Today, we’ll be digging into the other main type: hormonal methods. Hormonal methods are much more effective – provided they’re used correctly. They’re also the ones that are more taboo, especially in religious circles. People seem to object to the very way they work – some types more than others.
Their history is fairly convoluted and the disputes are many and varied, but its effectiveness cannot be argued.
As the name implies, these methods use lab-created pseudo-hormones to trick your body into believing certain things are happening. So far, all hormonal methods are controlled by women, as researchers have yet to develop a way to temporarily stay sperm production. (Due to their highly effective nature, these are organized into sections of effectiveness, with alphabetizing organizing further.)
Hormonal methods rely on synthetic estrogen to prevent ovulation and synthetic progestin thicken cervical mucus. You can’t get pregnant without an egg in the mix and it’s hard to swim through Jell-O – even for sperm.
- Perfect use: <1% (Imperfect: 9%)
- Patch: Birth control patches are an alternative to “the Pill,” but are a bit more low-maintenance. Instead of orally taking a pill once a day, one patch is simply applied to the buttocks, stomach, outer up or arm per week for three weeks in a row. It uses both estrogen and progesterin to stall ovulation and thicken cervical mucus. For more information on the patch, click here.
- Pills: “The Pill” sounds so great, but it’s misleading. It’s not as if a woman takes one pill and is magically unable to get pregnant until she’s ready. Pills come in packs of 28, these days, usually in a blister pack to slip unnoticed into a wallet, not the makeup-compact-like container we’re often taught to imagine. As a category, pills are extremely effective when used as directed: this includes taking one every day at the same time (within 30 minutes on either side shouldn’t affect effectiveness), not skipping doses, and monitoring your cycle. There are two classifications of oral contraceptives.
- Combined: This is the one we actually think of most often. Combined pills use both a synthetic estrogen and a synthetic progestin. These pills come in packs with three weeks of active pills which contain the hormones and one week of placebos, during which women can expect a pseudo-period. Almost immediately after FDA approval of the first contraceptive pills, blood clots, hear attacks, and other serious problems became an obvious side effect. Thus, in recent years, the doses of hormones have been reduced significantly.
- Mini Pill/POP: The “mini-pill” or “progesterin-only-pill” is used by women who have some reason to not add more estrogen to their systems. Estrogen is the known cause for most of the issues related to combined pills. POPs are very effective, but not quite as effective as the combined pill. Their defense against pregnancy is simply thickening cervical mucus. Because of this, women’s periods get out of rhythm, but are supposed to normalize over time.
For more information on pills, click here.
- Ring: Of the three patient-controlled hormonal methods, the vaginal ring is the lowest maintenance. A flexible plastic ring with progestin and estrogen is insterted into the vagina for three weeks, then taken out for a week of a period. It’s highly effective when used correctly. For more information on the rung, click here.
- Perfect use: <1
- Implant: The birth control implant is approximately an inch and a half long and inserted into the arm and contains progestin. Implants last for about three years and must be removed after that time. For more information on implants, click here.
- IUD: Intrauterine devices (IUDs) are T-shaped pieces of plastic which are inserted into the uterus and have two strings hanging approximately an inch into the vagina so they can be monitored. Both the hormonal and copper varieties disrupt the uterine environment to prevent pregnancy. After a long time of not advising women who had never given birth to not try IUDs, recent research seems to be leaning away from this practice.
- Hormonal: The hormonal IUD is called the Mirena and uses pregesterin. Because it is used so close to the ovary, it sometimes prevents ovulation.
- Copper: The copper IUD is called ParaGard and uses copper to disrupt the uterine lining and make it inhospitable for pregnancy.
Okay, to be honest, this is not a hormonal contraceptive method, but it fits into the category better than into the barrier method category because of its similarities to its hormonal cousin, Mirena.
For more information on IUDs, click here.
- Shot: Contraceptive shots are an extremely effective and private form of birth control. Timed correctly, the shots need to be administered at your doctor’s office once every three months. They are an injection of progestin. For more information on shots, click here.
Emergency Contraception: Emergency contraception is used in the case of unprotected sex, failure of other contraceptives, or any reason a woman has to think she may be pregnant soon after sex. When you hear “the morning after pill” – that’s what we’re talking about here. Each requires a different timeline and effectiveness.
- Plan-B One Step/Next Choice One Dose/etc.: These pill methods can be bought in pharmacies without prescriptions and they are progestin-only. They can be used up to 3 days after unprotected sex and are up to 89% effective within that time period.
- ella: ella is also progestin-based, but can be taken up to 5 days after unprotected sex and is up to 86% effective.
- ParaGard IUD: Again, it’s not actually hormonal, but it can be used as emergency contraception up to 5 days after unprotected sex and is 99.5% effective.
For more information on emergency contraception, click here.
Take away: Hormonal methods are far more effective than barrier methods. They do carry more risks and all but the pill forms of emergency contraceptives require a prescription and medical attention. Many are slightly dependent on weight – in that they’re more effective and more safe for lose with healthy BMIs – and require non-smoking users because of the increased risks of blood clots associated with them.
They can also be used with barrier methods to increase effectiveness all around!
I think the most important thing about hormonal contraception is that women are given complete control of their bodies and choices in a myriad of proactive means. That’s pretty stellar.
If today’s methods and yesterday’s still aren’t what you’re interested in, we’ll explore the last type tomorrow, those which are “natural” and physical.
Tomorrow will wrap up Barely Rebellious’s mini-mini-series on contraception.
February 4: The Truth About Sex February 11: Contraceptionist part 1 February 12: Contraceptionist part 2
- February 13: Contraceptionist part 3
- February 18: Pro-Options
- February 25: Let’s Talk
Thanks for checking this out. If there’s anything you think I ought to add or include in my series, please let me know.
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