Hormonal Methods - Sexual Health Peer Resource Center

There are many methods of hormonal contraception, the most popular of which is the combination birth control pill. In addition to the pill, however, there are a number of exciting new options of hormonal contraception, which continue to be introduced almost annually. This is an area where new methods and techniques are constantly appearing, and it is difficult to constantly keep up to date with all of our information. But we will try to always present you with as much knowledge as we have, and we will try to update as often as necessary!

Oral Contraception: Combined Pill

How it works: The combined birth control pill consists of the synthetic female sex hormones estrogen and progestin. Combination pills primarily work by preventing the release of eggs from the woman’s ovaries; they also thicken the cervical mucus to prevent sperm from entering the uterus and prevent implementation of the egg in the walls of the uterus. The body state produced by the pill resembles pregnancy, so in a sense the pill works to trick the body into believing it is pregnant so further fertilization cannot occur.

Effectiveness (failure rate): 0.1%-3%. Of 100 women who use the pill, only 3 will become pregnant during the first year with typical use. Failures are almost always attributed to forgetting to take the pills, failure to use a backup method of birth control during the first pill cycle, and to drug interactions.

Contraindications:

Absolute
- Personal history of blood clotting problems, strokes, or coronary disease
- Personal history of cancer of the breast or reproductive system
- Abnormal liver function
- Current pregnancy
Strong
- Smoker over the age of 35
- High blood pressure
- High cholesterol
- Undiagnosed vaginal bleeding

Possible side effects, risks, and considerations: these do not occur in all users

Minor, temporary effects:
- Breast tenderness
- Nausea
- Spotting between periods
- Mild headaches
- Vaginal irritation
- Weight gain
- Decreased sex drive
Major, adverse effects:
- Blood clots or thrombosis
- High blood pressure
- Jaundice or abnormal liver function
- Mental depression
- DOES NOT PROTECT AGAINST STDs

Cancer and the Pill: Most experts now agree that taking the Pill does not increase the overall risk of developing breast cancer, no matter how long a woman takes the Pill. The Pill does appear to lower the instance of ovarian cancer.

Benefits:

One of the most effective ways to prevent pregnancy
Return to fertility after stopping pills is rapid and does not require medical assistance
Does not restrict sexual sponteneity
Increased menstrual regularity
Decreased incidence of menstrual cramps and flow in some women

How to use it: The most crucial aspect when using the Pill is to stay on schedule. Correct and consistent use of the Pill greatly increases its efficacy. This requires that a woman take the correct pill each day.

How to get it: The Pill is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the Pill.

Costs: A one-month supply of pills costs between $15-25 at most pharmacies. Vaden sells it at a much reduced rate.

Oral Contraception: Mini Pill

How it works: The mini pill contains the sythetic female sex hormone progestin; it does not contain estrogen. The progestin inhibits conception by creating a thick cervical mucus which is hostile to sperm. It may also work to prevent implantation of a fertilized egg by altering the lining of the uterus.

Effectiveness (failure rate): 0.5%. Of 1,000 women who use the pill, only 5 will become pregnant during the first year with perfect use. Failures are almost always attributed to forgetting to take the pills, failure to use a backup method of birth control during the first pill cycle, and to drug interactions.

Contraindications:

Absolute
- Personal history of blood clotting problems, strokes, or coronary disease
- Personal history of cancer of the breast or reproductive system
- Abnormal liver function
- Current pregnancy
Strong
- Smoker over the age of 35
- High blood pressure
- High cholesterol
- Undiagnosed vaginal bleeding

Possible side effects, risks, and considerations: these do not occur in all users

Minor, temporary effects:
- Breast tenderness
- Nausea
- Spotting between periods
- Mild headaches
- Vaginal irritation
- Weight gain
- Decreased sex drive
Major, adverse effects:
- Blood clots or thrombosis
- High blood pressure
- Jaundice or abnormal liver function
- Mental depression
- DOES NOT PROTECT AGAINST STDs

Cancer and the mini-pill: Most experts now agree that taking the mini-pill does not increase the overall risk of developing breast cancer, no matter how long a woman takes the mini-pill. The mini-pill does appear to lower the instance of ovarian cancer.

Benefits:

One of the most effective ways to prevent pregnancy
Return to fertility after stopping pills is rapid and does not require medical assistance
Does not restrict sexual sponteneity
Increased menstrual regularity
Decreased incidence of menstrual cramps and flow in some women

How to use it: The most crucial aspect when using the mini-pill is to stay on schedule. Correct and consistent use of the mini-pill greatly increases its efficacy. This requires that a woman take the correct pill each day.

How to get it: The mini-pill is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the mini-pill.

Costs: A one-month supply of pills costs between $15-25 at most pharmacies. Vaden sells it at a much reduced rate.

Depo Provera

How it works: Depo Provera, also known as “the shot,” consists of progestin, a synthetic version of the female sex hormone progesterone. A single injection in the arm or buttock can prevent pregnancy for 12 weeks. Progestin prevents the ovaries from releasing eggs and thickens the cervical mucus to prevent sperm from joining eggs.

Effectiveness (failure rate): 0.3%. Of 1,000 women who use the pill, only 3 will become pregnant during the first year with typical use.

Contraindications:

Personal history of blood clotting problems, strokes, or coronary disease
Personal history of cancer of the breast or reproductive system
Abnormal liver function
Current pregnancy
Unexplained vaginal bleeding

Possible side effects, risks, and considerations: these do not occur in all users

Irregular bleeding, nausea, and sore breasts may occur
The effects of Depo cannot be easily reversed
Depo offers no protection against STDs

Depo has been recently under fire because it has been shown to increase osteoporosis in women after continued long-term use.

Benefits:

One of the most effective ways to prevent pregnancy
>Does not have to be taken daily or put into place before intercourse
Can be used by women who cannot tolerate estrogen
Can be used while breast feeding

How to get it: Depo is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the Depo. This is available at Vaden.

Costs: A yearly supply (4 injections) of Depo ranges from $215-$545.

Lunelle

How it works: Lunelle is a monthly injection that consists of the synthetic female sex hormones estrogen and progestin. It works in almost the exact same way as the combination pills, by preventing the release of eggs from the woman’s ovaries; it also thickens the cervical mucus to prevent sperm from entering the uterus and prevents implementation of the egg in the walls of the uterus. The body state produced by Lunelle resembles pregnancy, so in a sense it works to trick the body into believing it is pregnant so further fertilization cannot occur.

Effectiveness (failure rate): 0.1%. Of 1,000 women who use Lunelle, only 1 will become pregnant during the first year with typical use.

Contraindications:

Absolute

Personal history of blood clotting problems, strokes, or coronary disease
Personal history of cancer of the breast or reproductive system
Abnormal liver function
Current pregnancy

Strong
- Smoker over the age of 35
- High blood pressure
- High cholesterol
- Undiagnosed vaginal bleeding

Possible side effects, risks, and considerations: these do not occur in all users

Minor, temporary effects:
- Breast tenderness
- Nausea
- Spotting between periods
- Mild headaches
- Vaginal irritation
- Weight gain
- Decreased sex drive
Major, adverse effects:
- Blood clots or thrombosis
- High blood pressure
- Jaundice or abnormal liver function
- Mental depression
- DOES NOT PROTECT AGAINST STDs

Benefits:

One of the most effective ways to prevent pregnancy
Return to fertility after stopping Lunelle occurs in 2-3 months
Does not restrict sexual sponteneity
Increased menstrual regularity
Decreased incidence of menstrual cramps and flow in some women

How to use it: Receive an injection from a physician once a month in the arm, buttocks, or leg, during menstruation.

How to get it: Lunelle is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for Lunelle.

Costs: A one-month injection costs approximately $30.

Hormonal Vaginal Contraceptive Ring (Nuva Ring)

How it works: In a method similar to the combined birth control pill, the hormonal ring consists of the synthetic female sex hormones estrogen and progestin. The ring primarily works by preventing the release of eggs from the woman’s ovaries; it also thickens the cervical mucus to prevent sperm from entering the uterus and prevents implementation of the egg in the walls of the uterus. The body state produced by the ring resembles pregnancy, so in a sense it works to trick the body into believing it is pregnant so further fertilization cannot occur. The ring is inserted into the vagina, where it remains for three weeks, releasing a continuous low dose of the hormones. The woman inserts the ring herself and then removes it in order to have her period after the third week. Following a week of menstruation, a new ring is inserted the next week.

Effectiveness (failure rate): 1%-2%.

FOR ALL OTHER INFORMATION, REFER TO COMBINED PILL SECTION, BECAUSE ALL OTHER RISKS, CONTRAINDICATIONS, AND BENEFITS REMAIN SIMILAR.

Hormonal Contraceptive Skin Patch (Ortho Evra)

How it works: Again, in a similar way to the combined pill, Lunelle, and Nuva Ring, Ortho Evra works in the same way. It is essentially the same dose of the same hormones, administered through a skin patch that is changed once per week. During the fourth week, the patch is removed and menstruation occurs. Ortho Evra cannot be worn on the breasts, or other fatty areas, because the dense fat tissue inhibits the absorption of the hormones into the blood stream. Otherwise, the patch can be worn on the buttocks, back, or lower abdomen.

FOR ALL OTHER INFORMATION, REFER TO COMBINED PILL SECTION, BECAUSE ALL OTHER RISKS, CONTRAINDICATIONS, AND BENEFITS REMAIN SIMILAR.


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	Choosing a Method Non-Methods Barrier Methods Hormonal Methods Chemical Methods Combination Methods Intrauterine Device Natural Family Planning Emergency Contraceptive Pill Fertility Charting Abstinence Sterilization	Hormonal Methods There are many methods of hormonal contraception, the most popular of which is the combination birth control pill. In addition to the pill, however, there are a number of exciting new options of hormonal contraception, which continue to be introduced almost annually. This is an area where new methods and techniques are constantly appearing, and it is difficult to constantly keep up to date with all of our information. But we will try to always present you with as much knowledge as we have, and we will try to update as often as necessary! Oral Contraception: Combined Pill How it works: The combined birth control pill consists of the synthetic female sex hormones estrogen and progestin. Combination pills primarily work by preventing the release of eggs from the woman’s ovaries; they also thicken the cervical mucus to prevent sperm from entering the uterus and prevent implementation of the egg in the walls of the uterus. The body state produced by the pill resembles pregnancy, so in a sense the pill works to trick the body into believing it is pregnant so further fertilization cannot occur. Effectiveness (failure rate): 0.1%-3%. Of 100 women who use the pill, only 3 will become pregnant during the first year with typical use. Failures are almost always attributed to forgetting to take the pills, failure to use a backup method of birth control during the first pill cycle, and to drug interactions. Contraindications: Absolute Personal history of blood clotting problems, strokes, or coronary disease Personal history of cancer of the breast or reproductive system Abnormal liver function Current pregnancy Strong Smoker over the age of 35 High blood pressure High cholesterol Undiagnosed vaginal bleeding Possible side effects, risks, and considerations: these do not occur in all users Minor, temporary effects: Breast tenderness Nausea Spotting between periods Mild headaches Vaginal irritation Weight gain Decreased sex drive Major, adverse effects: Blood clots or thrombosis High blood pressure Jaundice or abnormal liver function Mental depression DOES NOT PROTECT AGAINST STDs Cancer and the Pill: Most experts now agree that taking the Pill does not increase the overall risk of developing breast cancer, no matter how long a woman takes the Pill. The Pill does appear to lower the instance of ovarian cancer. Benefits: One of the most effective ways to prevent pregnancy Return to fertility after stopping pills is rapid and does not require medical assistance Does not restrict sexual sponteneity Increased menstrual regularity Decreased incidence of menstrual cramps and flow in some women How to use it: The most crucial aspect when using the Pill is to stay on schedule. Correct and consistent use of the Pill greatly increases its efficacy. This requires that a woman take the correct pill each day. How to get it: The Pill is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the Pill. Costs: A one-month supply of pills costs between $15-25 at most pharmacies. Vaden sells it at a much reduced rate. Oral Contraception: Mini Pill How it works: The mini pill contains the sythetic female sex hormone progestin; it does not contain estrogen. The progestin inhibits conception by creating a thick cervical mucus which is hostile to sperm. It may also work to prevent implantation of a fertilized egg by altering the lining of the uterus. Effectiveness (failure rate): 0.5%. Of 1,000 women who use the pill, only 5 will become pregnant during the first year with perfect use. Failures are almost always attributed to forgetting to take the pills, failure to use a backup method of birth control during the first pill cycle, and to drug interactions. Contraindications: Absolute Personal history of blood clotting problems, strokes, or coronary disease Personal history of cancer of the breast or reproductive system Abnormal liver function Current pregnancy Strong Smoker over the age of 35 High blood pressure High cholesterol Undiagnosed vaginal bleeding Possible side effects, risks, and considerations: these do not occur in all users Minor, temporary effects: Breast tenderness Nausea Spotting between periods Mild headaches Vaginal irritation Weight gain Decreased sex drive Major, adverse effects: Blood clots or thrombosis High blood pressure Jaundice or abnormal liver function Mental depression DOES NOT PROTECT AGAINST STDs Cancer and the mini-pill: Most experts now agree that taking the mini-pill does not increase the overall risk of developing breast cancer, no matter how long a woman takes the mini-pill. The mini-pill does appear to lower the instance of ovarian cancer. Benefits: One of the most effective ways to prevent pregnancy Return to fertility after stopping pills is rapid and does not require medical assistance Does not restrict sexual sponteneity Increased menstrual regularity Decreased incidence of menstrual cramps and flow in some women How to use it: The most crucial aspect when using the mini-pill is to stay on schedule. Correct and consistent use of the mini-pill greatly increases its efficacy. This requires that a woman take the correct pill each day. How to get it: The mini-pill is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the mini-pill. Costs: A one-month supply of pills costs between $15-25 at most pharmacies. Vaden sells it at a much reduced rate. Depo Provera How it works: Depo Provera, also known as “the shot,” consists of progestin, a synthetic version of the female sex hormone progesterone. A single injection in the arm or buttock can prevent pregnancy for 12 weeks. Progestin prevents the ovaries from releasing eggs and thickens the cervical mucus to prevent sperm from joining eggs. Effectiveness (failure rate): 0.3%. Of 1,000 women who use the pill, only 3 will become pregnant during the first year with typical use. Contraindications: Personal history of blood clotting problems, strokes, or coronary disease Personal history of cancer of the breast or reproductive system Abnormal liver function Current pregnancy Unexplained vaginal bleeding Possible side effects, risks, and considerations: these do not occur in all users Irregular bleeding, nausea, and sore breasts may occur The effects of Depo cannot be easily reversed Depo offers no protection against STDs Depo has been recently under fire because it has been shown to increase osteoporosis in women after continued long-term use. Benefits: One of the most effective ways to prevent pregnancy >Does not have to be taken daily or put into place before intercourse Can be used by women who cannot tolerate estrogen Can be used while breast feeding How to get it: Depo is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for the Depo. This is available at Vaden. Costs: A yearly supply (4 injections) of Depo ranges from $215-$545. Lunelle How it works: Lunelle is a monthly injection that consists of the synthetic female sex hormones estrogen and progestin. It works in almost the exact same way as the combination pills, by preventing the release of eggs from the woman’s ovaries; it also thickens the cervical mucus to prevent sperm from entering the uterus and prevents implementation of the egg in the walls of the uterus. The body state produced by Lunelle resembles pregnancy, so in a sense it works to trick the body into believing it is pregnant so further fertilization cannot occur. Effectiveness (failure rate): 0.1%. Of 1,000 women who use Lunelle, only 1 will become pregnant during the first year with typical use. Contraindications: Absolute Personal history of blood clotting problems, strokes, or coronary disease Personal history of cancer of the breast or reproductive system Abnormal liver function Current pregnancy Strong Smoker over the age of 35 High blood pressure High cholesterol Undiagnosed vaginal bleeding Possible side effects, risks, and considerations: these do not occur in all users Minor, temporary effects: Breast tenderness Nausea Spotting between periods Mild headaches Vaginal irritation Weight gain Decreased sex drive Major, adverse effects: Blood clots or thrombosis High blood pressure Jaundice or abnormal liver function Mental depression DOES NOT PROTECT AGAINST STDs Benefits: One of the most effective ways to prevent pregnancy Return to fertility after stopping Lunelle occurs in 2-3 months Does not restrict sexual sponteneity Increased menstrual regularity Decreased incidence of menstrual cramps and flow in some women How to use it: Receive an injection from a physician once a month in the arm, buttocks, or leg, during menstruation. How to get it: Lunelle is only available by prescription. Women should see a nurse practitioner or gynocologist to receive a complete gynocological exam before receiving a prescription for Lunelle. Costs: A one-month injection costs approximately $30. Hormonal Vaginal Contraceptive Ring (Nuva Ring) How it works: In a method similar to the combined birth control pill, the hormonal ring consists of the synthetic female sex hormones estrogen and progestin. The ring primarily works by preventing the release of eggs from the woman’s ovaries; it also thickens the cervical mucus to prevent sperm from entering the uterus and prevents implementation of the egg in the walls of the uterus. The body state produced by the ring resembles pregnancy, so in a sense it works to trick the body into believing it is pregnant so further fertilization cannot occur. The ring is inserted into the vagina, where it remains for three weeks, releasing a continuous low dose of the hormones. The woman inserts the ring herself and then removes it in order to have her period after the third week. Following a week of menstruation, a new ring is inserted the next week. Effectiveness (failure rate): 1%-2%. FOR ALL OTHER INFORMATION, REFER TO COMBINED PILL SECTION, BECAUSE ALL OTHER RISKS, CONTRAINDICATIONS, AND BENEFITS REMAIN SIMILAR. Hormonal Contraceptive Skin Patch (Ortho Evra) How it works: Again, in a similar way to the combined pill, Lunelle, and Nuva Ring, Ortho Evra works in the same way. It is essentially the same dose of the same hormones, administered through a skin patch that is changed once per week. During the fourth week, the patch is removed and menstruation occurs. Ortho Evra cannot be worn on the breasts, or other fatty areas, because the dense fat tissue inhibits the absorption of the hormones into the blood stream. Otherwise, the patch can be worn on the buttocks, back, or lower abdomen. FOR ALL OTHER INFORMATION, REFER TO COMBINED PILL SECTION, BECAUSE ALL OTHER RISKS, CONTRAINDICATIONS, AND BENEFITS REMAIN SIMILAR.