Which Birth Control Pill Is Right for Me?

With so many birth control pills out there, it’s completely normal to feel unsure about where to start. The good news? You don’t have to figure it out alone.

Each pill option is a little different—some may help with acne, others with period pain or irregular cycles.

Hormone levels, potential side effects, and added benefits all vary, so the right fit really depends on your body, your health history, and what matters most to you.

Understanding the basics of how they work is a good first step in making your decision.

How birth control pills work

Birth control pills are one of the most commonly used—and trusted—forms of hormonal birth control. When taken correctly, they prevent ovulation, which means your ovaries don’t release an egg each month. No egg, no need to stress about fertilization.

The pill also works in a few other smart ways. It thickens the cervical mucus, which makes it harder for sperm to reach an egg. It also thins the lining of the uterus, so even if an egg were fertilized, it’s less likely to implant.

Most birth control pills use synthetic versions of the hormones estrogen and progestin. These hormones signal to your body that it doesn’t need to ovulate—essentially putting your cycle on pause.

Taking the pill consistently is what makes it effective. Skipping pills or taking them at different times can lower protection. A daily routine—like taking it at the same time each morning or keeping it next to your toothbrush—can help you stay on track. When taken as directed, the pill is over 99% effective at preventing pregnancy.

Active pills and placebo pills

Birth control pill packs can feel a little confusing at first, but once you understand the difference between active and placebo pills, it gets much easier to stay on track.

Most pill packs contain a combination of active pills—the ones with hormones that prevent pregnancy—and placebo pills, which are hormone-free and meant to keep your daily routine going during the week you get your period.

Active pills are the ones doing the work. In most 28-day packs, there are 21 or 24 active pills that maintain steady hormone levels and stop your ovaries from releasing an egg. It’s important to take these pills in the right order and not miss any—especially during the active weeks—because skipping them can reduce pregnancy protection.

Placebo pills don’t contain hormones. They’re often included to help you stay in the habit of taking your pill every day. During the placebo week, your hormone levels drop, which can cause a withdrawal bleed that looks like a period. You’re still protected from pregnancy during this time, as long as you’ve taken all your active pills correctly and start your next pack on time.

Some people choose to skip the placebo week altogether and start a new pack right away to avoid bleeding—this is called continuous cycling. If you’re using a monophasic pill (where each active pill contains the same dose of hormones), this is generally safe. It’s a personal choice and can be helpful when managing period symptoms or planning around travel and special events.

If you’re thinking about this option, it’s a good idea to talk with a healthcare provider to make sure it’s right for you.

Types of birth control pills

When you’re choosing birth control, knowing your options can make all the difference. There are two main types of birth control pills: combination pills and progestin-only pills. Each has its own benefits, depending on your body and your health needs.

Combination birth control pills

Combination pills contain two hormones—estrogen and progestin—and are the most commonly prescribed type of birth control pill. These pills come in a range of formulations and hormone levels, so it’s easier to find one that works with your body.

Some well-known options like Beyaz® are FDA-approved to help with acne and symptoms of PMS, which can be a welcome added benefit for many people.

Combination pills typically follow a 28-day cycle: 21 pills with active hormones and 7 placebo pills that allow for a withdrawal bleed. Some newer versions shorten that hormone-free window with 24 active pills and 4 placebo pills, which often results in lighter, shorter periods.

These pills may also offer other benefits beyond contraception—like more regular cycles, reduced menstrual cramps, and clearer skin. If you’re using a monophasic combination pill (meaning the hormone dose stays consistent throughout the cycle), such as Sprintec® or Yasmin®, you may be able to skip your period by skipping the placebo week—something that can be especially helpful for those with painful or heavy periods.

Progestin-only pills

Progestin-only pills—often called the “mini-pill”—contain just one hormone and are a good fit for people who can’t take estrogen. This includes those who have certain medical conditions, or have experienced side effects with combination pills.

Some commonly prescribed options are Camila® and Heather®, which many people find easier to tolerate. Because these do not contain estrogen, they may come with fewer side effects and avoids some of the rare but more serious risks linked to estrogen-containing pills.

Progestin-only pills work a little differently: they thicken cervical mucus and thin the lining of the uterus to prevent pregnancy. There is also another type of progesterone-only pill that can help stop ovulation. 

One important thing to know: timing is key. To stay protected, you’ll need to take your pill at the same time each day—within a three-hour window. If you’re more than three hours late, you’ll need to use backup contraception (like condoms) for the next 48 hours. This kind of precision can be a bit of an adjustment, but many find the benefits are worth the consistency it requires.

What to consider when choosing a birth control pill

Finding the right birth control pill is personal. Like your favorite pair of jeans, the right fit depends on your lifestyle, health history, and preferences. What works well for someone else may not be the best option for you—and that’s okay.

At Nurx, we make it simple to find a birth control option that supports your health and your life. Our licensed medical providers are here to guide you with care and expertise, helping you make choices that feel right for you.

Your needs

Before exploring different pill types, it’s helpful to ask yourself: What do I want birth control to do for me? The answer can guide your provider toward the best match.

• Pregnancy prevention: Most pills are highly effective when taken consistently—but some may be easier to stay on track with depending on your routine.
• Clearer skin: Certain combination pills are FDA-approved to treat acne and may help reduce breakouts by regulating hormones.
• Lighter or more regular periods: Many pills help regulate cycles, reduce cramping, and lighten bleeding.
• Managing PMS or PMDD: Some pill formulations can help ease physical and emotional symptoms.
• Minimizing side effects: If you’ve had issues with past birth control (like mood changes, nausea, or spotting), your provider can recommend options that work better with your body.

Whatever your goals, our team takes the time to understand what matters most to you—so your birth control supports your overall well-being.

Lifestyle factors

Here are a few things your provider will consider when presenting your options:

• Age and smoking status: If you’re over 35 and smoke, combination pills (which contain estrogen and progestin) may not be the safest option due to a higher risk of blood clots.
• Medical history: If you’ve experienced migraines with aura, high blood pressure, or blood clots, progestin-only pills or non-pill options may be better suited for you.
• Daily routine: If remembering a daily pill is tough, alternatives which require weekly or monthly attention—might be a better fit.
• Cost and coverage: Many birth control pills are available in affordable generic forms, like Junel®  Fe and Sprintec®. Most insurance plans cover branded birth control at no cost, but generics are a budget-friendly choice if you’re paying out of pocket.

Weight gain

If you’re curious about potential weight changes while on birth control, you’re not alone. It’s one of the most common concerns—and a totally valid one to ask about. Here’s the good news: most modern birth control pills don’t lead to noticeable or lasting weight gain.

• Estrogen can cause some fluid retention at first, which might make you feel a little puffier—but this usually fades as your body adjusts.
• Progestin may slightly increase appetite in some people, but this varies from person to person.

If you’re worried about weight changes, your provider may suggest a low-dose combination pill or a progestin-only option. Keep in mind: sleep, stress, movement, and nutrition tend to have a much bigger impact on weight than the pill itself.

Breast tenderness

It’s not uncommon to experience breast tenderness when you start a new pill—your body’s adjusting to different hormone levels. This tenderness often feels like what you might experience before your period: fullness, sensitivity, or mild soreness.

The good news is that for most people, this goes away after a few months. In the meantime, a few things may help:

• Wear a supportive bra (yes, even at night!)
• Cut back on caffeine
• Use over-the-counter pain relievers if needed

If the tenderness doesn’t improve after a few months—or feels too intense—your provider can help you explore a different formulation. Pills with lower estrogen or a different type of progestin may work better for your body.

Protection against sexually transmitted infections

Birth control pills are great at preventing pregnancy, but they don’t protect against sexually transmitted infections (STIs). That’s a common misunderstanding.

Here’s the bottom line: the pill helps prevent pregnancy, but it won’t protect you from infections like chlamydia, gonorrhea, herpes, or HIV. That’s why many providers recommend using condoms in addition to the pill—especially in new relationships, when you or your partner have other partners, or when STI status is unknown.

This kind of “dual protection” offers peace of mind: birth control pills help prevent pregnancy, while barrier methods like condoms reduce the risk of STIs.

And remember, regular STI testing is just as important as birth control when it comes to protecting your sexual health. Whether you’re starting a new relationship or just checking in with yourself, getting tested is a smart and empowering choice.

Emergency contraception and missed pills

Missed a pill? Don’t panic. There’s a clear path forward. Understanding what to do when pills are missed can help you stay protected and avoid unnecessary stress.

If you miss one active pill, take it as soon as you remember—even if that means taking two pills in one day. You’ll still be protected.

If you miss two or more active pills in a row, take the most recent missed pill right away, and then continue taking the rest as scheduled (even if that means discarding earlier missed pills). You’ll need to use backup birth control—like condoms—for the next 7 days. If you had unprotected sex in the past 5 days, emergency contraception may be a smart next step.

Emergency contraception—such as Plan B One-Step® or Ella®—helps prevent pregnancy after unprotected sex or a birth control slip-up. These are not abortion pills. Instead, they work by delaying ovulation, giving sperm and egg less chance to meet. Timing matters: Plan B One-Step® is available over the counter and works best the sooner you take it. Ella®, which requires a prescription, is effective for up to 5 days after unprotected sex.

If you find yourself missing pills often, it may be time to explore different birth control methods. Long-acting methods like the IUD, implant, patch, or ring can be easier to keep up with, depending on your routine. There’s no one-size-fits-all approach—and there’s no shame in finding what works best for you. The right birth control is the one you can use consistently and confidently.

Choosing the right pill for your life

Finding the right birth control pill doesn’t have to cause you unnecessary stress. When you understand how different types of birth control work, take your personal health needs into account, and stay honest about your lifestyle and preferences, you’re already on the right path.

And remember—there’s no one-size-fits-all answer. The “perfect” pill for one person might not be the right fit for someone else. It can take a little time (and sometimes a little trial and error) to find your match. Be patient with the process, and don’t hesitate to speak up about any side effects or concerns. Your provider is there to help you explore alternatives and adjust as needed.

Take your time. Ask questions. Trust yourself. Be sure to use the advice of your clinician as you decide. 

At Nurx, we make that process simpler by offering expert, judgment-free care from licensed medical providers—plus delivery right to your door.

Frequently Asked Questions (FAQ)

What is the best birth control pill to lose weight?

No birth control pill is specifically designed for weight loss. Some people notice changes in weight on certain pills, but it varies from person to person and isn’t guaranteed.

How do I know if birth control isn’t right for me?

If you’re experiencing side effects that interfere with your daily life—like nausea, mood changes, or migraines—it’s worth talking to a healthcare provider. You may benefit from switching to a different pill or birth control method.

Does my partner need to ‘pull out’ if I’m on the pill?

When taken correctly, the pill is a highly effective form of birth control. That said, some people choose to use a backup method, such as condoms or ‘pulling out’.  ’Pulling out’ is not as effective as using condoms in preventing STI—so for the most protection, it’s a good idea to use a barrier method (such as condoms). . 

What is the best birth control with the least side effects?

There’s no single pill that works best for everyone. What causes side effects in one person may be perfectly tolerable for another. A provider can help you find the option that works best with your body and lifestyle. 

The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional.

Services not offered in every state. Medications prescribed only if clinically appropriate, based on completion of required consultation. Not all options discussed here are available through Nurx. Individual results may vary. Costs apply. See Nurx.com for details.

Medication costs vary based on prescribed treatment and applicable insurance coverage, price not guaranteed. Not all insurance plans are accepted. Additional costs apply, including consultation fee. 

Bayez® (drospirenone 3mg/ethinyl estradiol 0.02mg/levomefolate calcium 0.451mg tablets and levomefolate calcium 0.451mg tablets), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including irregular and/or heavy uterine bleeding, headache, breast tenderness, nausea, and dizziness. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

Sprintec® (norgestimate 0.25mg and ethinyl estradiol 0.035mg tablets), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH/default.htm or call 1-800-FDA-1088.

Drospirenone/ethinyl estradiol, Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

Camila® (norethindrone tablets, USP), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including irregular and/or heavy uterine bleeding, headache, breast tenderness, nausea, and dizziness. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH/default.htm or call 1-800-FDA-1088.

Heather® (norethindrone), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH/default.htm or call 1-800-FDA-1088.

Junel Fe 1/20® (norethindrone acetate 1mg and ethinyl estradiol 0.02mg tablets, and ferrous fumarate 75mg tablets), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

Ella® (Ulipristal Acetate tablet, 30mg), Rx only, is an emergency contraceptive used to prevent pregnancy up to five days (120 hours) after unprotected sex. Ella® may cause side effects, including headache, nausea, and stomach pain. If you would like to learn more about Ella®, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: https://www.fda.gov/Safety/MedWatch/default.htm or call 1-800-FDA-1088.

Levonorgestrel tablet 1.5 mg, intended to reduce the chance of pregnancy after unprotected sex, may cause side effects, including dizziness, abdominal pain, diarrhea, headache, fatigue, irregular menstruation, breast tenderness, nausea or spotting. If you would like to learn more about Levonorgestrel tablet 1.5 mg, please see product information here. Use as directed.

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