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Hormonal Methods

Whether administered as a pill, shot, ring or implant, hormone medications contain manufactured forms of the hormones estrogen and/or progesterone. Hormonal methods work in one of three ways: 1) preventing a woman’s ovaries from releasing an egg each month; 2) causing the cervical mucus to thicken making it harder for sperm to reach and penetrate the egg; 3) thinning the lining of the uterus which reduces the likelihood that a fertilized egg will implant in the uterus wall. Hormonal contraceptives do NOT protect against the transmission of sexually transmitted diseases.

What are the Hormonal Methods?

  • Birth control pills are taken daily as prescribed by your healthcare provider.
  • Depo-Provera is an injection given by your health care provider that prevents pregnancy for three months.
  • NuvaRing, or vaginal ring, is a flexible ring that is inserted into the vagina for three weeks, removed for one week, and then replaced with a new ring. The ring releases estrogen and progesterone into your body.
  • The IUD (intrauterine device) Mirena is a small plastic device containing hormones and is inserted into the uterus for five years.

How do birth control methods with artificial hormones work?

Hormonal forms of birth control contain artificial estrogen and/or progestin to mimic the hormones your body produces. Your body then responds to these increased levels of hormones in different ways, all of which can prevent a pregnancy. The main way in which these forms of contraception are designed to work is by suppressing ovulation. The extra hormones also work to thicken your cervical mucus thereby creating a hostile environment for sperm. Both of these methods help to prevent fertilization. If the other two methods fail and an egg were to be fertilized, then the Pill may work to thin the uterine lining thereby blocking the implantation of a fertilized egg.

After I go off my birth control pills, how long should I wait before I try to conceive?

It can take a while for a woman’s body to adjust back to a normal menstrual cycle when she has stopped taking hormonal forms of birth control. While some women may return to a normal menstrual cycle right away, others can take as long as a year. If you want to try to conceive, it may be a good idea to first wait until you’ve had two to three normal menstrual cycles. This will give your body time to adjust to life without the extra hormones, making it better able to deal with a pregnancy.

Is it still possible for me to be pregnant if I take my pill every day?

Yes. While perfect use of the Pill has shown to be highly effective in preventing pregnancy, no method is 100% effective. Additionally, missing a pill or taking a pill a few hours later than normal, can decrease the effectiveness of your oral contraceptives. Moreover, certain medications including antibiotics can increase the likelihood of your contraceptives failing.

I forgot to take my pill. What do I do?

Women taking combination birth control pills should take the missed pill as soon as they remember and then take the next pill as they normally would. In some cases, this means taking two pills on the same day. Although the risk of pregnancy is minimal, it is still a good idea to use a back-up method of birth control, such as condom, for the next seven days. If the forgotten pill occurred during day 15 to 21 of your pill cycle, then check with your doctor for special instructions. In some cases, you may be advised to skip the pill-free/ sugar pill week and just start a new package as soon as you finish your current set of hormonal pills.

Women using progestin only oral contraceptives should take the forgotten pill as soon as they remember and then take the next pill as they normally would. In some cases, this may mean that you take two pills on the same day. You will need to use a back-up method of birth control for the next two days.

Is there anyone who shouldn’t use hormonal methods of birth control?

Not all women are suited to hormonal forms of birth control. If any of the following conditions apply to you, you may not be able to use this type of contraceptives:

  • You are, or suspect you are pregnant
  • Are breastfeeding and/or are less than 6 weeks postpartum
  • Have unexplained vaginal bleeding
  • Have active liver disease or a history of liver tumors
  • Are over the age of 35 and smoke
  • Have a history of heart disease, stroke, high blood pressure or some other condition that puts you at risk of a heart attack
  • Have a history of blood clotting problems
  • Have diabetes
  • Have breast cancer, history of breast cancer or an abnormal growth in the breast

How does NuvaRing work?

NuvaRing is a comfortable, flexible vaginal birth control ring designed to work in your body by releasing a low and steady dose of hormones that prevent pregnancy, just like birth control pills. You can place NuvaRing anywhere in your vagina that is comfortable for you, and it will work.

Simply use one ring for three weeks then replace it with the new one after a one-week break.

Can NuvaRing fall out?

The muscles of your vagina will keep the ring secure in place, even during exercise or sex. You can check it periodically. In rare cases that NuvaRing does slip out, simply rinse it off and reinsert it promptly.

What is the difference between ParaGard and Mirena?

The TCu380A (ParaGard) is a copper-containing IUD. The IUD is a small “T”-shaped device with a monofilament tail that is inserted into the uterus by a health care practitioner in the office setting. When inserted into the uterus, the arms of the “T” are folded down, but they then open out to form the top of the “T”. The device rests inside the uterus with the base of the T just above the cervix and the arms of the T extending horizontally across the uterus. A short piece of monofilament string attached to the IUD extends through the cervix into the vagina. This string makes it possible to be sure that the IUD is still in the uterus.

It releases copper from a copper wire that is wrapped around the base. The released copper contributes to an inflammatory reaction in the uterus that helps prevent fertilization of the egg. It is approved to remain in place for up to 10 years.

Levonorgestrel-releasing IUD (Mirena): This form of IUD releases a progestin hormone from the vertical part of the T. Progestin acts to thicken cervical mucus, creating a barrier to sperm, as well as renders the lining of the uterus inhospitable to implantation of a pregnancy. This form of IUD is approved for up to five years of use.

What is Depo- Provera shot?

Depo-Provera (Medroxyprogesterone Acetate) is a medication that can be injected every 3 months in order to prevent pregnancy. It is a derivative of progesterone hormone which acts to inhibit ovulation and prevent pregnancy. It has been used for decades. When used properly, pregnancy is extremely rare. It is very convenient, effective and inexpensive. You need to make a decision if this option of birth control is for you.

What are the shot’s side effects?

Most women beginning using Medroxyprogesterone Acetate, experience abnormal bleeding patterns which may include:

  • Spotting
  • Absent or irregular periods
  • Heavy bleeding
  • Weight gain

The use of Medroxyprogesterone Acetate may cause a decrease in mineral density of your bones. That is why some healthcare providers do not recommend using this option for longer than two years.

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