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Women's Health

What on Earth is a triphasic pill, and is it better?

Thu 19th March, 2020

Reviewed by: Dr. Vamsee Thalluri

For something we call “The Pill”, there sure are a lot of variations of this medication. There are pills with low oestrogen, high oestrogen, no oestrogen, levonorgestrel, norethisterone,  dienogest, and drospirenone. The list goes on.

So what is the triphasic pill?

Triphasic contraceptive pills contain three different doses of hormones, so that the formulation changes approximately every week throughout your cycle. Your “standard”, or monophasic pill, on the other hand, contains the same dose of hormones for the whole 21 days before the pill-free period.

One triphasic pill, “Trifeme”, has a cycle of 28 tablets with varying levels of Ethinylestradiol (oestrogen) and Levonorgestrel (progestin), to be taken at different stages of the menstrual cycle. This is what it looks like:

When you take a triphasic pill, the oestrogen component bumps up in the middle of your cycle (when you’d normally ovulate), while the progesterone component ramps up throughout your cycle.

They’re not all like this, but the general idea is that triphasic pills allow a lower dose of oestrogen (theoretically meaning fewer side effects), with a mid-cycle boost to prevent ovulation.

Meanwhile, the progestin component is low at the start (as normal) but ramps up to simulate the natural increase following ovulation. You can see this in the graph below of the normal hormonal changes during the menstrual cycle.


Do triphasic pills work as well as standard pills to prevent pregnancy?

For most women, the top priority for contraception is not falling pregnant. And for those women not yet ready for motherhood, there’s some good news: triphasic pills are just as effective as standard formulations, and are just as simple to take. This was shown in a review paper from 2011 which included more than 20 different studies, so you can feel pretty confident about this one.

Do triphasic pills reduce spotting?

Some probably do, but it’s hard to say for sure. Across the board, most studies on the triphasic pill, ‘trifeme’, showed that fewer women reported intermenstrual bleeding, or spotting, between their periods. This makes sense as the hormone progesterone, which stops your endometrium from breaking down, ramps up over time in these pills.

Do triphasic pills have more side effects?

The different side effects of The Pill can cause a lot of women to think twice before changing things up. And there are definitely some women who say their PMS is worse on triphasic pill formulations. But here’s some good news: on average, women taking triphasic pills report no additional side effects, cycle disturbances or medical problems than on standard pills.

This is great news for anyone thinking about making the switch. Still, it’s worth remembering that different pills have different effects in different women. So if yours is working for you, that’s what really matters.