Hormonal Contraceptives: What Are Your Options?

Time to get clued up on birth control! Hormonal contraceptives work for a lot of people, but like most things they have their downsides, so it’s always good to be knowledgeable of everything you are putting into and on your body.

According to the National Cancer Institute, there is contrasting evidence that hormonal contraceptives could increase the risk of breast and cervical cancer due to progestogen and oestrogen stimulating the growth of certain cancer cells. Conversely, hormonal contraceptives have long been thought to improve conditions like endometrial and ovarian cancers, so it’s hard to know what’s best.

Here is a breakdown of all the hormonal birth control options you may be curious about.

Vaginal Ring

The Vaginal Ring is a small plastic ring that is placed inside your vagina and releases a continuous dose of oestrogen and progestogen (aka, hormones) to prevent pregnancy. When used as it should be, the vaginal ring is more than 99% effective - score! The hormones oestrogen and progestogen go into your bloodstream and prevent the release of an egg each month.

Upsides: A ring offers contraception for a whole month, so you don't have to think about it every day

Downsides: Some experience temporary side effects like excess vaginal discharge, breast tenderness and headaches.

Progestogen-only Pill

The Progestogen-only Pill is most useful for those who can't take oestrogen-based contraceptives. The Progestogen-only Pill is more than 99% effective if taken correctly, which means you should be taking a pill every day with no break between packs.

Upsides: Users may find their periods become lighter, and it’s handy if you don’t fancy fumbling for a condom before sex.

Downsides: Some women report side effects like acne and breast tenderness, but with continued use this should clear up eventually. You must also remember to take your pill around the same time daily, which gives you additional life admin.

Contraceptive Patch

The Contraceptive Patch is a small patch that sticks to the skin and releases hormones into your body. This is another method of contraception that is over 99% effective at preventing pregnancy. Each applied patch works for 1 week before it needs changing. You should do this three times and then have one week patch-free for your period. Every day the patch is applied, it releases daily oestrogen and progestogen into your system to prevent pregnancy.

Upsides: The idea of wearing a patch may seem strange, but they’re pretty handy, and usable in the bath, while swimming, and even if you get sweaty while exercising. It’s also useful as you don’t need to think about it on a daily basis.

Downsides: It’s worth knowing in advance that this method of contraception has been linked to increased blood pressure, and side effects such as headaches.

Intrauterine Device (IUD)

An IUD is a very small, T-shaped plastic device that is inserted into your womb by a professional, and releases progestogen to stop pregnancy. One device lasts 3-5 years depending on the brand, and is more than 99% effective. The IUD thickens cervical mucus and makes it difficult for sperm to travel to the egg, as well as thinning the womb lining so the egg cannot attach.

Upsides: You don’t need to think about birth control for a very long time - yay! If you do want to get pregnant at any time you can simply have it removed by a professional. It tends to make periods lighter, shorter or stop them altogether, which is handy for many women.

Downsides: The implantation can be pretty painful, and side effects are always possible, like mood swings or skin issues.

Contraceptive Injection

If you’re not a fan of needles, this one probably isn’t for you, but if not then the Contraceptive Injection could be a good option. Depending on the brand, the injection could protect you anywhere from 8 to 13 weeks, releasing progestogen into your bloodstream regularly and preventing eggs from being released during ovulation. This too is more than 99% effective.

Upsides: It’s nice if you don’t want to interrupt sex for birth control, and the long useage time means you don’t need to worry about contraception for several weeks. 

Downsides: Side effects include weight gain, headaches, mood swings, breast tenderness and irregular bleeding. One difference with the injection is that it may not be suitable if you are considering starting a family in the near future - it can take up to 1 year for fertility to return to normal, so keep this in mind when discussing options with your doctor.

Contraceptive Implant

The Contraceptive Implant is a small, flexible plastic stick inserted under the skin of the arm by a professional. It releases progestogen at regular intervals into the bloodstream to prevent pregnancy, and one stick lasts 3 years, being more than 99% effective.

Upsides: It’s a popular long-term choice, and can be removed at any time to quickly return to your natural fertility. There’s no need to think about it before sex, as it has you covered for 3 years. It’s also an option if you can't use oestrogen-based birth control like the combined pill.

Downsides: Local anaesthetic makes it relatively painless, but the idea of having a piece of plastic under your skin can understandably freak some women out! You may experience some initial bruising and tenderness around the implant, and your periods may become irregular and possibly heavier, but this all depends on the individual.

Combined Pill

The Combined Pill is arguably the most common form of birth control as it’s usually one of the first methods to be prescribed by doctors. Referred to as simply "the pill", it introduces oestrogen and progestogen to the system through a daily tablet, normally taken for 21 days, followed by 7 days without a pill. During this time you will usually have your period.

Upsides: When taken correctly, the pill is over 99% effective at preventing pregnancy. It is often used to treat issues such as heavy and painful periods, acne, or even endometriosis.

Downsides: While the pill is over 99% effective, it’s probably the form of contraception least likely to be taken correctly, as it’s easy to accidentally skip a day, or for it to be rendered ineffective due to diarrhea or vomiting. Plus you could experience side effects like mood swings, nausea, breast tenderness and headaches.

Which is best?

The simple answer? There is truly no one-size-fits-all approach to birth control. Some of the above methods will not be safe for all women, just as some will be inconvenient, or simply won’t suit based on the potential side effects.

It’s always best to discuss the options with your doctor, answer any medical questions they have (honestly, as some lifestyle factors like smoking can put you at risk with certain contraceptives) and know that you may have to try a few options out before you settle on something that fits your body. It's a bit like speed dating!  And remember, none of the above mentioned options offer protection against sexually transmitted infections (STIs).

Got questions about hormonal birth control? Tried one of the above that did or didn’t work for you? Let us know over in our private Facebook group Fem Life - we're chatting about it all the time!