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Combination Pill and MiniPill birth control compared in Canada

Combination Pill and MiniPill birth control compared in Canada

There are primarily two kinds of birth control pills – ones that contain estrogen, called Combination Pills and the ones that do not, known as Minipill. Read on to find out more about each of them before making a decision on what to get.

Among the different birth control options available, if you’re thinking of going ahead with birth control pills, it’s paramount to understand the different kinds of pills available, the way they work and the one that may be a better choice for you.

Studies have shown that birth control pills are 99.7% effective in preventing pregnancy if taken as prescribed.  

There are no ‘one shoe fits all’ when it comes to birth control pills, as each birth control pill contains different levels of hormones, to which your body may respond differently. Depending on your medical history and general health, your doctor may prescribe a pill that might be more suitable for you than the others. 

1. What is the contraceptive Combination Pill?

All birth control pills contain hormones that mimic those naturally produced by your body to regulate your menstrual cycle. Combination pills contain Estrogen as well as Progestin and are the most commonly used birth control pills. 

How do birth control Combination Pills Work?

  • How does estrogen work to prevent pregnancy?  Estrogen suppresses ovulation so it keeps your ovaries from producing an egg.
  • How does progestin prevent pregnancy? Progestin thickens the cervical mucus so it prevents sperm from reaching the egg.
  • What about Progestin, how does it prevent pregnancy? Progestin contributes to thinning of uterus lining so makes it difficult for a fertilized egg to attach to the lining.

What is the common Combination Pill Dosage?

  • Combination pills come in 28-day packs that contain some active pills (those with hormones) and some inactive pills (those without hormones). Most brands include 21 active pills and 7 inactive pills in a pack. Bleeding occurs when you’re on inactive pills. 

For shorter period cycles, some brands also provide a pack with 24 active pills and just 4 inactive pills. 

Then there are extended-cycle combination pills which include 12-weeks of active pills followed by 1-week of inactive pills. If you’re on these pills, the periods are less often – 3 to 4 times a year.

Different types of combination pills based on the levels of hormones in each dose:

  • Monophasic pills: These pills contain same amount of Estrogen and Progestin in each dose
  • Biphasic, Triphasic or Quadriphasic: These pills contain varying amounts of hormones in each dose and are designed to mimic the rise and fall in hormone levels during your natural menstrual cycle, thereby reducing the chances of side effects.

Is Combination Pill the Right Choice for You?

Since birth control pills contain hormones, it’s likely for you to experience some effect on your sleep cycles, skin condition, mood etc., which is a result of the change in the hormonal balance in your body. 

Benefits of Combination Pill:

  • Lesser stomach cramps when you’re menstruating
  • Reduces the risk of period-related anemia
  • Less severe pre and post-menstrual syndrome
  • Might help with acne
  • More regular periods
  • Shorter and lighter periods
  • Reducing risk of ovarian cancer

Possible Side effects:

  • Nausea
  • Breast tenderness
  • Headaches
  • Weight gain
  • Bloating
  • Spotting or bleeding between periods
  • Higher risk of blood clots and heart strokes

Who Might be Advised by the Doctor to NOT Use Combination Pills?

  • Those who’ve had or have breast cancer
  • People suffering from heart diseases
  • Breastfeeding mothers
  • Those who’re using certain medications like those for tuberculosis, anticonvulsant agents.
  • Those who’ve suffered from  liver disease in the past, or currently do
  • 35 years or older women who smoke
  • High blood pressure patients
  • Those with diabetes related complications 
  • People who use supplements like St. John’s wort
  • Alesse Birth Control Pill
  • Alysena
  • MinEstrin
  • LoEstrin
  • Diane 35
  • Lolo Birth Control Pill
  • Yasmin
  • TriCyclen Lo
  • Yaz
  • Linessa
  • Yasmin

2. What is the birth control Minipill?

MiniPills are oral contraceptive pills, containing only one hormone called progestin. They are also known as the Progestin-only pill. 

How does Minipill Work?

  • Minipill does not suppress ovulation as they lack Estrogen, but the presence of Progestin helps increase thickness of cervical mucus to make it difficult for sperm cells to reach the egg, and in the same way as it does in combination pills, also contributes to thinning of uterus lining which prevents a fertilized egg from attaching to the inner wall.


  • Minipills also come in 28-day packs. Unlike combination pills, all 28 pills are active pills (have hormones in them)
  • You must consume Minipills at the same time every day. If missed by more than 3 hours compared to the regular time, Minipills become less effective and require the use of a backup birth control method like a condom for the next 2-3 days.

Is  Minipill the Right Choice for You?

After taking into consideration your medical history, a current medication that you’re on and your general health condition, your doctor may advise Minipill instead of a combination pill.

Reasons why your Doctor might Prescribe Minipill instead of Combination Pill:

  • If you’ve had a history of heart-related ailments
  • You’re 35 years or older and smoke
  • You’re sensitive to changing levels of Estrogen
  • You’ve experienced or regularly have blood clots
  • You’re a breastfeeding mother
  • You have high blood pressure 
  • You’re looking for a quick return to fertility


  • As stated above, doctors sometimes prescribe Minipills which are safer for those who have a history of ailments like heart diseases, blood clots and high blood pressure.
  • Minipill also is a saviour for those who are sensitive to Estrogen hormone
  • They work the best when you want to quickly return to fertility

Possible Side effects:

  • Weight gain
  • Decreased sexual drive
  • Acne
  • Ovarian cysts
  • Irregular bleeding
  • Breast tenderness
  • Depression 

Minipills might also be at a slightly higher risk of failing to prevent pregnancy than Combination Pills as they need to be taken at the exact same time everyday in order to be truly effective.

Before you Choose a Pill…

While it is good to know about the different birth control pills, how they work and who they may be the right choice for, it might still not be that simple to find the one that would work the best for you.

Since the pills involve different levels of hormones – to which your body may respond differently, depending on a variety of reasons, it is wise to consult with your doctor who could further look into your general health condition, lifestyle and current medications to advise you the best possible birth control pill. 

Where to buy birth control pills?

PocketPills pharmacy will help you manage your birth control prescription by delivering for free, right at your doorstep. Download the PocketPills app from the App Store or from the Google Play Store and transfer your refills to PocketPills today.

Read more on alternatives to birth control pills:

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