Hormonal Birth Control Options

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Here’s the deal: Your body naturally produces hormones such as estrogen and progesterone. These hormonal birth control options use different forms of synthetic hormones (that mimic your natural ones) to affect your cycle in ways that may help prevent pregnancy.

The side-effect list is not exhaustive.

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Combined oral contraceptive (COC) pill

You probably know someone on a birth control pill, as it’s very widely used. The combined oral contraceptive (COC) contains both estrogen and progestin. 

How it works

  • Helps prevent the ovary from releasing an egg
  • May change the cervical mucus slowing the movement of the sperm through the mucus and through the uterus
  • May change the lining of the uterus

How it's taken

A birth control pill is taken orally, daily. Certain pills require a few pill-free days, while others include a few days of placebo pills, allowing for a period to occur.

 

Effectiveness

Highly effective when taken as prescribed.

Pros

  • May reduce the risk of ovarian cysts
  • May reduce the incidence of ovarian and uterine cancers
  • Reversible
  • May reduce  menstrual flow and cramps (lose less blood)
  • Menstrual cycle may be more regular
  • May cause a decrease in painful menstruations and in  premenstrual syndrome (PMS)

Cons

  • Effectiveness may be reduced by other medications
  • May cause irregular bleeding/spotting
  • May cause breast tenderness, nausea/vomiting,  headaches, change in weight, acne, itching/rash, dizziness, mood changes, vaginal infection, urinary track infection, back/abdominal pain, upper respiratory tract infections, painful menstruations.
  • Put the user at higher risk of blood clots (including blood clot in legs, lungs, heart, eyes or brain).
  • Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels. This risk increases with age and with the number of cigarettes smoked. Women who use birth control pills should not smoke. COC should not be used by women who are over 35 years of age and smoke.
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex and take your birth control pills.

Progestin-only pill (POP)

The progestin-only pill (POP) which contain a low dosage of norethindrone without the addition of an estrogen agent.

How it works

  • Prevents ovulation (release of the egg from the ovary) in about half of the cycles.
  • Changes the mucus produced by the cervix., which slows the movement of the sperm through the mucus and through the uterus (womb).
  • Affect other hormones, the fallopian tubes and the lining of the uterus.

How it's taken

Take one pill orally at the same time every day for 28 days. Without missing a day, start taking tablets from your new package.

 

Effectiveness

The typical failure rate is estimated to be 5%, which is slightly less effective than combination birth control pills.

Pros

  • May be suitable for women who cannot take estrogen
  • Reversible
  • May result in no period

Cons

  • May cause periods to be either early or late, or may cause spotting between periods.
  • May cause include headaches, tender breasts, nausea, vomiting, tiredness, weight gain, dizziness, acne, extra hair on your face or body, loss of hair, rash, abdominal pain, yellowing of the skin or eyes (jaundice), and tubal pregnancy.
  • May be less effective when used with certain drugs, or may affect the effectiveness of other drugs
  • Should not be used by women who smoke. Cigarette smoking increases the risk of serious negative effects on the heart and blood vessels. This risk increases with age and becomes significant in hormonal contraceptive users over 35 years old.
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex and take your birth control pills.

The patch

An approximately 4 x 4 cm beige patch that sticks to the skin and continuously releases estrogen and progestin into the bloodstream.

How it works

  • Helps stop the ovaries from releasing an egg
  • May change the cervical mucus the cervical mucus slowing the movement of the sperm through the mucus and through the uterus

How it's used

  • One patch a week, for 3 weeks, is worn on the skin
  • The patch should be changed on the same day every week
  • The fourth week is patch-free, allowing for a period to occur

Effectiveness

Highly effective when used as prescribed.

Pros

  • Reversible
  • May reduce menstrual flow (lose less blood)
  •  Menstrual cycle may be more regular
  • May cause a decrease in painful menstruations and in premenstrual syndrome (PMS)
  • May reduce the incidence of  ovarian and uterine cancers
  • May reduce the risk of ovarian cysts

Cons

  • Effectiveness may be reduced by other medications.
  • Cigarette smoking increases the risk of serious side effects on the heart and blood vessels. This risk increases with age and with the number of cigarettes smoked. The patch should not be used by women who are over 35 and smoke.
  • Requires remembering to change the patch once per week.
  • May cause irregular bleeding or spotting.
  •  Put the user at higher risk of blood clots, (including blood clot in legs, lungs, heart, eyes or brain). Women who are obese are at particularly high risk.
  • May cause breast  discomfort, nausea/vomiting,  headaches, abdominal/back/muscle pain, acne, allergy, diarrhea, dizziness, flu-like symptoms, genital itching, urinary tract infection, vaginal infection, weight gain, painful menstruations.
  • May cause skin irritation
  • May be less effective in women who weigh more than 198 lbs
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex in combination with your patch.

The vaginal ring

Available in one size, this is a soft, flexible, clear plastic ring that measures about 5.4 cm in diameter and is inserted into the vagina. It steadily releases estrogen and progestin for 3 weeks.

How it works

  • Helps stop the ovaries from releasing an egg
  • May change the cervical mucus slowing the movement of the sperm through the mucus and through the uterus

How it's used

  • Self-inserted and removed
  • The ring is worn inside the vagina for three weeks, followed by one week that’s ring-free allowing a period to occur
  • The ring doesn’t need to be in a particular position in the vagina to be effective. It is held in place by the walls of the vagina and women usually cannot feel the ring once it is inside the vagina 

Effectiveness

Highly effective when used as prescribed.

Pros

  • Reversible 

Cons

  • Effectiveness may be reduced by other medications
  • Cigarette smoking increases the risk of serious side effects on the heart and blood vessels. This risk increases with age and with the number of cigarettes smoked. The ring should not be used by women who are over 35 and smoke.
  • Ring can be felt/evicted and cause problems during intercourse.
  • May cause irregular bleeding or spotting
  • Put the user at higher risk of blood clots,  (including blood clot in legs, lungs, heart, eyes or brain).
  • May cause breast pain, nausea, or headaches weight increase, mood changes, painful menstruation, acne, decreased libido, abdominal pain.
  • May cause vaginal irritation, discomfort, or discharge
  • Requires remembering to change the ring once per month
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex in combination with your ring.

A shot

Injectable contraception contains a progestin but does not contain estrogen. Given only four times a year.

How it works

  • Stops the maturing of the egg in the ovaries
  • May thicken the cervical mucus
  • May change the lining of the uterus

How it's given

Administered by a healthcare professional, the injection is given in the muscle (usually in the upper arm or buttocks) every 12 to 13 weeks.

Effectiveness

Highly effective

Pros

  • Long-lasting
  • Reversible
  • May be suitable for women who can’t take estrogen
  • May be suitable for women over the age of 35 who smoke
  • May help reduce or eliminate periods

Cons

  • Effectiveness might be affected by few medications.
  • Should only be used if no other treatment will work and should be used for the shortest period of time possible. The risks and benefits should be regularly reevaluated.
  • May increases the risk of serious side effects on the heart and blood vessels in smokers.
  • May increase risk of HIV acquisition.
  • May cause irregular menstrual bleeding.
  • Causes a decrease in bone mineral density which can lead to osteoporosis or broken bones. It is worse the longer you use the drug. It may return to normal when a woman stops using the injection.
  • May be associated with change of appetite and/or weight gain in some women.
  • May cause headaches, mood issues, lower sex drive, nausea/vomiting, swelling of the arms and legs, problems sleeping, leg cramps, joint/back/abdominal/pelvic pain, hot flashes, bloating, skin reaction, injection site reaction, dizziness, no hair growth or excessive hair growth.
  • It can take a longer time to get pregnant after getting your last shot. For some, it can take approximately 6 to 10 months after the last injection for the ovaries to start releasing eggs again.
  • Must be administered by a healthcare professional.
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex in combination with the shot.

The implant

A small, flexible rod that is  placed in the upper arm. It continuously releases a small amount of a progestin into your bloodstream to prevent pregnancy for up to 3 years.

How it works

  • Helps stop the ovaries from releasing an egg
  • May change the cervical mucus making it difficult for the sperm to enter the uterus

How it's used

Your healthcare professional will perform a small procedure to insert the implant into your upper arm. Once in place, pregnancy can be prevented for up to 3 years.

Effectiveness

Highly effective

Pros

  • Long-lasting
  • Reversible
  • May be suitable for women who can’t take estrogen
  • May reduce or eliminate periods

Cons

  • May moved from the place it was inserted and may need to be removed.
  • Possible risks with insertion or removal 
  • Effectiveness may be reduced by other medications 
  • May cause irregular menstrual bleeding
  • Must be inserted, removed, and replaced by a healthcare professional familiar with the implant
  • May cause painful period, ovarian cyst, vaginal infection, decreased sex drive, breast pain/discharge/enlargement, inflammation of the vagina/vaginal pain, insertion site reaction, trouble sleeping, flu-like symptoms, back/abdominal/joint/muscle/bone pain, dizziness, mood changes and headaches.
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex in combination with the implant.

A hormonal intrauterine contraception (IUC)

Intrauterine contraceptives (IUCs) are small T-shaped devices that are inserted into the uterus by a healthcare professional. The IUC contains a progestin, which is slowly and continuously released to prevent pregnancy for up to 3 to 5 years depending on the brand. 

How it works

  • The cervical mucus becomes thicker which makes it harder for sperm pass through the cervix
  •  Reduces the normal monthly thickening of the lining of the uterus
  • Impairs sperm movement and function

How it's used

The device is inserted into the uterus by a health professional. Once in place, pregnancy can be prevented for up to 3 to 5 years.

Effectiveness

Highly effective

Pros

  • Reversible
  • Long lasting
  • May reduce menstrual flow and cramps or lead to absence of period
  • May be suitable for women who cannot take estrogen

Cons

  • Cigarette smoking increases the risk of serious side effects on the heart and blood vessels.
  • Must be inserted, removed, and replaced by a healthcare professional.
  • Effectiveness may be reduced by other medications.
  • Irregular bleeding, or spotting may occur
  • Irregular/painful periods, light, or no menstrual periods
  • Some pain or discomfort during insertion
  • May cause oily skin/acne, headaches, breast pain/discomfort, mood issues, nausea, hair loss/excess, skin problems, lower sex drive, weight gain, infection of the ovaries, fallopian tubes or uterus, discharge from the vagina, breakage of the IUS, expulsion of the device, increased blood pressure.
  • Risks with the insertion could include infection, perforation of the uterus, or expulsion of the IUC
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDS. Use a condom when you have sex in combination with the implant.

Disclaimer: The contents of this article are for informational purposes only and are not exhaustive, and are not intended, nor should they be used, as a substitute for professional medical advice. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding contraception.
The lists of side-effects presented on this website are not exhaustive.
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