What is hormonal birth control?
Hormonal birth control is any pill, injection, device, or treatment that uses hormones to prevent pregnancy in women. Different kinds of hormonal birth control exist. Some contain the hormones estrogen and progestin. Others contain only progestin.
All hormonal birth control methods are very effective. The methods differ in how easy they are to use and their side effects. Of the many types of hormonal birth control options out there, you can get the three most common through Alpha Medical: Birth control pills, the patch, or the vaginal ring.
A woman who takes birth control pills needs to take a pill every day. Skipping pills can increase the chance of getting pregnant. Birth control pill packets usually include 4 to 7 days of hormone-free pills each month (though this can vary by the specific type of pill you’re taking). It is during these hormone-free days that a woman gets her period. Women who prefer not to get periods can skip the hormone-free pills and take a hormone pill every day instead. This is called continuous dosing. Most birth control pills contain estrogen and progestin but there is one that contains only progestin. Alpha offers options for all of these categories - you can even specify your preferred pill, or, have a provider help you decide which is best for you.
A woman can wear a hormone patch on her upper arm, shoulder, back, or hip. The patch, also known by the brand name Xulane, must be changed once a week. Usually, a woman wears a new patch each week for 3 weeks and then leave the patch off during week 4. Week 4 is when a woman has her period. Continuous use of the patch is discouraged because the patch may have a higher risk of causing a blood clot compared to birth control pills. Skin patches for contraception contain both estrogen and progestin.
A woman can put a bendable ring in her vagina that can stay in place for 3 weeks at a time. The ring, also known by the brand name NuvaRing, isn’t felt by the user once in place and releases hormones in the body. It does not need to be removed during sexual intercourse. If the ring is removed or expulsed, it may be rinsed in cool or warm water (not hot) and reinserted into the vagina within 3 hours without reduction of contraceptive effectiveness. Vaginal rings for contraception contain both estrogen and progestin.
For most women, Alpha can prescribe birth control pills, the transdermal patch, and vaginal ring, safely and effectively via an online medical consultation. Other hormonal options require an in-person office visit in order to be administered by a medical professional. These other methods - injections, implants, or intrauterine devices (IUD) - are not available through Alpha’s services.
Women who use hormone injections get either an intramuscular shot in the arm or buttocks or a subcutaneous shot in the anterior thigh or abdomen every 3 months. Injections for birth control (brand name: Depo-Provera) contain only progestin.
A birth control implant (brand name: Nexplanon) is a tiny rod that is implanted under the skin of the upper arm by a trained health care provider. The rod releases progestin and can stay in the arm for up to 3 years.
An intrauterine device (IUD) is placed inside the uterus by a trained health care provider in order to prevent pregnancy. IUDs contain either copper or progestin and both work by causing a foreign body effect. A Copper IUD last for 10-12 years, depending upon the woman’s age. Hormonal IUDs also release progestin . Skyla is a progestin-containing IUD that lasts for up to 3 years. Mirena, Liletta, or Kyleena are progestin-containing IUDs that last for up to 5 years.
Hormonal birth control is a safe and reliable way to prevent pregnancy for most women. But it does not protect women from HIV or other infections that spread through sex (called "sexually transmitted infections" or “STIs”).
How do I choose the right hormonal birth control for me?
Work with your health care provider to choose the best option for you. As you think about your decision, think about how likely you are to use each method the right way. Can you remember to take a pill every day? Can you remember to change a patch once a week? Can you remember to remove a vaginal ring after 3 weeks and insert a new one every 4 weeks? Long-acting methods (IUD, implant) are the most convenient because they work for 3 to up to 12 years, depending on the method. The injection, which works for 3 months, is more convenient than the pill, patch, or ring. Also, ask your health care provider how the method you are thinking about will affect your period. See the table for a list of side effects and risks for each of the different forms.
Is hormonal birth control safe for all women?
No. Some women should not use estrogen-containing hormonal birth control. This includes women who:
- Are age 35 or older and smoke cigarettes – These women are at increased risk for heart attacks and strokes.
- Are pregnant
- Have had blood clots or a stroke in the past
- Are being treated for breast cancer, or have had breast cancer before
- Have irregular or very heavy periods – Women with this problem should have it checked out before starting hormonal birth control.
- Have some types of liver disease – Hormonal birth control can make some types of liver disease worse.
- Have some types of heart disease
- Get the type of migraine headaches that cause vision problems (flashing or zigzag lights)
Women who have high blood pressure can use hormonal birth control, but their blood pressure needs to be followed closely by a doctor.
Many women who can't take estrogen-containing hormonal birth control can take other kinds of hormonal birth control that contain only progestin.
What if I take medicines besides birth control?
Some medicines can affect how well hormonal birth control works. These include:
- Some medicines used to prevent seizures (called "anticonvulsants")
- Some antibiotics
- St. John's Wort (an herbal medicine for depression)
If you take any of these medicines, talk to your health care provider about how to handle birth control. Also, if you already take hormonal birth control, mention it to any health care provider who might be prescribing medicines for you.
What if I forget to use my hormonal birth control?
If you have sex and have forgotten to use your birth control, you can either take emergency oral contraceptives or have a copper IUD placed by your healthcare provider. Both oral and intrauterine emergency contraceptives are only effective before a pregnancy has implanted. When used within 72 hours of unprotected intercourse, the copper IUD prevents 95% of expected pregnancies, ulipristal acetate (an antiprogestin; Brand name: Ella; prescription-only) prevents ⅔ of expected pregnancies, and levonorgestrel (a progestin; Brand names: Plan B One-Step, Next Step One Dose, Take Action; available over-the-counter) prevents 50% of expected pregnancies.