Want to hop on the birth control train, but don’t know where to start? You aren’t the first, and you won’t be the last. It’s all about the method you use. Thinking of going the hormonal contraception route? You’ve come to the right place. Hormonal birth control methods are safe and effective ways to prevent pregnancy, and there are several options to choose from. From the pill to the IUD to the patch, there’s something out there for almost everyone. Here is all you need to know about hormonal birth control.
What kinds of hormonal birth control are available? How do they work?
Now for some science…
- Oral Contraceptives
The most popular form of hormonal birth control, oral contraceptives come in the form of a pill that you take daily. There are two types of birth control known as the pill: the combination pill and the progestin-only pill. Let’s discuss both:
- The Combination Pill
The combination pill contains low doses of synthetic estrogen and progesterone, and it prevents pregnancy by stopping ovulation.
Okay, so this is how your menstrual cycle happens naturally: there are two glands in your brain that control the reproductive endocrine system and these glands talk to your ovaries and let them know when it’s time to release an egg (ovulation). When an egg is released, estrogen levels take a dip while progesterone levels go up, preparing your uterus for pregnancy. If the egg doesn’t get fertilized, progesterone levels fall, which sends a message to your uterus and brain that it’s time to get a move on to the next phase of the menstrual cycle. Bring on your period. Estrogen gets put back into gear about 2 weeks later, ovulation will begin again and the cycle repeats itself. Got that?
When on the pill, your pituitary gland gets the message that it doesn’t need to grow that egg and that that it doesn’t have to go through the usual hormonal cycle because the gland is convinced you’ve already ovulated. Basically you’re tricking your ovaries into preventing pregnancy. Easy peasy.
Combination pills usually come in packs of 28 pills with 21 days of active pills and 7 days of inactive pills, or placebos. You get your period during the placebo week. You need to take the pill daily at the same time every day for it to be most effective, and if you miss a pill, you should always use a backup form of birth control just to be safe.
- The Progestin-Only Pill
Progestin-only pills, also known as minipills, contain progesterone only, as you may have guessed by the name. Unlike the combo pill, these pills don’t rely on stopping ovulation. Instead they work by thickening the mucus around the cervix. This makes your uterus a pretty hostile place for sperm. No sperm, no pregnancy.
This pill is super tricky because you have to (note: have to) take the pill at the same time every day. And we mean the same time every day. You’ve got about a 3-hour window in which to take the pill, and missing that window leaves you at risk for pregnancy. When you’re late taking the pill, the mucus in your cervix thins, and those little spermies? They can march right on through. You must must use a backup contraceptive method for 48 hours after a missed pill, no exception.
- The Patch
Like combination pills, the patch contains both estrogen and progesterone. The patch prevents pregnancy by stopping ovulation, but instead of taking the hormones orally, they are absorbed through the skin. Like the progestin-only pill, the patch also thickens the mucus in your cervix, creating an inhospitable environment for sperm.
The patch usually comes in a beige-color and you can wear it on your upper arm, stomach, back or bum. You wear the patch for three weeks, switching it out monthly for a new one. On the fourth week, you skip the patch and get your period. Don’t worry, the patch doesn’t hurt, and in case you’re wondering, it’s completely waterproof.
- The Ring
Just like the combo pill and the patch, the vaginal ring contains both estrogen and progesterone. This time, the hormones are absorbed through the mucus membrane inside the vagina. The vaginal ring is fairly small coming in at two inches wide. It’s soft and flexible and slowly releases hormones throughout the month.
The ring stays in place for three weeks and is removed the fourth week at the same day and same time that it was inserted (and yes, you insert it and take it out yourself). During that fourth week, you’ll get your period. After your period, you put in a new ring, and voila, the cycle repeats itself. The ring, also called the NuvaRing, must be stored at room temperature, and if not used right away, should be kept cool. So, no, it’s not weird that your friend stashes her ring in the fridge, she’s just keeping it nice and fresh.
- The Injection
The birth control injection aka Depo-Provera is a progestin-only birth control that prevents ovulation and gives you three months of pregnancy protection each injection. You may not get your period during those three months, but you can expect some irregular bleeding. And the actual injection isn’t so scary, we promise.
- The Implant
Okay, so this one sounds like it comes straight out of a sci-fi movie. The progestin-based contraceptive implant is a 1.6 inch rod that you put into your upper inner arm. You can’t see it, but you can feel it, and it needs to be put in (and taken out) by a professional. It works by slowly releasing progesterone and prevents pregnancy by stopping ovulation and thickening your cervical mucus. It’s a double whammy.
To put in the implant, a doctor will use an inserter attached to a needle, position the implant and then remove the needle. Yikes! Seems like it would hurt, right? Most women, though, don’t complain about the rod insertion, instead they complain about the numbing meds used before application, that can sting. The implant can stay in your arm for up to five years and can be taken out at any time.
- The Hormonal IUD
The hormonal intrauterine device, better known as the IUD, is a small T-shaped bit of plastic. It’s implanted in the uterus (by a professional, of course) and can be taken out anytime. The progestin-only IUD can prevent pregnancy for three to six years.
There are a couple of ways the IUD prevents pregnancy. First, it thickens the mucus in the cervix, which the sperm don’t like. It can stop ovulation, but only sometimes, and it may affect the movement of your fallopian tubes so that its harder for sperm to get anywhere near an egg. To put it in a nutshell, sperm abhor the IUD and want nothing to do with it. All of the methods together make the hormonal IUD 99.8% effective in preventing pregnancy. Praise be.
Are there any disadvantages to using hormonal birth control?
Unfortunately, hormonal birth control doesn’t leave you scot-free. Each method comes with its own side effects and troubles, and none of them protect you from sexually transmitted infections. Let’s discuss one by one.
- Oral Contraceptives
Birth control pills come with a list of side effects that range from annoying to potentially serious. On the pill, you can often expect nausea, breast tenderness, headaches, weight gain, and sometimes symptoms of depression, anxiety, fatigue and low libido. The pill also carries the increased risk of breast cancer as well as blood clots, both of which can be life threatening.
Also, you have to make sure to take your birth control every day or you could risk getting pregnant. Not only that, but you should take the pill at the same time daily for it to be at its most effective. Progestin-only pills are extremely particular because you have to take the pill within the same three-hour window every day. How do you remember to take your pill? You can set an alarm on your phone or keep your pill pack close to something you use everyday, like your toothbrush in the morning.
- The Patch
Like the pill, the patch can cause breast tenderness, nausea and headaches. The patch can also cause breakthrough bleeding, which can be quite a nuisance for you and your underwear. Some people get irritated and sore where the patch is, but most don’t. Many of the side effects will go away after three months, so you won’t be nauseous forever.
It’s super important to change your patch every week or you could get pregnant. Like with the pill, set a weekly alarm in order to remember to switch it or make a note in your planner. You can never be too careful!
- The Ring
The ring can cause the usual hormonal side effects: sore boobs, nausea, spotting or headaches. You may experience a little extra vaginal fluid when you’re on the ring, and your level of sexual desire could change. Most women find their sex drive takes a nosedive. Womp womp. Again, most of these side effects will abate after a few months of use.
Like the pill and the patch, you must remember to change the ring on time. So, get out that calendar and schedule a date with your NuvaRing.
- The Injection
Some people get pesky side effects with the injection, but a lot of women don’t. In addition to the usual set of side effects, the injection can make changes to your period, like bleeding more than usual, spotting or no period at all. A lot of women report that they stop getting their period all together after about a year of injections. You can also get slight bruising when you get the shot and though it’s rare, you could get a small, permanent dent where the shot was given.
Unlike the pill, patch and ring, you have to go to a doctor to get the injection every three months. This can be super annoying, especially if you don’t live near somewhere that administers it.
Also, after you stop the injections, it could take up to 10 months to get pregnant. And yeah that’s a long time to wait.
- The Implant
The side effects of the implant usually go away after a few months after your body gets used to it. The most common side effect is spotting, especially within the first year. Your periods may also get longer and heavier, but most women find their periods to actually get lighter. Some women stop getting their period all together. While it’s possible to get an infection at the insertion site, it’s pretty rare. All and all, the implant is super effective.
- The Hormonal IUD
Side effects of the IUD usually go away in three to six months, when your body gets used to the alien in your uterus. Most women complain about the insertion of the IUD because it can sometimes be quite painful and the pain can last for a few days. You may get cramps with the IUD as well as irregular bleeding.
How can I pick which method to use?
It’s all about your individual body. Our bodies are like snowflakes, no two are alike, and no two will respond the same to birth control. You can choose based on which pill has the least side effects or based on your lifestyle. It’s all up to you. Will you remember to take the pill? No? Then maybe the IUD is right for you. Are you only going on birth control for a short while? Pills may be your best bet instead of something more permanent such as the implant. It’s your body, your choice. And don’t freak out if the method you use doesn’t immediately agree with you. Half of finding the right birth control method is trial and error.
If you’re thinking about starting hormonal birth control and are worried about potential side effects, we got you. Top Up Tonic replenishes essential nutrients that birth control is known to strip your body of. Adequate levels of these key nutrients allow your body (and mind) to work in tip top shape, so that you’re ready to take on any obstacle that’s thrown your way. You are a woman, you are strong, and you don’t have to let birth control symptoms interfere with being your best self. Find out more about Top Up Tonic here.