Oral birth control pills are categorized into different generations based on when they were developed. Just like the generations within a family, the different generations of birth control pills have developed over the years with the first generation being the oldest, followed by the second generation birth control pill, and then the third and fourth generations being the most recent. Although each brand of oral birth control pill is slightly different, perhaps the biggest change between the generations is the type of progestin being used.
The first generation birth control pill was introduced in 1960 and was made from synthetic forms of estrogen and progesterone. This was not the birth control pill of today, this was the early version that your mother or even grandmother might have taken that had higher levels of hormones in each pill. Second generation birth control pills were introduced in the 1970’s and had much lower amounts of hormones in each pill. The synthetic estrogen was changed to a natural version, and the synthetic progestin that was being used was swapped out for either norgestrel or levonorgestrel. Second generation birth control pills dominated the market for about twenty five years. Next came third generation birth control pills which have been on the market more recently, with the progestin source changing yet again. And now we have fourth generation birth control pills with another progestin change. It seems like every time you turn on the TV there’s another birth control pill on the market.
I like to recommend second generation birth control pills whenever possible. These pills are well tolerated, have a history of success, and are the most widely prescribed generation of birth control pills. When it comes to birth control pills, newer is not always better.