Women have more choices for contraception now than ever before. Every option has different benefits, risks and levels of effectiveness. In today’s post, we’ll discuss hormonal contraception methods. In the coming weeks, we’ll also talk about non-hormonal, long-acting reversible and permanent options.
Hormonal birth control methods prevent pregnancy by releasing hormones into the body. Usually hormonal birth control releases both estrogen and progestin, though some methods contain only one or the other. These hormones thicken the mucus in the cervix, which then hinders sperm from reaching the egg. Hormones also thin the lining of the uterus, so fertilized eggs are less likely to attach to it. Hormonal methods work similarly, but today they come in many different forms. Many forms of hormonal contraception are also used to treat abnormal menstrual bleeding.
The Birth Control Pill
The most common form of hormonal birth control is the pill, which a woman must take orally at the same time every day. Birth control pills are either combination pills, which contain estrogen and progestin, or progestin-only. Pills usually contain hormones for three weeks; during the fourth week, a woman’s monthly period occurs. Placebo pills may be included in the pack to help maintain the habit of taking them. “Continuous-dose” pills are another option for women with heavy or painful menstrual periods. These contain hormones throughout the whole month and reduce the frequency of menstrual cycles—or stop them completely.
- Effectiveness: With typical use, 8 in 100 women will become pregnant in their first year of taking the pill; if used perfectly, 1 in 100 women will become pregnant in their first year.
- Other benefits: Beyond preventing pregnancy, the pill may also be used to regulate the menstrual cycle, treat cramps and other causes of menstrual pain and sometimes control acne.
- Risks: The pill is generally safe, but it may increase the risk of deep vein thrombosis, heart attack and stroke—especially for older women, smokers, and those already at risk for cardiovascular disease.
The Birth Control Patch
A birth control patch releases hormones into the body through the skin. You must wear a new patch every week for three weeks. In the fourth week, no patch is worn and menstrual bleeding occurs. Patches may be worn while bathing, exercising and swimming.
- Effectiveness: With typical use, 8 in 100 women on the patch will become pregnant.
- Other benefits: The patch may also improve acne, reduce menstrual migraines (if used continuously) and reduce unwanted excessive hair growth.
- Risks: Like the pill, the patch can increase risk of heart problems for older women, smokers and those with risk factors for cardiovascular disease.
Vaginal rings are inserted into the upper vagina and worn for three weeks. During the first week of each month, another birth control method (such as condoms) may be necessary, and during the fourth week the ring is removed and menstrual bleeding occurs.
- Effectiveness: With typical use, 8 in 100 women wearing a vaginal ring will become pregnant.
- Other benefits and risks: Similar to those of the patch.
Injections and Implants
Doctors may administer hormonal birth control injections, which can prevent pregnancy for three months. Women may also choose to receive a hormonal implant, which is a single rod inserted under the skin. Implants can prevent pregnancy for up to three years.
- Effectiveness: During a year of typical use, 3 in 100 women who receive injections will become pregnant, and less than 1 in 100 women who have an implant will.
- Other benefits: Both methods can be used by women breastfeeding, and women who receive an injection may have a decreased risk of developing endometrial cancer.
- Risks: Injections pose the same heart risks to certain women as the patch and ring, and many women have a decrease in bone density levels while receiving injections. These levels return to normal when injections cease.
An IUD (intrauterine device) is a long-lasting and highly effective method of birth control. The t-shaped device is inserted by a physician under the skin in the uterus. Once inserted, this long-acting method of birth control does not interfere with sex or other daily activities, though it serves as no protection against sexually transmitted diseases. Although non-hormonal IUDs exist, a hormonal IUD continuously releases small amounts of progestin into the uterus, which prevents the fertilization of the egg. This hormonal method is effective for up to five years. Mirena is currently the only hormonal IUD available.
- Effectiveness: During the first year of use, less than 1 in 100 women using an IUD will become pregnant.
- Other benefits: an IUD can be removed by a trained healthcare provider at any time and requires no action on the part of the user. Like other forms of hormonal birth control, it may decrease menstrual pain and heavy bleeding. Some women may stop having periods entirely after several years.
- Risks: Risks and side effects are low, but some women may experience headaches, nausea, or breast tenderness, and others may develop ovarian cysts in their first months of using a hormonal IUD. Though pregnancies while using a hormonal IUD are rare, if they occur they are at an increased risk of being an ectopic pregnancy in which the fetus grows and develops outside of the uterus.
In choosing a birth control method, the one universal truth is that everyone is different. Feel free to talk to your friends about what works for them, but keep an open mind about various methods. Birth control is not one-size-fits-all.
Do you have questions about contraception? Make an appointment with one of our women’s health nurse practitioners, nurse midwives or physicians. Contact an office.
Sources: Content – American Congress of Obstetricians and Gynecologists; Image – Fox News