Hormonal contraceptives, as their name suggests, are a type of birth control that uses hormones to prevent pregnancy. They either contain estrogen and progesterone or only progesterone. They prevent pregnancy by stopping the release of eggs from the ovaries, thinning the uterine lining, or thickening the mucus in the cervix, all of which help prevent sperm from reaching the egg. Hormonal contraceptives can be taken orally, injected or inserted under the skin, applied as a patch to the skin, or implanted in the vagina or uterus.1
What was the first hormonal contraceptive?
The Federal Drug Administration (FDA) approved the first hormonal pill, Enovid, in May 1960. It has mestranol and norethisterone in it. 2
What are the common form of hormonal contraception?
- Implant: The implant contains progestin, released into your arm via the thin rod. Your doctor will insert it under the skin on the inside of your upper arm, and it last up to three years.
- Intrauterine devices (IUD): IUDs are available with and without hormones. They may contain progesterone in those that are releasing hormones. Depending on the type, IUDs must be changed every 3 to 10 years and are inserted into the uterus by a doctor.
- Birth control pills or oral contraceptives: The main variation in each brands is the estrogen and progestin levels present in them.This is why some women switch brands if they believe they are getting too little or too many hormones based on symptoms. It is necessary to the pills every day to avoid pregnancy.
- Vaginal patch: The patch contains estrogen and progestin; and is placed on the skin. It has to be changed once a week for maximum effectiveness.
- Vaginal ring: The ring delivers estrogen and progestin into the body and is worn into the vagina so that the vaginal lining can absorb the hormones. You’ll have to replace it with a new vaginal ring once a month.
- Depo-Provera (birth control shot): It contains only progestin and is given at your doctor’s office every 12 weeks.3
Hormonal contraceptives classification :
1. Classification based on hormonal components:
Contraceptives containing progestin:
- Implant
- Hormonal IUDs
- Birth control shot
- Progestin-only pills
Contraceptives containing both estrogen and progestin:
- Combined oral contraceptives
- Contraceptive patch
- Vaginal Ring
2. Classification based on the route of administration:
Oral contraceptives:
Vaginal route:
- Vaginal ring
- Intrauterine devices (IUD)
Under the skin:
- Implant
- Contraceptive patch
Intramuscular (IM) route:
- Birth control shot
3. Classification based on the duration of action:
Long-acting contraceptives:
- IUD
- Implants
Short-acting contraceptives:
- Birth control pills
- Vaginal ring
- Contraceptive patch
- Birth control shot 4
What are hormonal contraceptive pills?
Hormonal contraceptive pills or birth control pills are oral contraceptives that contain small amounts of hormones that your body needs during the menstrual cycle. They are sold in a pack, usually a 28-day cycle and you have to consume one pill every day. You take a birth control pill every day, generally during the same time each day, depending on the pill. This keeps certain hormones up, making it less likely for you to become pregnant.
So, how do birth control pills work? Birth control pills or oral contraceptives contain hormones that prevent pregnancy by preventing the process of ovulation, which is the release of an egg from the ovary. Certain birth control pills also temporarily change the uterine lining, making it less likely for the implantation of a fertilised egg.
Oral contraceptive pill can be classified into two types:
- Combination pills (contain hormones estrogen and progestin).
- Progestin-only pills (known as the mini pill).
Mini pills (progestin-only pills) are preferable in some women. For example, those who are breastfeeding or who have a history of blood clots and strokes and should avoid estrogen.
The pill is available in a wide range of dosage forms, from 21-day pill packs to 90-day pill packs and even 365 days of active pills. The way you should take birth control pills varies based on the specific type of pill you are using. Normally, depending on the brand and dose, you take active pills for at least three weeks, followed by hormone-free (inactive) pills for two to seven days. Most women get their menstrual period while using inactive pills. Several brands do not include inactive pill in their oral contraceptive packs (they only supply three weeks of active pills).
What are 21-day hormone pills?
A woman who uses the 21-day pack can skip a week of taking the pills. During inactive pill time, most women get their periods.
What are the advantages of birth control pills?
The birth control pill has the following advantages:
- Regulate and lighten the menstrual cycle
- Prevents anemia
- Lessen menstrual cramps (dysmennorhea)
- Manage premenstrual syndrome (PMS)
- Treat polycystic ovary syndrome (PCOS)
- Treat endometriosis or uterine fibroids
- Reduce the risk of having ovarian, uterine or colon cancer
- Improve acne
- Stop the growth of unwanted hair
- Reduce migraine
- Control hot flashes during the menopause transition.
What are the side effects of hormonal contraceptives?
Some women encounter medication side effects when they begin taking the pill. These side effects usually disappear in a few months.
- Swollen and tender breasts
- Headaches
- Irritability or moodiness
- Nausea
- Spotting between periods (abnormal menstruation). 5
Is iPill a hormonal contraceptive?
Yes, iPill is a sort of emergency contraception which contains a hormone known as levonorgestrel that is used to delay ovulation and in turn prevent pregnancy. You can use it to prevent pregnancy after having unprotected sex or if your contraception method has failed unexpectedly (a condom has split or you have missed a pill). For the pill to be effective, you must take it within 72 hours or 3 days of having unprotected sex.6
Contraceptives for hormonal imbalance:
Hormonal birth control methods may help balance the hormonal imbalance that occurs during your cycle. Hence, it can help with menstruation issues, including heavy or irregular bleeding. It can even help regulate polycystic ovary syndrome (PCOS) symptoms, such as acne and excess hair. While each form of birth control works differently, most of them can make periods lighter and more regular. It can also help treat endometriosis and certain cancers. 7
Non-hormonal contraceptive method:
It refers to any method that does not interfere with hormones. Condoms are one type, but there are many more. Hormonal contraceptives, such as birth control pills and hormonal implants, alter the hormone levels to prevent pregnancy. They can be both convenient and dependable. However, they may not be the best option for some people due to factors such as:
- Remember to take the pill every day at the same time.
- You must see a doctor for prescriptions or to insert the device.
- They do not prevent sexually transmitted infections (STIs) if you had unprotected sex.
- They may increase the risk of blood clots or breast cancer or cause mood swings or weight gain.
- You may not have sex frequently enough to need ongoing birth control.
- If you are breastfeeding, you may pass hormones to your baby.
There are many non-hormonal birth control methods, such as – barrier methods (male and female condoms), contraception diaphragm, copper IUD, cervical cap, spermicides and vaginal gel.
In fact, you can use barrier and hormonal contraceptive methods together to further reduce the risk of getting pregnant. For example, Using a condom with another birth control method — such as the pill, patch, ring, shot, implant, IUD, or pulling out — can make vaginal sex much safer. Using them together is a very effective way to reduce the risk of pregnancy and getting or spreading an STI. 8
Contraindications of hormonal contraceptives:
Before starting any new medications or herbal supplements, consult with your doctor. Some medicines can reduce the pill’s effectiveness and increase your chances of becoming pregnant. Among these items are:
- Anti-seizure medicines
- Some herbal supplements
- HIV medicines
What are the risks of hormonal contraceptives?
Birth control pill are generally safe for most women. The pill is being sold since 60 years! So, women generally experience a lot of comfort and experience while using them. Also, you need to remember that the combination pill is not suitable for you if you are over 35 and smoke or have certain medical conditions. A small percentage of women who use the combination (estrogen-containing) birth control pill are more likely to have these rare complications:
- Blood clots
- Deep vein thrombosis (DVT)
- Heart attack
- Hypertension (high blood pressure)
- Stroke
Based on your medical history, your doctor will discuss your level of risk with you. Fortunately, if a woman can not take an estrogen-containing pill, she can still use progestin-only pills safely. 9
If you are worried about the right birth control option for yourself, consult a gynaecologist on the Pinky Promise app @ ₹59/- only! You can also check out our gynaecologist-verified chatbot to understand more about your reproductive health symptoms and connect with thousands of women on our anonymous community support chat rooms. So what are you waiting for? Download the Pinky Promise App now!
