Combination birth control pillsareoral contraceptivesthat combine ethinyl estradiol and progestin. Even though all combination birth control pills have estrogen, they can differ in how much estrogen they contain. Combination birth control pills also differ from one another in the amount andtype of progestinin eachpill brand.The combination of the amount of estrogen and the type and amount of progestin found in combination birth control pills can also cause differentprogestational, estrogenic, and androgenic effects.This article explains the differences between monophasic and multiphasic (biphasic and triphasic) combination birth control pills.There is no “best” birth control pill brand or type. However, some pills may help tominimize certain side effects. All combination birth control pills are equally effective in preventing pregnancy—as long as the pills areused consistently and correctly.
Combination birth control pillsareoral contraceptivesthat combine ethinyl estradiol and progestin. Even though all combination birth control pills have estrogen, they can differ in how much estrogen they contain. Combination birth control pills also differ from one another in the amount andtype of progestinin eachpill brand.
The combination of the amount of estrogen and the type and amount of progestin found in combination birth control pills can also cause differentprogestational, estrogenic, and androgenic effects.
This article explains the differences between monophasic and multiphasic (biphasic and triphasic) combination birth control pills.
There is no “best” birth control pill brand or type. However, some pills may help tominimize certain side effects. All combination birth control pills are equally effective in preventing pregnancy—as long as the pills areused consistently and correctly.
Multiphasic vs. MonophasicEnvision / Getty ImagesCombination birth control pills are categorized as monophasic, biphasic, or triphasic depending on whether the level of hormones stays the same during the first three weeks of yourmenstrual cycleor if it changes. Keep in mind that for 28-day pill packs, the pills for the fourth week are usually placebo pills (and do not have any hormones).Multiphasic birth control pills were developed during the 1980s. Phasic birth control pills have differing amounts of hormones—designed to be taken at specific times throughout the course of each pill pack. These pills were originally developed to help lessen the side effects of monophasic birth control pills.When compared to monophasic combination pills, some multiphasic birth control pills may lower the total hormone dosage you may receive in each pill pack. They are also designed to more naturally mimic your body’s menstrual cycle.
Multiphasic vs. Monophasic
Envision / Getty Images
Combination birth control pills are categorized as monophasic, biphasic, or triphasic depending on whether the level of hormones stays the same during the first three weeks of yourmenstrual cycleor if it changes. Keep in mind that for 28-day pill packs, the pills for the fourth week are usually placebo pills (and do not have any hormones).
Multiphasic birth control pills were developed during the 1980s. Phasic birth control pills have differing amounts of hormones—designed to be taken at specific times throughout the course of each pill pack. These pills were originally developed to help lessen the side effects of monophasic birth control pills.
When compared to monophasic combination pills, some multiphasic birth control pills may lower the total hormone dosage you may receive in each pill pack. They are also designed to more naturally mimic your body’s menstrual cycle.
Monophasic Birth Control Pills
Monophasic birth control pills have the same amount of estrogen and progestin in each active pill in the pill pack. The hormone levels in each pill stay consistent, so monophasic birth control pills may be less likely to cause side effects that could result from fluctuating hormones.
Monophasic birth control pills work just as well as multiphasic pills. Low estrogen, monophasic pills may cause less bloating or breast tenderness but they may result in morespotting. Most people find that a monophasic birth control pill brand tends to be a good first choice.
Biphasic Birth Control PillsBiphasic birth control pills change the level of hormones once during the pill pack. Biphasic birth control pills deliver the same amount of estrogen each day, but the level of progestin is increased about halfway through the pill cycle.The progestin/estrogen ratio is usually lower during the first half of the cycle. During the second half of the cycle, the progestin/estrogen ratio tends to be higher.The first seven to 10 days are of one strength (usually one color), and the next 11 to 14 pills are of another strength (and another color). The last seven days (if included) are placebo pills and do not contain hormones.
Biphasic Birth Control Pills
Biphasic birth control pills change the level of hormones once during the pill pack. Biphasic birth control pills deliver the same amount of estrogen each day, but the level of progestin is increased about halfway through the pill cycle.
The progestin/estrogen ratio is usually lower during the first half of the cycle. During the second half of the cycle, the progestin/estrogen ratio tends to be higher.
The first seven to 10 days are of one strength (usually one color), and the next 11 to 14 pills are of another strength (and another color). The last seven days (if included) are placebo pills and do not contain hormones.
Triphasic Birth Control PillsTriphasic birth control pills (likeOrtho Tri-Cyclen) contain three different doses of hormones so the hormone combination changes approximately every seven days throughout the pill pack.Depending on the pill brand, the amount of estrogen may change as well as the amount of progestin. In a single month’s supply, triphasic birth control pills may have a slow increase in estrogen, and some pills may also increase the dose of progestin.The first few pills are one strength (and one color) in each pill pack. The next phase of pills is another strength (and another color). The final phase of pills also changes strength and is a different color. The last seven pills (if included) are placebo pills, so they do not contain hormones.
Triphasic Birth Control Pills
Triphasic birth control pills (likeOrtho Tri-Cyclen) contain three different doses of hormones so the hormone combination changes approximately every seven days throughout the pill pack.
Depending on the pill brand, the amount of estrogen may change as well as the amount of progestin. In a single month’s supply, triphasic birth control pills may have a slow increase in estrogen, and some pills may also increase the dose of progestin.
The first few pills are one strength (and one color) in each pill pack. The next phase of pills is another strength (and another color). The final phase of pills also changes strength and is a different color. The last seven pills (if included) are placebo pills, so they do not contain hormones.
SummaryCombination birth control pills combine ethinyl estradiol and progestin. All combination birth control pills have estrogen but differ in how much they contain. Pills also vary in the amount and type of progestin.The combination of the amount of estrogen and the type and amount of progestin found in combination birth control pills can cause different progestational, estrogenic, and androgenic effects. There is no single best choice of combination birth control pills.Does Birth Control Have Long-Term Side Effects?
Summary
Combination birth control pills combine ethinyl estradiol and progestin. All combination birth control pills have estrogen but differ in how much they contain. Pills also vary in the amount and type of progestin.
The combination of the amount of estrogen and the type and amount of progestin found in combination birth control pills can cause different progestational, estrogenic, and androgenic effects. There is no single best choice of combination birth control pills.
Does Birth Control Have Long-Term Side Effects?
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Contraception.Stewart M, Black K.Choosing a combined oral contraceptive pill.Aust Prescr. 2015;38(1):6–11. doi:10.18773/austprescr.2015.002Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF.Biphasic versus triphasic oral contraceptives for contraception.Cochrane Database Syst Rev. 2006;2006(3):CD003283. Published 2006 Jul 19. doi:10.1002/14651858.CD003283.pub2Additional ReadingAllen RH.Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use.Christin-Maitre S.History of oral contraceptive drugs and their use worldwide. Best practice & research.Clinical Endocrinology & Metabolism. 2013 Feb 28; 27(1):3-12. doi:10.1016/j.beem.2012.11.004
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Contraception.Stewart M, Black K.Choosing a combined oral contraceptive pill.Aust Prescr. 2015;38(1):6–11. doi:10.18773/austprescr.2015.002Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF.Biphasic versus triphasic oral contraceptives for contraception.Cochrane Database Syst Rev. 2006;2006(3):CD003283. Published 2006 Jul 19. doi:10.1002/14651858.CD003283.pub2Additional ReadingAllen RH.Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use.Christin-Maitre S.History of oral contraceptive drugs and their use worldwide. Best practice & research.Clinical Endocrinology & Metabolism. 2013 Feb 28; 27(1):3-12. doi:10.1016/j.beem.2012.11.004
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Contraception.Stewart M, Black K.Choosing a combined oral contraceptive pill.Aust Prescr. 2015;38(1):6–11. doi:10.18773/austprescr.2015.002Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF.Biphasic versus triphasic oral contraceptives for contraception.Cochrane Database Syst Rev. 2006;2006(3):CD003283. Published 2006 Jul 19. doi:10.1002/14651858.CD003283.pub2
Centers for Disease Control and Prevention.Contraception.
Stewart M, Black K.Choosing a combined oral contraceptive pill.Aust Prescr. 2015;38(1):6–11. doi:10.18773/austprescr.2015.002
Van Vliet HA, Grimes DA, Helmerhorst FM, Schulz KF.Biphasic versus triphasic oral contraceptives for contraception.Cochrane Database Syst Rev. 2006;2006(3):CD003283. Published 2006 Jul 19. doi:10.1002/14651858.CD003283.pub2
Allen RH.Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use.Christin-Maitre S.History of oral contraceptive drugs and their use worldwide. Best practice & research.Clinical Endocrinology & Metabolism. 2013 Feb 28; 27(1):3-12. doi:10.1016/j.beem.2012.11.004
Allen RH.Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use.
Christin-Maitre S.History of oral contraceptive drugs and their use worldwide. Best practice & research.Clinical Endocrinology & Metabolism. 2013 Feb 28; 27(1):3-12. doi:10.1016/j.beem.2012.11.004
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