but because changes in weight can be related to so many other factors, it’s difficult to link the two.

    It’s important to know that everyone reacts to medications differently. For example, weight loss has also been recorded as a possible side effect of Sprintec. If you’re concerned about changes in your weight, speak with our clinician.
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