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Hormonal Contraception - Benefits, Side Effects, Risk Factors, and Types

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Hormonal Contraception - Benefits, Side Effects, Risk Factors, and Types

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The use of hormonal contraceptives is a safe method of practice to prevent pregnancy compared to mechanical methods. In this article, I will take you through hormonal contraception methods in detail.

Medically reviewed by

Dr. Ushasi Mukherjee

Published At October 26, 2021
Reviewed AtDecember 12, 2022

What is Hormonal Contraception?

Hormonal contraception is a type of contraception that acts on the endocrine system, and all methods involve the use of steroid hormones like Progesterone or Estrogen, or only Progesterone. These hormonal contraceptives cause changes in the hormone levels of women to prevent pregnancy. It hampers the release of eggs from the ovary, thickens the cervix’s mucus to prevent the entry of sperm, and thins down the uterine lining to prevent pregnancy.

How Do Hormonal Contraceptives Work?

All hormonal contraceptives contain Progestin and may or may not contain Estrogen. Although these are also synthesized by a woman, the hormones used for contraception are synthetic hormones produced in the laboratory. Both the hormones work together, or Progesterone works in unison and prevents pregnancy by the following:

  • Prevents the release of an egg from the ovary (ovulation).

  • Thins down the uterus (womb) lining to prevent the attachment of the fertilized egg from attaching to the womb.

  • Thickens the cervical mucus and prevents the entry of sperm into the uterus.

What are the Benefits of Hormonal Contraceptives?

  • The effectiveness of hormonal contraceptives is relatively more than 99%, which means that only one in about 1000 women have a chance of getting pregnant after using hormonal contraceptives.

  • The blood flow of the menstrual cycle is reduced.

  • Menstrual pain is reduced after taking hormonal contraceptives.

  • The risk of ovarian, colon, and uterine cancer is decreased.

  • Improves the skin type in teenage girls and women who are prone to acne.

side effects

What are the Side Effects of Hormonal Contraceptives?

  • Headache.

  • Nausea.

  • Vaginal thrush or vaginal yeast infections.

  • Soreness of the breasts.

  • Reduced sexual drive in women.

  • Mid-cycle spotting.

  • Mood swings

What are the Potential Risks Associated With Hormonal Contraceptives?

Formation of Blood Clots:

The risk of developing blood clots is comparatively less. However, the risk of thrombosis is increased with hormonal contraceptives, which combine the use of Estrogen along with Progesterone. Also, the risk is even higher in people with an existing predisposing condition.

Bone Strength:

A reduction in bone mass is seen in people who use injectable progestins.

Breast Cancer:

Few studies have shown the risk of developing breast cancer in women below the age of 35 and who use hormonal contraceptive methods. However, there is no or minimal risk in women above the age of 50.

Stroke:

Although rare, stroke is a potential complication of hormonal contraceptives, which is increased in women with migraine, visual changes followed by migraine, have the habit of smoking, and are above the age of 35 years.

Heart Attack:

It is an infrequent complication; however, the risk increases in people above the age of 35 years who have a smoking habit.

What are the Different Types of Hormonal Contraceptives?

1. Oral Contraceptive Pills:

The oral contraceptive pills are of two types, namely combination pills and mini pills.

A. Combination Pills- These contain two types of synthetic hormones, namely Progesterone and Estrogen. It is composed of two kinds of pills: active pills, which contain hormones, and inactive pills that do not contain hormones. The following are the types of combination pills.

  • Monophasic Pills

These are given for a period of one month, with each dose of a pill containing the same amount of hormones for 21 to 22 days. After which, the inactive pills are given, and menstruation happens.

  • Multiphasic Pills

They are similar to monophasic pills except that the multiphasic tablets contain different amounts of hormones throughout the cycle.

  • Extended Cycle Pills

When you are in this type of pill, menstruation occurs only three to four times a year. It comprises a 13-week cycle, in which the first twelve weeks involve the intake of active drugs, and on the 13th week, inactive pills are given to get menstruation.

Common brand names of combination pills include:

  • Levora.

  • Low-Ogestrel.

  • Seasonale.

  • Enpresse.

  • Yasmin.

  • Azurette.

B. Mini pills:

Mini pills are also called Progestin-only pills. As the name suggests, they contain only Progestin and are recommended in people who cannot take Estrogen. In the case of mini-pills, all the pills taken in a month are active pills. Therefore, menstruation may or may not occur with mini pills.

Common brand names of mini pills include:

  • Camila.

  • Nor-QD.

  • Ortho Micronor.

  • Heather.

What Factors Decide the Type of Contraceptive Pill?

Factors that decide the type of oral contraceptive pill to be taken include the following:

  • Cardiovascular health.

  • Breastfeeding.

  • Medicines taken.

  • Chronic health conditions.

  • Menstrual symptoms.

2. Injectable Progestins:

These injectable forms of Progestin are taken every 12 weeks. After you get the shot, it usually takes about a year to have ovulation.

3. Contraceptive Skin Patch:

It is a thin skin patch of size 5 cm by 5 cm and can be placed on the back belly, outside upper arm, or anywhere on a woman's upper body except her breasts. It contains both Progesterone and Estrogen and is absorbed from the skin and enters the bloodstream. The patch is replaced once a week for the first three weeks, and then no patch is placed for the fourth week when the menstruation occurs. It should be made sure that the patch does not excessively rub against clothing. These patches do not come off due to daily activities like bathing or using a swimming pool, etc. Once the patch is removed during menstruation, a new patch should be placed after seven days. If it is delayed by a day, then it does not serve as a reliable contraceptive. Since the amount of Estrogen that enters the bloodstream is high in the case of a skin patch, the side effects are also high compared to vaginal rings and oral contraceptive pills.

4. Hormone-Releasing Contraceptive Coils:

These are T-shaped plastic coils with a string that are placed intrauterine. They contain and release Levonorgestrel. The lining of the uterus (womb) absorbs the Levonorgestrel. It prevents pregnancy by thinning the uterus lining to prevent the attachment of fertilized egg onto the ovary and thickens the cervical mucus to restrict the entry of sperm into the cervix.

Depending on the type of coil used, the contraceptive coils help prevent pregnancy for three to five years. A medical professional places it, and its position is then checked with the help of an ultrasound. It is recommended to have regular check-ups to evaluate the position of the coil. Since there is a continuous release of hormones into the blood, some women have a chance of lighter or no periods. Spotting, nervousness, and headache are seen after placing the coil initially. Injury to the uterus or pelvic infections can rarely occur in women, so these are not advised in women who have not given birth.

5. Vaginal Ring:

It is a synthetic ring made up of soft and flexible material and is 5 cm in diameter. It releases the hormones Progesterone and Estrogen, which are absorbed by the vaginal wall and enter the bloodstream. It can be self-placed inside the vagina deeply with the help of a finger. The reliability of the vaginal ring depends on the time of placement and removal. It should be placed and removed after three weeks precisely at the same time, and also after menstruation, it should be placed after seven days at the same particular time of the day. A delay of three hours is acceptable; however, placing it at the correct time improves the efficacy. Nausea, depression, and irritability are the side effects of vaginal rings, while in a few, there can be frequent vaginal infections.

What is the Use of Hormonal Contraceptives In Emergency Contraception?

Emergency contraception is a method of contraception, which is done after sexual intercourse, usually within five days of intercourse. However, the tablet should be taken earlier to prevent the chance of pregnancy. Emergency contraception is achieved by emergency contraceptive pills, combined oral contraceptive pills, and copper IUD. Emergency contraceptive pills work by preventing or delaying ovulation. These emergency contraceptive pills contain Ulipristal Acetate or Levonorgestrel.

Conclusion:

Although hormonal contraceptive methods are a reliable method of contraception, they should not be used in excess or without the doctor’s advice.

In case of further queries, consult with a specialist online at www.icliniq.com.

Frequently Asked Questions

1.

What Are the Examples of Hormonal Contraceptives?

There are several forms of hormonal contraception. They are:
- Birth control pill.
- Contraceptive skin patch.
- Vaginal ring.
- Hormone-releasing contraceptive coils.
- Hormonal birth control implant.
- Three-month injection contraceptives.

2.

How Does Hormonal Contraception Work and Prevent Pregnancy?

Hormonal contraceptives contain Progestin and Estrogen. Although a woman synthesizes these hormones, contraception can be done with synthetic hormones produced in the laboratory. These hormones work by preventing the egg release from the ovary, thins the uterus lining to prevent the attachment of the fertilized egg, thickens the cervical mucus, thus preventing the sperm entry into the uterus.

3.

What Causes the Hormonal Imbalance?

The leading causes of hormonal imbalances are problems with the thyroid, stress, anxiety, and eating disorders. Some of the symptoms include low sex drive, irregular periods, mood swings, and unexplained weight gain. The hormones, which the endocrine system makes, are the body's messengers.

4.

How to Identify Hormonal Imbalance?

The symptoms of hormonal imbalance are weight gain, muscle weakness, sweating, frequent urination, increased thirst, depression, puffy face, increased hunger, infertility, pink stretch marks, blurred vision, hair thinning, constipation, stiffness of the joints, and nervousness.

5.

What Can I Drink to Balance My Hormones?

The liver is responsible for our body's hormone metabolism. It also depends on certain nutrients and minerals. In order to maintain an optimal hormone balance, herbal tea infusions like dandelion root tea free of caffeine or Tulsi (Holy Basil) might help the liver detox and reduce stress.

6.

Is Hormonal Birth Control Bad for You?

Even though birth control pills are safe, combination pills can increase the risk of health problems. Complications of hormonal birth control are rare, but they can be serious. They are stroke, heart attack, liver tumors, and blood clots. In rare cases, it leads to death.

7.

Are Hormonal Contraceptives Effective?

When hormonal contraceptives are used correctly, they are more than 99% effective in preventing pregnancy. Also, they have potential benefits such as reducing the risk of ovarian, uterine, and colon cancers and menstrual blood flow.

8.

What Is the Most Common Form of Hormonal Contraception?

Hormonal contraceptives help to prevent pregnancy, and the most commonly used form of contraception is a birth control pill. They cause some side effects such as headaches and spotting between the periods.

9.

What Is the Role of Hormones in Contraception?

The hormones present in contraception are estrogen and progesterone. They help to prevent pregnancy by:
- Thinning the uterus lining.
- Blocking the egg release from the ovaries.
- Thickening of the mucus in the cervix, which helps prevent the sperm from reaching the egg.

10.

Who Cannot Take Oral Contraceptives?

Oral contraceptives cannot be taken in people with coronary artery disease or cerebrovascular disease; when there is a history of pulmonary embolism, deep vein thrombosis, or congestive heart failure (CHF), estrogen-dependent neoplasia, diabetes with vascular complications, undiagnosed abnormal vaginal bleeding, and breast cancer.
Dr. Ushasi Mukherjee
Dr. Ushasi Mukherjee

Obstetrics and Gynecology

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