In general, hormonal contraceptives prevent pregnancy by suppressing ovulation. Without an egg to fertilize, pregnancy cannot take place. The active ingredients in hormonal contraceptives are different combinations and concentrations of hormones—estrogen, progestin, and progesterone.
Although they are very effective at preventing pregnancy, hormonal contraceptives do NOT protect against sexually transmitted infections. Below is a brief introduction to the different types of hormonal contraceptives.
The Pill
The pill is the most common form of birth control used by women who report using contraception. Birth control pills are prescribed by a healthcare provider and must be taken at about the same time every day for maximum effectiveness. In actual use, the pill is about 91% effective. Some other medications can lower the effectiveness of birth control pills, so it’s important for both a woman’s healthcare provider and her pharmacist to know all the medications that woman is taking.
The Patch
The contraceptive patch is more convenient than the pill. Prescribed by a health care provider, the patch delivers hormones through the skin for 1 week. The woman then replaces the patch with a new one. Like the pill, the patch is about 91% effective in actual use.
The Ring
Even more convenient than the patch is the contraceptive ring, a thin, flexible device that is placed in the vagina and releases hormones gradually over 3 weeks. At the end of that time, the woman removes the ring, has a menstrual period, and inserts a new ring. The ring also has an actual effectiveness of about 91%.
The Injection
Even longer lasting than the ring, contraceptive injections must be prescribed and given by a healthcare provider. These progestin-only injections suppress ovulation for 3 months. Contraceptive injections require visits to a clinic or healthcare office every 90 days, and they are 94% effective in actual use.
The Implant
The contraceptive implant is a matchstick-size device that a healthcare provider inserts under the skin of a woman’s upper arm. The implant gradually releases progestin, which suppresses ovulation for 3 years. Implants are more than 99% effective in actual use.
Emergency Contraception
Emergency contraception (EC) is a hormonal contraceptive that helps prevent pregnancy after sexual intercourse, rather than before or during. Taken up to 3 to 5 days after unprotected sex or birth control failure (like a torn condom), EC has an actual effectiveness of 75%. Depending on when in a woman’s cycle emergency contraception is taken, EC can stop ovulation, prevent fertilization, or prevent implantation of the fertilized egg in the uterus. Emergency contraception is NOT the "abortion pill." EC will not abort an embryo that is already implanted.
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- PROS OF HORMONAL CONTRACEPTION
- Generally very effective
- Can be very long-lasting
- Cost usually covered by health insurance
- CONS OF HORMONAL CONTRACEPTION
- Require visits to and prescription from a healthcare provider
- Require consistency in use—daily, weekly, every 3 weeks, etc.
- Some may cause a woman to stop menstruating or to have very heavy periods
- Do not protect against STIs
- Risk of blood clots, especially for smokers
NOTE:The most serious risk associated with all types of hormonal contraceptives is that of blood clots forming in the circulatory system. Such clots are a medical emergency. The women at greatest risk for clots are smokers. Therefore, smokers should discuss the risks and benefits of different contraceptive methods with their healthcare provider.
Question
Compare the actual effectiveness of the different types of hormonal birth control. What most likely accounts for the differences between the pill, the patch, and the ring (91%); the injection (94%); and the implant (>99%)?
The pill, patch, and ring require the user to remember to take or use the product exactly as instructed. People can forget or get distracted and risk becoming pregnant. The slightly higher effectiveness rate for the injection is most likely due to its long-lasting effect. However, if the woman does not or cannot come to the clinic or office for the injection every 90 days, she risks becoming pregnant. The implant has such a high level of effectiveness because the healthcare provider ensures that it is placed correctly, and it requires no further action or remembering on the part of the user for 3 years.
