What is Hormonal Birth Control?

Hormonal birth control is one of many methods and refers to contraceptive methods that use synthetic hormones to prevent pregnancy. There are various forms of hormonal birth control, including pills, patches, injections, intrauterine devices (IUDs), and implants. Each method delivers hormones into the body, which then work to prevent pregnancy through different mechanisms.

Types of Hormonal Birth Control

1. Birth Control Pills: These are oral contraceptives taken daily. There are two main types: combination pills (which contain both estrogen and progestin) and progestin-only pills.
2. Patches: These are adhesive patches that stick to the skin and release hormones into the bloodstream. They are typically replaced weekly.
3. Injections: These involve getting a hormone shot, usually every three months, to maintain contraceptive effectiveness.
4. Implants: These are small rods inserted under the skin of the arm, releasing hormones over an extended period (usually up to three years).
5. Hormonal IUDs: These are small, T-shaped devices placed in the uterus by a healthcare provider, releasing hormones locally for several years.

How Hormonal Birth Control Differs from Other Methods

Unlike barrier methods like condoms or diaphragms, which physically block sperm from reaching the egg, hormonal birth control works by altering the body's natural hormone levels to prevent pregnancy. This can be more convenient for many women as it does not require action at the time of intercourse.

The Hormones Involved

Hormonal birth control primarily uses two types of synthetic hormones: estrogen and progestin. These hormones are similar to the natural hormones produced by a woman's ovaries. Understanding their roles can help you grasp how hormonal birth control works.

Estrogen

Estrogen is a hormone that regulates the menstrual cycle and is responsible for the development of female secondary sexual characteristics, such as breast growth. In hormonal birth control, estrogen helps to:

• Prevent Ovulation: Estrogen suppresses the hormones that trigger the release of an egg from the ovary (ovulation). Without ovulation, there is no egg available for fertilization.
• Stabilize the Uterine Lining: It helps to maintain a stable uterine lining, reducing irregular bleeding and making periods lighter and more regular.

Progestin

Progestin is a synthetic form of progesterone, another hormone involved in the menstrual cycle and pregnancy. Progestin works in several ways to prevent pregnancy:

• Thickening Cervical Mucus: It thickens the mucus around the cervix, the entrance to the uterus. This thicker mucus acts as a barrier, making it difficult for sperm to enter the uterus and reach an egg.
• Thinning the Uterine Lining: Progestin makes the lining of the uterus thinner, which makes it less likely for a fertilized egg to implant and grow.
• Preventing Ovulation: Like estrogen, progestin also helps to suppress ovulation, particularly in progestin-only contraceptives.

Combined Effects

When used together, estrogen and progestin create a highly effective method of birth control. By preventing ovulation, thickening cervical mucus, and thinning the uterine lining, these hormones work together to provide multiple layers of protection against pregnancy.

Mechanism of Action

Hormonal birth control works through a combination of mechanisms to effectively prevent pregnancy. These mechanisms ensure that the chances of fertilization and implantation are significantly reduced.

Prevention of Ovulation

Ovulation is the process in which an ovary releases an egg. Hormonal birth control prevents this from happening by altering the levels of estrogen and progestin in the body. Normally, a rise in these hormones triggers the release of an egg. Birth control maintains steady hormone levels, tricking the body into thinking it has already released an egg. Without ovulation, there is no egg available for fertilization by sperm.

Thickening of Cervical Mucus

Cervical mucus is a fluid produced by the cervix, which can change in consistency throughout the menstrual cycle. During ovulation, cervical mucus becomes thinner and more slippery to help sperm travel through the cervix to fertilize an egg. Hormonal birth control causes the mucus to remain thick and sticky. This thick mucus acts like a barrier, making it difficult for sperm to swim through the cervix and reach an egg.

Thinning of the Uterine Lining

The uterine lining, also known as the endometrium, thickens each month in preparation for a potential pregnancy. If an egg is fertilized, it implants in this thickened lining and begins to grow. Hormonal birth control keeps the uterine lining thin and less suitable for implantation. Even if an egg were to be fertilized, it would have a harder time attaching to the uterus and developing into a pregnancy.

Different Forms of Hormonal Birth Control

Hormonal birth control comes in various forms, each designed to deliver hormones in a way that suits different preferences and lifestyles. Understanding the differences can help you choose the best option for your needs.

Birth Control Pills

• Combination Pills: These pills contain both estrogen and progestin. They are taken daily, usually for three weeks, followed by a week of placebo pills (inactive pills) during which you have your period. Combination pills are effective when taken consistently at the same time every day.
• Progestin-Only Pills (Mini-Pills): These pills contain only progestin. They must be taken at the same time every day without a break. They are a good option for women who cannot take estrogen.

Pros:

• High effectiveness with consistent use
• Can regulate menstrual cycles
• May reduce acne

Cons:

• Requires daily intake at the same time
• Possible side effects include nausea and mood changes

Patches

• Transdermal Patch: This is a small, adhesive patch that sticks to your skin and releases hormones into your bloodstream. You wear the patch on your abdomen, buttocks, back, or upper arm. It is replaced weekly for three weeks, followed by a patch-free week during which you have your period.

Pros:

• Weekly application, easier to remember than daily pills
• Consistent hormone levels

Cons:

• May cause skin irritation at the application site
• Visible on the skin

Injections

• Depo-Provera: This injection contains progestin and is administered by a healthcare provider every three months. It provides a long-lasting option without the need for daily or weekly attention.

Pros:

• Administered every three months, reducing daily or weekly maintenance
• Highly effective

Cons:

• May cause weight gain and irregular periods
• Requires a healthcare visit for each injection

Implants

• Nexplanon: This is a small, flexible rod inserted under the skin of your upper arm by a healthcare provider. It releases progestin continuously and can prevent pregnancy for up to three years. It is a highly effective and low-maintenance option.

Pros:

• Long-term protection (up to three years)
• Low maintenance once inserted

Cons:

• Requires a minor surgical procedure for insertion and removal
• May cause irregular bleeding

Hormonal IUDs

• Mirena, Skyla, Liletta, and Kyleena: These are small, T-shaped devices inserted into the uterus by a healthcare provider. They release progestin locally within the uterus, providing protection for 3 to 7 years, depending on the brand. Hormonal IUDs are very effective and convenient, requiring minimal maintenance once inserted.

Pros:

• Long-lasting (3 to 7 years)
• Low maintenance once inserted
• Can reduce menstrual cramps and bleeding

Cons:

• Requires insertion and removal by a healthcare provider
• Possible initial discomfort and spotting

Vaginal Rings

• NuvaRing: This is a flexible ring inserted into the vagina, where it releases a continuous dose of estrogen and progestin. The ring is worn for three weeks, followed by a ring-free week during which you have your period. It provides monthly protection and is easy to insert and remove.

Pros:

• Monthly use, requiring insertion only once a month
• Provides consistent hormone levels
• Can be removed temporarily if needed, but not for more than three hours within a 24-hour period

Cons:

• Requires correct placement and timely monthly replacement
• Possible side effects include vaginal irritation or discharge
• Some women may find insertion and removal uncomfortable

Why some opt for progestin-only pills

Suitable for Women Who Cannot Take Estrogen

• Health Conditions: Women with certain health conditions, such as a history of blood clots, high blood pressure, or migraines with aura, are often advised to avoid estrogen due to the increased risk of serious side effects. Progestin-only pills do not contain estrogen, making them a safer alternative.
• Breastfeeding: Estrogen can reduce milk supply in breastfeeding women. Progestin-only pills are considered safe for breastfeeding mothers as they do not affect milk production and provide effective contraception.

Lower Risk of Cardiovascular Side Effects

• Reduced Risk of Blood Clots: Progestin-only pills carry a lower risk of blood clots compared to combination pills, which makes them a safer option for women with a higher risk of cardiovascular issues.
• Safer for Older Women: Women over the age of 35 who smoke or have other cardiovascular risk factors may find progestin-only pills to be a safer option due to the absence of estrogen.

Fewer Hormonal Side Effects

• Reduced Estrogen-Related Side Effects: Some women experience side effects from estrogen, such as nausea, headaches, and breast tenderness. Progestin-only pills eliminate these side effects, making them more tolerable for some users.

Effective Contraception with Consistent Use

• Immediate Return to Fertility: Progestin-only pills do not cause a delay in the return of fertility once discontinued. Women can usually conceive soon after stopping the mini-pill, which is ideal for those planning pregnancy in the near future.

Choosing the Right Method

When choosing a form of hormonal birth control, consider factors such as:

• Convenience: How often you need to take or apply it (daily, weekly, monthly, every few years).
• Lifestyle: Your daily routine and how a method fits into it.
• Health Conditions: Any medical conditions or risk factors that might make one type of hormonal birth control more suitable than another.
• Effectiveness: How effective each method is in preventing pregnancy when used correctly.

Consulting with a healthcare provider can help you weigh these factors and choose the method that best fits your needs and lifestyle.

Benefits of Hormonal Birth Control

Hormonal birth control offers a variety of benefits beyond preventing pregnancy. These advantages can improve overall health and quality of life for many women.

Effectiveness in Preventing Pregnancy

• High Success Rate: When used correctly, hormonal birth control methods are over 99% effective in preventing pregnancy. This high level of effectiveness provides peace of mind for those looking to avoid unintended pregnancies.

Regulation of Menstrual Cycles

• Predictable Periods: Hormonal birth control can make menstrual cycles more regular and predictable. This is especially beneficial for women with irregular periods.
• Reduced Menstrual Cramps: Many users experience less severe menstrual cramps, making monthly cycles more manageable.
• Lighter Periods: Birth control can lead to lighter menstrual bleeding, reducing the discomfort and inconvenience associated with heavy periods.

Improvement of Acne

• Clearer Skin: Hormonal birth control, particularly combination pills, can help reduce acne. The hormones in birth control pills can decrease the production of androgens, hormones that increase oil production in the skin.

Management of Other Health Conditions

• Endometriosis: Hormonal birth control can help manage symptoms of endometriosis, a condition where tissue similar to the lining inside the uterus grows outside of it, causing pain and heavy periods.
• Polycystic Ovary Syndrome (PCOS): For women with PCOS, hormonal birth control can help regulate menstrual cycles and reduce symptoms like excessive hair growth and acne.
• Reduced Risk of Certain Cancers: Long-term use of hormonal birth control has been shown to reduce the risk of ovarian and endometrial cancers.

Convenience and Flexibility

• Various Options: With multiple forms available (pills, patches, injections, IUDs, implants), women can choose the method that best fits their lifestyle and preferences.
• Long-Term Options: Some forms of hormonal birth control, such as implants and IUDs, provide long-term protection without the need for daily or weekly attention.

Potential Side Effects and Risks

While hormonal birth control offers many benefits, it’s important to be aware of potential side effects and risks. Understanding these can help you make an informed decision about which method is best for you.

Common Side Effects

• Nausea: Some women experience nausea when they start taking hormonal birth control, especially with pills. This usually subsides after a few months.
• Weight Gain: Hormonal changes can lead to weight gain in some women, although this is often temporary.
• Mood Changes: Hormonal birth control can affect your mood, leading to mood swings, anxiety, or depression in some cases.
• Breast Tenderness: Sore or tender breasts can occur, especially in the initial months of use.
• Spotting Between Periods: Light bleeding or spotting between periods, known as breakthrough bleeding, can happen, particularly with the pill, patch, or ring.

Serious Risks

• Blood Clots: Hormonal birth control, especially those containing estrogen, can increase the risk of blood clots. This risk is higher for smokers and women over 35.
• Cardiovascular Issues: There is a slightly increased risk of heart attack and stroke, particularly in women with other risk factors such as smoking, high blood pressure, or a history of migraines with aura.
• Breast Cancer: Some studies suggest a slight increase in the risk of breast cancer with hormonal birth control, although the risk decreases after discontinuation.

Who Should Avoid Hormonal Birth Control

• Smokers Over 35: Smoking increases the risk of serious cardiovascular side effects, particularly with estrogen-containing birth control.
• Women with Certain Health Conditions: Those with a history of blood clots, certain types of cancer, liver disease, or uncontrolled high blood pressure should avoid hormonal birth control.
• Migraines with Aura: Women who experience migraines with aura may have an increased risk of stroke when using estrogen-containing birth control.

Managing Side Effects

• Consult with Your Doctor: Discuss any side effects with your healthcare provider. They can help adjust the type or dosage of birth control to better suit your body.
• Monitor Your Health: Keep track of any changes in your body and mood, and report these to your healthcare provider.
• Lifestyle Adjustments: Eating a balanced diet, exercising regularly, and managing stress can help mitigate some side effects.

Weighing the Benefits and Risks

• Personalized Choice: The decision to use hormonal birth control should be based on weighing the benefits against the potential risks for your individual health situation.
• Professional Guidance: Regular check-ups with your healthcare provider ensure that your chosen method remains safe and effective for you.

Myths and Misconceptions

Many myths and misconceptions surround hormonal birth control. Understanding the facts can help dispel these myths and allow you to make informed decisions about your contraceptive options.

Myth 1: Hormonal Birth Control Causes Infertility

• Fact: Hormonal birth control does not cause permanent infertility. It temporarily prevents pregnancy while in use. Once you stop using it, your fertility typically returns to normal. Some women may experience a brief delay in regaining fertility, but this is not permanent.

Myth 2: Birth Control Pills Always Cause Weight Gain

• Fact: While some women may experience slight weight gain due to water retention, most studies show no significant long-term weight gain with birth control pills. Lifestyle factors such as diet and exercise play a more significant role in weight management.

Myth 3: Hormonal Birth Control Increases Cancer Risk

• Fact: While there is a slight increase in the risk of breast and cervical cancer, hormonal birth control reduces the risk of ovarian and endometrial cancers. The overall impact on cancer risk varies and should be discussed with a healthcare provider.

Myth 4: You Need to Take Breaks from Birth Control

• Fact: There is no medical need to take breaks from hormonal birth control. Taking breaks does not provide health benefits and can increase the risk of unintended pregnancy. Continuous use is safe and effective for most women.

Myth 5: Hormonal Birth Control is Only for Young Women

• Fact: Women of all reproductive ages can use hormonal birth control. It can be beneficial for managing symptoms of menopause, such as hot flashes and irregular periods, in older women.

Myth 6: It Takes a Long Time to Get Pregnant After Stopping Birth Control

• Fact: Fertility generally returns quickly after stopping hormonal birth control. Most women can conceive within a few months. The time frame can vary depending on the type of birth control and individual health factors.

Clarifying the Facts

• Reliable Sources: Information from healthcare providers and scientific studies is the best way to learn about hormonal birth control.
• Consulting Professionals: Always discuss any concerns or questions with a healthcare provider to get accurate, personalized advice.

Choosing the Right Method

Selecting the right hormonal birth control method involves considering various factors that match your health needs, lifestyle, and preferences. Here are some key points to help you decide which option is best for you.

Health Considerations

• Medical History: Discuss any existing health conditions with your healthcare provider. Conditions like high blood pressure, migraines with aura, or a history of blood clots can influence which method is safe for you.
• Medications: Some medications can interact with hormonal birth control, reducing its effectiveness. Make sure your healthcare provider knows about any medications you are taking.

Lifestyle Factors

• Daily Routine: If you have a busy or unpredictable schedule, a method that requires daily attention, like the pill, might be less convenient. Long-term options like the implant or IUD might be more suitable.
• Travel and Accessibility: Consider how easy it will be to access your birth control while traveling or if you live far from a pharmacy or healthcare provider.

Convenience and Maintenance

• Frequency of Use: Birth control methods vary in how often they need to be administered. Pills are taken daily, patches are changed weekly, injections are given every three months, and implants and IUDs can last several years.
• Ease of Use: Some methods require you to remember to take or apply them regularly, while others are more "set it and forget it." Choose what fits best with your ability to maintain the regimen.

Effectiveness

• Consistency: The effectiveness of birth control can depend on how consistently you use it. Methods that require less frequent attention, like the implant or IUD, are less prone to user error.
• Perfect vs. Typical Use: Understand the difference between perfect use (how effective the method is when used exactly as directed) and typical use (how effective it is in real life, considering human error).

Side Effects and Personal Preferences

• Tolerance to Side Effects: Different methods can have different side effects. Your tolerance for these side effects will help determine the best method for you.
• Non-Contraceptive Benefits: Some methods offer additional benefits like reducing acne, regulating periods, or decreasing menstrual cramps. These benefits might make one method more appealing than another.

Consulting with a Healthcare Provider

• Personalized Advice: A healthcare provider can offer personalized advice based on your health, lifestyle, and preferences.
• Trial and Adjustment: It might take trying a couple of different methods to find the one that works best for you. Keep open communication with your healthcare provider to make adjustments as needed.

Choosing the right hormonal birth control method is a personal decision that should be made with careful consideration of your health, lifestyle, and preferences. For those in Canada, TeleTest offers all the major brands of hormonal birth control. By understanding the various options and discussing them with a healthcare provider, you can find the method that best meets your needs.

Disclaimer: This blog post is intended for educational purposes only and should not be taken as medical advice. Always consult your healthcare provider for personal health concerns.