What Is the Best Form of Birth Control?

QUESTION: I am confused about the many possible choices that I have now that
I have decided to use birth control pills. Is there anything like a "best
choice", and would you consider reviewing the different dose forms which are
now available? I would be most grateful.
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ANSWER: Birth control pills, or oral contraceptives, have been around for
over 25 years now and they are still the most effective nonpermanent form of
birth control. Oral contraceptives have changed. The pills that were first
marketed in the 1960's had large doses of estrogen and progestin, whereas
those made today have far lower doses and are still effective.
The best choice for birth control pills--or any other medicine--is the
smallest dose that does the job. Most brands of oral contraceptives today
contain 30 to 35 micrograms of estrogen. Some women have breakthrough
bleeding at this low dose and may need to be switched to brands with 50
micrograms of estrogen. This is still a far lower amount of estrogen than was
once used. Some types of oral contraceptives use slightly different amounts
of estrogen and progestin over the course of the cycle, to mimic the normal
rise and fall of hormones in the body.
The most serious health risks of taking the pill are cardiovascular,
meaning an increased risk of heart attack, stroke, and blood clots. However,
this risk is significant only for women over age 40 or those who smoke. For
most women, the health risks of a possible unwanted pregnancy outweigh the
risks of contraception. The pill can cause nuisance side effects such as
acne, weight gain and headaches, but these are minimized with newer low-dose
versions. There are actually several benefits to taking oral contraceptives.
They appear to prevent formation of ovarian cysts and there is evidence they
protect against endometrial and ovarian cancer.
But please remember, we are all unique individuals, and what may be right
for your neighbor, may not be the best for you. In this case it really is
smart to get the personalized advice of your own physician.