Hormonal Birth Control Options
Hormonal birth control refers to birth control methods that contain synthetic forms of hormones. These contraceptives mimic the naturally-occurring hormones produced in a woman's body. Hormonal birth control must be prescribed by your doctor.
There are two types of hormonal birth control:
- Combination Hormonal Birth Control: Combination birth control is methods that contain both synthetic estrogen and some type of progestin.
- Progestin-Only Birth Control: These methods are contraceptives that only contain progestin and are good options if you cannot use birth control that contains estrogen.
Hormonal birth control methods tend to be very popular. You may wish to use hormonal contraception because:
- These methods are reversible (with the exception of Depo Provera). This means that your fertility (or ability to get pregnant) quickly returns once you stop using them.
- Hormonal birth control is convenient and easy to use.
- Many of these methods have some of the lowest failure rates (when used correctly), so they are very effective.
- Hormone birth control can offer you many non-contraceptive health benefits as well (like helping with bad menstrual cramps or reducing acne).
Here is a list of all of the available hormonal birth control methods for you to use. The first three are combination methods and the rest of the list are progestin-only hormonal birth control options.
Combination Birth Control Pills
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Combo birth control pills must be taken every day, at the same time. They contain Ethinyl estradiol and one of the following types of progestin: norethindrone, norethindrone acetate, ethynodiol diacetate, levonorgestrel, norgestrel, desogestrel, norgestimate, or drospirenone. Each of these progestins has its own profile based on its progestational, estrogenic, and androgenic effects on your body. There is also a new combination birth control pill called Natazia—this is the only pill that contains estradiol valerate and the progestin, dienogest. Combination birth control pills are also categorized as monophasic, biphasic or triphasic—this is based on how the hormones are distributed over the weeks in each pill pack. There are also extended cycle combination pills.
The NuvaRing is a combination contraceptive that must be inserted into the vagina. Once inserted, it gradually releases Ethinyl estradiol and the progestin, etonogestrel. You insert NuvaRing and leave it in place for three weeks. On Week 4, you take it out—this is when you should have your withdrawal period.
The birth control patch is applied to the skin. It releases Ethinyl estradiol and the progestin, norelgestromin directly through the skin. You need to replace the patch every week (for three weeks). During Week 4, you keep the patch off.
Nexplanon is a progestin-only birth control insert that contains 68 mg of the progestin, etonogestrel. This single rod is inserted into your upper arm where the progestin is slowly released. The implant also contains radiopaque (this is so it can be easily seen on an x-ray to make sure that the rod has been properly placed). It is considered to be a long-acting, reversible contraceptive (LARC)—once Nexplanon is inserted, it provides pregnancy protection for up to 3 years.
Depo Provera and Depo-subQ Provera 104 Injection
Depo Provera and Depo-subQ Provera 104 are hormonal contraceptive injections. Both depo shots are similar—each injection slowly releases the progestin, medroxyprogesterone acetate. You must get a Depo Provera injection every 11 to 13 weeks (Depo-subQ Provera 104 injections must happen every 12-14 weeks). If you use Depo Provera, you basically need to have 4 injections each year. Like all hormonal birth control methods, Depo Provera does have some side effects. Many women stop using Depo Provera because of the side effects (like irregular or continuous bleeding). There is no way to know before starting Depo Provera if you will have any of these side effects. The good news about Depo Provera -- it has been FDA-approved to help treat endometriosis.
Mirena is a type of IUD. Mirena releases the progestin, levonorgestrel (20 mcg a day). Mirena is inserted into your uterus by a doctor. Once inserted, it can be left in place for 5 years. All you need to remember to do is check the Mirena IUD strings—this will tell you that your Mirena is still in place. Because it has progestin, Mirena is a little more effective than the ParaGard IUD. Besides being used as contraception, Mirena has been FDA-approved to help treat heavy periods. You can also have your Mirena IUD removed at any time before the 5-year timeframe is over.
The mini-pill is a progestin-only type of birth control pill. They are known to cause fewer side effects than combination pills. Because they do not contain estrogen, the mini-pill is a good birth control option for new moms who are breastfeeding. The mini-pill come in 28-day packs—you need to remember to take one of these pills every day for each 4-week pill cycle.
Skyla is also known as the mini IUD. Once inserted, Skyla releases the progestin levonorgestrel (14 mcg a day)—Skyla lasts for 3 years. The Skyla IUD is considered a great hormonal birth control option for teenagers and women who haven't given birth. The Skyla IUD (and the tube used to insert it) is smaller than Mirena and ParaGard. This makes Skyla a little bit easier and less painful to insert. Like any IUD, you can also have Skyla removed at any time.
These birth control methods may not be the safest contraception for all women. This is why it is important to talk to your doctor to review your medical history.
You must be honest during this conversation. Why? Well certain behaviors, like smoking, may put you more at risk for certain complications if you use hormonal birth control.
Also, keep in mind that hormonal birth control:
- Does not provide any protection against sexually transmitted diseases.
- May be less effective if you use certain medications.
- Could possibly increase your risk of developing a blood clot.
- May be less effective if you are very overweight.