Ranking of Oral Contraceptives by Hormone Strength: An Expert Look on Birth Control Pills

Overview

Oral contraceptives are one of the several methods of birth control; and if taken properly, these pills are effective in preventing pregnancy. The synthetic forms of the naturally-occurring female hormones are found in these pills – estrogen and progestin. These hormones inhibit the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH) that play a role in the development of the egg and in the preparation of the uterus lining during implantation of the embryo. Ovulation also stops due to the effect of progestin.

Hormone Strength of Oral Contraceptives

Oral contraceptives are generally safe and effective in preventing pregnancy, as long as each pill is taken regularly and according to the doctor's prescription. These pills are made up of the synthetic version of estrogen (ethinyl estradiol) and progesterone. The amount of ethinyl estradiol affects the estrogen potency of the pill, although specific progestin components also have minimal estrogen activity.

The estrogen level in oral contraceptives is measured in micrograms, where the highest is 50 mcg and the lowest is 20 mcg. Here is a ranking of oral contraceptives by hormone strength to give you an idea on the potency of each pill.

Brand names of oral contraceptives containing 50 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Necon® 1/50 (1.00 mg of norethindrone)
  • Norinyl® 1/50 (1.00 mg of norethindrone)
  • Ortho-Novum® 1/50 (1.00 mg of norethindrone)
  • Ovcon-50® (1.00 mg of norethindrone)
  • Ovral® (0.50 mg of norgestrel)
  • Demulen® 1/50 (1.00 mg of ethynodiol diacetate)
  • Zovia® 1/50E (1.00 mg of ethynodiol diacetate)

Brand names of triphasic oral contraceptives containing 35/35/35 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Ortho-Tri-Cyclen® (0.15/0.215/0.25 mg of norgestimate)
  • Ortho-Novum® 7/7/7 (0.50/0.75/1.00 mg of norethindrone)
  • Tri-Norinyl® (0.50/1.00/0.50 mg of norethindrone)

Brand names of biphasic oral contraceptives containing 35/35 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Ortho-Novum® 10/11 (0.50/1.00 mg of norethindrone)
  • Jenest® (0.50/1.00 mg of norethindrone)

Brand names of oral contraceptives containing 35 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Ortho-Cyclen® (0.25 mg of norgestimate)
  • Ovcon-35® (0.40 mg of norethindrone)
  • Brevicon® (0.50 mg of norethindrone)
  • Modicon® (0.50 mg of norethindrone)
  • Necon® (1.00 mg of norethindrone)
  • Norethin® (1.00 mg of norethindrone)
  • Norinyl® 1/35 (1.00 mg of norethindrone)
  • Ortho-Novum® 1/35 (1.00 mg of norethindrone)
  • Demulen® 1/35 (1.00 mg of ethynodiol diacetate)
  • Zovia® 1/35E (1.00 mg of ethynodiol diacetate)

Brand names of triphasic oral contraceptives containing 30/40/30 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Triphasil® (0.05/0.075/0.125 mg of levonorgestrel)
  • Tri-Levlen® (0.05/ 0.075/0.125 mg of levonorgestrel)
  • Trivora® (0.05/0.075/0.125 mg of levonorgestrel)

Brand names of oral contraceptives containing 30 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Levlen® (0.15 mg of levonorgestrel)
  • Levora® (0.15 mg of levonorgestrel)
  • Nordette® (0.15 mg of levonorgestrel)
  • Lo/Ovral® (0.30 mg of norgestrel)
  • Desogen® (0.15 mg of desogestrel)
  • Ortho-Cept® (0.15 mg of desogestrel)
  • Loestrin® 1.5/30 (1.50 mg of norethindrone acetate)
  • Yasmin® (3.0 mg of drospirenone)

Brand names of oral contraceptives containing 20 mcg of ethinyl estradiol, and their corresponding progestin content:

  • Alesse® (0.10 mg of levonorgestrel)
  • Levlite® (0.10 mg of levonorgestrel)
  • Loestrin 1/20® Fe (1.00 mg of norethindrone acetate)
  • Mircette® (0.15 mg of desogestrel)
  • Ortho Evra®(patch) (0.15 mg of norelgestromin/norgestimate metabolite)

Conclusion

The amount of ethinyl estradiol in each pill determines the estrogen activity level. Oral contraceptives that have higher doses of progestin have greater androgenic effects (e.g., excess body hair). Women should consult their health care provider to determine the best oral contraceptive pill suitable for them.

Resources

Jelovsek, Frederick, MD, "Deciding on Oral Contraceptive Pills," https://www.wdxcyber.com/ncontr13.htm

Stoppler, Melissa Conrad, MD, "Birth Control Pills," https://www.medicinenet.com/oral_contraceptives_birth_control_pills/article.htm