| **Indication** | **Preferred Contraceptive Options** |
|---|---|
| **Contraception (general)** | **Any monophasic: [Loestrin 24 Fe](#bkmrk-loestrin-24-fe), [Alesse (Aviane)](#bkmrk-alesse-%28aviane%29), [Ortho-Cyclen](#bkmrk-ortho-cyclen), [Yaz](#bkmrk-yaz), [Beyaz](#bkmrk-beyaz)** **Patch: [Xulane](#bkmrk-xulane-%28patch%29), [Twirla](#bkmrk-twirla-%28patch%29)** **Progestin-only (estrogen contraindicated): [Camila](#bkmrk-camila), [Errin](#bkmrk-errin), [Slynd](#bkmrk-slynd)** |
| **Menstrual regulation (irregular cycles)** | **[Loestrin 24 Fe](#bkmrk-loestrin-24-fe), [Yaz](#bkmrk-yaz), [Ortho-Cyclen](#bkmrk-ortho-cyclen), [Alesse (Aviane)](#bkmrk-alesse-%28aviane%29)[ ](#bkmrk-alesse-%28aviane%29)** **Patch: [Xulane](#bkmrk-xulane-%28patch%29), [Twirla](#bkmrk-twirla-%28patch%29)** |
| **Dysmenorrhea** **(painful periods)** | **[Loestrin 24 Fe](#bkmrk-loestrin-24-fe), [Yaz](#bkmrk-yaz), [Ortho-Cyclen](#bkmrk-ortho-cyclen)** **Extended-cycle: [Seasonique](#bkmrk-seasonique), [Seasonale](#bkmrk-seasonale), [Quartette](#bkmrk-quartette)** **Patch: [Xulane](#bkmrk-xulane-%28patch%29), [Twirla](#bkmrk-twirla-%28patch%29)** |
| **Menorrhagia** **(heavy bleeding)** | **[Loestrin 24 Fe](#bkmrk-loestrin-24-fe), [Yaz](#bkmrk-yaz), [Slynd](#bkmrk-slynd) (if estrogen contraindicated)** **Avoid ultra-low estrogen pills (e.g., [Lo Loestrin Fe](#bkmrk-lo-loestrin-fe))** |
| **Acne** | **FDA Approved: [Yaz](#bkmrk-yaz), [Beyaz](#bkmrk-beyaz), [Ortho Tri-Cyclen](#bkmrk-ortho-tri-cyclen), [Estrostep Fe](#bkmrk-estrostep-fe)[ ](#bkmrk-estrostep-fe)** **Others: [Yasmin](#bkmrk-yasmin), [Ortho-Cyclen](#bkmrk-ortho-cyclen) (may help but not FDA-approved)** |
| **Premenstrual Dysphoric Disorder (PMDD)** | **[Yaz](#bkmrk-yaz), [Beyaz](#bkmrk-beyaz) (due to drospirenone’s mood benefits)** |
| **Desire for fewer or no periods** | **Extended-cycle OCPs: [Seasonique](#bkmrk-seasonique), [Seasonale](#bkmrk-seasonale), [Quartette](#bkmrk-quartette), [Amethyst](#bkmrk-amethyst)[ ](#bkmrk-amethyst)** **Continuous use of monophasic pills** |
| **Estrogen contraindicated (migraine with aura, VTE, breastfeeding)** | **Traditional: [Camila](#bkmrk-camila), [Errin](#bkmrk-errin) (traditional minipills)** **Novel: [Slynd](#bkmrk-slynd) (better cycle control)** |
| **Desire for non-daily method** | **Patch: [Xulane](#bkmrk-xulane-%28patch%29), [Twirla](#bkmrk-twirla-%28patch%29) (weekly)** |
| **PCOS** | **[Yaz](#bkmrk-yaz):** Anti-androgenic progestin → improves acne and hirsutism; regulates cycles **[Beyaz](#bkmrk-beyaz):** Same as Yaz with added folate; helpful if pregnancy prevention is also a goal **[Ortho Tri-Cyclen](#bkmrk-ortho-tri-cyclen):** improves acne; cycle regulation; moderate anti-androgenic effect **[Estrostep Fe](#bkmrk-estrostep-fe):** acne; milder anti-androgenic action |
| **Brand Name** | **Formulation/****Delivery** | **Estrogen Dose** | **Progestin Type** | **Medical Indications** | **Special Considerations** |
| **Alesse (Aviane)** | Monophasic OCP | 20 mcg EE | Levonorgestrel | Cycle control | Low-dose, well tolerated |
| **Amethyst** | Continuous OCP | 20 mcg EE | Levonorgestrel | Continuous cycle, no periods | Continuous; may suppress periods entirely |
| **Beyaz** | Monophasic OCP + folate | 20 mcg EE | Drospirenone | Acne, PMDD | Anti-androgenic for acne and mood; added folate for neural tube protection |
| **Camila** | Progestin-only pill (POP) | None | Norethindrone 0.35 mg | Estrogen contraindicated, breastfeeding, VTE risk | Strict timing; breakthrough bleeding risk |
| **Errin** | Progestin-only pill (POP) | None | Norethindrone 0.35 mg | Estrogen contraindicated, breastfeeding, VTE risk | Strict timing; breakthrough bleeding risk |
| **Estrostep Fe** | Triphasic OCP | 20/30/35 mcg EE | Norethindrone | Acne, menstrual regulation | Gradual estrogen increase; effective for acne |
| **Lo Loestrin Fe** | Monophasic OCP (26+2) | 10 mcg EE | Norethindrone acetate | Light or absent periods desired, minimal estrogen exposure | May cause amenorrhea; less effective for heavy bleeding |
| **Loestrin 24 Fe** | Monophasic OCP (24+4) | 20 mcg EE | Norethindrone acetate | Menstrual regulation, menorrhagia, dysmenorrhea | Good cycle control; helps reduce heavy bleeding and cramps; preferred for menorrhagia |
| **Ortho Tri-Cyclen** | Triphasic OCP | 35 mcg EE | Norgestimate | Acne | Triphasic with acne indication |
| **Ortho-Cyclen** | Monophasic OCP | 35 mcg EE | Norgestimate | Menstrual regulation, moderate acne | Higher estrogen; effective for acne but more estrogen side effects |
| **Quartette** | Extended-cycle OCP | Step-up EE | Levonorgestrel | Extended-cycle, fewer periods | Reduces breakthrough bleeding |
| **Seasonale** | Extended-cycle OCP | 30 mcg EE | Levonorgestrel | Fewer periods/year, dysmenorrhea | Less frequent bleeding |
| **Seasonique** | Extended-cycle OCP | 30 mcg EE | Levonorgestrel | Fewer periods/year, dysmenorrhea | Less frequent bleeding |
| **Slynd** | Progestin-only pill (Minipill) | None | Drospirenone 4 mg | Estrogen contraindicated, heavy bleeding | Better cycle control; flexible timing vs traditional POPs |
| **Twirla (Patch)** | Transdermal patch | 30 mcg EE/day | Levonorgestrel | Cycle regulation | Weekly patch; avoid in high BMI; Lower estrogen vs. Xulane; limited data in adolescents |
| **Xulane (Patch)** | Transdermal patch | 35 mcg EE/day | Norelgestromin | Cycle regulation, dysmenorrhea | Weekly patch; higher estrogen exposure |
| **Yasmin** | Monophasic OCP | 30 mcg EE | Drospirenone | Menstrual control | Higher estrogen than Yaz; acne control |
| **Yaz** | Monophasic OCP | 20 mcg EE | Drospirenone | Acne, PMDD, hirsutism | Anti-androgenic for acne and mood |