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One of the most important things for paleo women to consider is what we are going to do about birth control.

Should you take hormonal birth control? Is it really all that good? Bad? What happens to you when you’re on it? Of course, non-hormonal  would be ideal for any woman who prioritizes having a natural menstrual cycle. Unfortunately, natural options are really not as abundant as they should be. Check out my top picks for low dose birth control options.


Non-hormonal birth control options

1) condoms and other prophylactics

2) pulling out

3) fertility awareness

4) the copper IUD

This last one is pretty powerful–and popular–but it carries a modest risk of copper toxicity with it and may exacerbate bleeding and cramps during your cycle. The copper IUD also costs a pretty penny… somewhere in the neighborhood of $500-$1000.

So, hormonal alternatives seem like a reasonable choice to many women. And they are. Side effects are often minimal (but again, I caution you against them), and many women are completely happy on the birth control pill.

One way to give yourself the best chance of this happening is to go on a low dose birth control option.

There are more than 60 varieties of the birth control pill available today, and every one of them is different. The dosages for the least impactful birth control pills are classified as: “ultra-low dose” and “low dose.”


Different ways higher hormone birth control can affect you

“Ultra-low dose” birth control pills are those that contain 0.02 mg of estrogen

0.02mg of estrogen is just about the lowest you can go and still prevent pregnancy. The reason many people opt for higher doses is that the side effects of spotting and breakthrough bleeding are more common with ultra-low dose birth control pills versus low dose birth control pills.

There are two ultra-low dose varieties:

Alesse (Aviane, Lessina, Lutera, Sronyx)
Contains 0.02 mg ethinyl estradiol and 0.1 mg levonorgestrel (a kind of progestin – read more about progestin types in my blog here and here)

Contains 0.02 mg ethinyl estradiol and 0.15 mg desogestrel (a kind of progestin)

Five low dose birth control pills:

Pills containing 0.02mg- 0.035mg.of estrogen fall into this category. They have a lower incidence of spotting and breakthrough bleeding.

ethinyl estradiol : 0.03 mg
norgestrel (progestin) : 0.3 mg

ethinyl estradiol : 0.03 mg
levognorgestrel : 0.15 mg

Ortho-Cept (Reclipsen, Solia)
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg

ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg

Levlen 21
ethinyl estradiol : 0.03
levonorgestrel : 0.15 mg

ethinyl estradiol : 0.03mg
levonorgestrel : 0.15 mg


Triphasic Pills

Other favorites of women interested in natural health are low dose “triphasic” pills, which better approximate the hormonal fluctuations a woman normally experiences. They also tend to be a bit better than average for weight maintenance and even weight loss.


  • Phase 1: ethinyl estradiol : 0.025 mg and desogestrel (a kind of progestin) : 0.1 mg
  • Phase 2: ethinyl estradiol : 0.025 mg and desogestrel : 0.125 mg
  • Phase 3: ethinyl estradiol : 0.025 mg and desogestrel : 0.15 mg

Ortho Tricyclen Lo 

  • Phase 1: 0.025 mg ethinyl estradiol and 0.180 mg of norgestimate
  • Phase 2: 0.025 mg of ethinyl estradiol and 0.215 mg norgestimate
  • Phase 3: 0.025 mg of ethinyl estradiol and 0.250 mg of norgestimate

(Ortho Tricyclen and Ortho-Cyclen, each with 0.035 mg of ethinyl estradiol, contain slightly higher amounts of estrogen in each type of pill than Ortho Tricyclen Lo)


Finally, YASMIN and YAZ are two more low dose birth control pills containing 0.03 mg and 0.02 mg respectively of estrogen. What is unique about them is that they have a different type of progestin from the other pills called drospirenone (3.0 mg).

Drospirenone has the benefit of reducing acne and water retention in a lot of women. On the other hand, and this is a huge ON THE OTHER HAND, I have taken a similar substance and nearly died from a potassium overload, as well as developed a severe case of insomnia and anxiety that I am still dealing with two years later. If you take Yaz or Yasmin, please keep your potassium-containing foods to a minimum, drink plenty of fluids, and regularly check in with your doctor on your potassium levels. If you experience muscle weakness or heart palpitations, stop taking your pill immediately.

low dose birth control pills

So aside from the YAZ, those are my favorite low dose birth control pills. These are the ones I fear the least, as they are the lowest dose birth control pills I know of. If I were to use hormonal birth control (to be clear: I don’t, I use prophylactics) – these are the ones I would investigate using, or at least ask my doctor about trying.

If you happen to struggle with acne and be on a birth control pill or contemplating it, take a moment and think about it. Each type of birth control pill has a different relationship with your skin! I discuss the nuances of hormone balance and specifics kinds of pills as they relate to acne in my brand new, 50% off program on the topic, Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin

If you happen to struggle with PCOS, it is worth learning about the condition and how to overcome it naturally before going on the pill. I describe how  I did and how you can do it too in my manual on the topic, PCOS Unlocked: The Manual.


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