One of the most common questions my patients ask me in our discussions regarding birth control is: "Dr. Francis, which birth control pill is best for me?" And I have to admit, I don't know. The problem is that what pill works for you may not be the pill that works for your friend and vice versa. So sometimes my patients come in and say: "I want the lowest form of birth control. I want the least amount of hormones possible, because that's what my friend has, and that's what I've read about is the best for me." But the truth is you may have a lot of breakthrough bleeding when you take that birth control pill, or you might have a lot of headaches or a lot of nausea. And that if we change the balance between the estrogen and progesterone, the next birth control option that we choose might be the better option for you.
What I usually do is I use a birth control pill that's a monophasic pill, which means that you have the same estrogen and progesterone throughout the pack, and then you have one week of placebo pills. And then, if that pill doesn't work for you, depending on the side effect profile or the way that you feel, then I can change it to a different pill.
So in general, keep an open mind when it comes to birth control pill options. The pill that works for your friend may not be the pill that works for you, and the lowest hormone dose may be the wrong balance for you. Understand that it's a balance between the estrogen and progesterone that's going to work best for you, not necessarily the lowest amount of hormones.