These days, access to birth control is pretty abundant. About 62 percent of women of reproductive age are currently using some form of contraception, according to the Centers for Disease Control and Prevention. You can get it at almost any pharmacy with a prescription from a doctor, and if that’s not available, there are services that deliver contraception straight to your door.
These days, women have more options of types of birth control than ever. According to the CDC, roughly 16 percent of women ages 15 to 44 are using the pill, 8 percent use an implant and 15 percent have gone the sterilization route. One thing nearly all of them have in common? They introduce additional hormones to your body.
But what kinds of hormones are we talking about, and how do they impact us day to day? Here, experts weigh in on how the different types of birth control hormones can affect your body and what options are out there to help you make an informed decision on what’s for you.
Before we dive into the different options on the market for contraception, it’s important to note what hormones are used to prevent unwanted pregnancy. First and foremost, the hormones in birth control aren’t real hormones at all. They’re man-made (or synthetic) versions of estrogen and progesterone, referred to as progestin. Depending on the type of contraception you’re using, there are different amounts of the hormones in each method of birth control, and those amounts can even vary between brands (i.e., two different birth control pills can have different levels).
Typical side effects from forms of contraception that include both hormones include headache, nausea, breast tenderness and vaginal spotting when you’re not on your period, according to Dr. Diana Ramos, an OB-GYN at the National Preconception Health and Health Care Initiative. Ramos also tells SheKnows that combination birth control can have the following impacts: a decrease in menstrual cramps; a decrease of blood flow during your period; a decrease facial acne; prevention of pregnancy; and a decrease in ovarian, uterine and colon cancer. Sometimes, these factors can cause women to lean into birth control even though they aren’t looking to prevent pregnancy.
Now that you know how the hormones in birth control can impact your body, here are the different types of contraceptives and how those hormones work within them.
Hormones involved: estrogen and progestin or progestin-only
The pill comes in two varieties: combination (both hormones) and progestin-only. Combination pills suppress ovulation by stopping the production of the luteinizing hormone in your pituitary gland, Dr. Christine Greves, an OB-GYN at Orlando Health Winnie Palmer Hospital for Women and Babies, tells SheKnows. They also trigger changes in the lining of the uterus and cervix, making it difficult for an egg to implant and sperm to travel. These pills come in three different styles: monophasic, multiphasic and extended cycle.
Monophasic: This provides the exact same dose of each hormone each day.
Multiphasic: Users will get different levels of hormones during the cycle.
Extended-cycle: Each pack contains 84 active pills (as opposed to 28 pills in a standard monthly pack). That means this type of user should only get a period four times a year.
Progestin-only pills are for individuals who may not be able to take estrogen, whether that is because they are prone to blood clots or to the development of dense breast tissue. These are often referred to as minipills.
“I tell my patients that pills are like boyfriends: You have to find the right one,” Greves says. “Different levels of the hormones impact everyone in different ways. You have to feel out what feels right for you and your body. Just make sure to wait about three months, giving your body time to adjust, before seeking out a different alternative.”
Hormones involved: combination of both estrogen and progestin
The birth control patch looks similar to a Band-Aid measuring roughly 1.5 inches square and sticks to your skin, delivering hormones through your skin into your bloodstream. About 11 percent of women between the ages of 15 and 44 have used the patch as a contraception method, according to the CDC.
Hormones involved: progestin
The shot involves a much higher does of progestin than other progestin-inclusive forms of birth control (Greves highlights this at 150 milligrams versus a low-dose minipill at 35 micrograms). Because of this, users may gain weight since the hormone dose could trigger an increased appetite.
One 2014 study published in the journal Contraception compared the shot to IUD use and found that those using the shot gained an average of 4.2 pounds over 12 months but stayed the same for IUD users. Another 2017 study published in the Archives of Endocrinology and Metabolism recommended that the health effects of weight gain should be carefully considered for those choosing the shot as a primary form of birth control.
Hormones involved: Progestin or nonhormonal
The hormone-free form of birth control is a great option for anyone hesitant about putting more hormones into their body and looking for something long-term.
“The fact that this lasts 10 years is great,” says Greves. “I make sure to tell my patients what common side effects could be, including sporadic spotting, so they can expect to manage it.”
The copper in the IUD acts as a spermicide within the uterus by increasing white blood cells, copper ions and prostaglandins within uterine fluids. Research out of the John A. Burns School of Medicine at the University of Hawaii shows a remarkably low failure rate, at less than 1 per 100 women in the first year of use compared to what research published in the journal Perspectives in Sexual and Reproductive Health found was a 7 percent failure rate with the birth control pill.
Hormones involved: Combination of both progestin and estrogen
The birth control ring is a small, flexible ring that is inserted right inside the vagina. The ring works to stop sperm from meeting an egg, and your vaginal lining absorbs the hormones. Women who use the ring replace it once a month after a three-week cycle that gives their bodies seven ring-free days. That ring-free week is similar to the hormone-free pills taken during the final week of most birth control pill packs and allows your body to have a period.
Barrier protection (condoms & diaphragms)
Hormones involved: None
Condoms and diaphragms have a similar effective rate — around 85 percent according to Planned Parenthood — and both are external forms of birth control without any sort of hormones. Both types of contraception are most effective when used correctly and are meant to be worn on their own (nope, doubling up won’t do you any favors).
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