Hormonal Methods of Birth Control

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideChoosing Your Birth Control Method

Choosing Your Birth Control Method

What are advantages and disadvantages of hormonal birth control methods?

Advantages of hormonal methods of birth control include that they are all highly effective and their effects are reversible. They do not rely on spontaneity and can be used in advance of sexual activity.

Disadvantages of hormonal methods for birth control include:

  • The necessity of taking medications continuously
  • The cost of the medications
  • Women must remember to take them regularly or use them exactly as prescribed
  • A doctor’s visit and prescription are required.
  • They do not protect a woman against STDs or sexually transmitted diseases
  • Women must begin using hormonal contraceptives in advance before they become effective.
  • For some women, hormonal preparations are associated with unpleasant side effects or increased health risks.

Oral hormones: The pill

The combination pill contains the hormones estrogen and progestin, a form of progesterone. When a woman uses the combination pill, the eggs in her ovaries do not mature and she does not ovulate. She doesn't become pregnant because no egg is available to be fertilized by a sperm.

The traditional combination pill comes in 21-day packs or 28-day packs depending on the manufacturer. The 21-pill pack has pills for 21 "on" days and no pills for the seven "off" days that follow. The 28-pill pack has active pills for the first 21 "on" days and seven inactive (placebo) or reminder pills for the following seven "off" days.

New preparations have been developed that allow for extended or continuous use of combination pills for months at a time. These products allow for a reduction in the number of menstrual periods a woman experiences.

The minipill only contains one hormone, progestin. Progestin thickens the cervical mucus, making it more difficult for sperm to pass through the cervix. It also makes the lining of the uterus less receptive to the implantation of a fertilized egg. The progesterone-only pill is sometimes recommended for women who have medical reasons for which they must avoid taking estrogen hormones. (These reasons can include liver disease, certain types of blood clots in the veins, breast cancer, and uterine cancer.) In addition, it is often recommended in nursing mothers because it has no adverse effects on breastfeeding. Indeed, extended breastfeeding, as well as delay in the need for formula supplementation has been observed in breastfeeding users of the minipill.

How is the minipill taken?

The minipill is taken every day. There are no "on" or "off" days with the minipill.

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