Hormonal contraception pertains to a range of contraceptive methods that rely on artificial hormones to prevent pregnancy. Available in pill, injection, or implant form, hormonal contraception works by suppressing ovulation (eggs are prevented from being released from the ovaries) or by thickening the cervical mucus, making it tough for sperm to reach the egg.
Hormonal Contraceptives
Oral Contraceptive Pills (OCPs) or The Pill:
Oral contraceptive pills are a hormonal type of contraception that work by preventing the release of an egg from the ovaries. Taken once daily at the same time, the pills taken during the first 3 weeks contain hormones, while the ones taken in the fourth week are non-hormonal placebos, allowing for menstruation. This cycle is repeated every 28 days.
Pros:
Highly effective in preventing unplanned or unwanted pregnancies when taken daily.
Reduces bleeding, menstrual pain, anemia, and acne.
Does not interrupt flirting, foreplay, and intercourse.
Relatively inexpensive.
Cons:
Some women may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches.
Not suitable for individuals who smoke and for those with a history of breast cancer, blood clots, and liver and heart conditions.
May interact with other medications.
Does not protect against STIs.
Tips:
If you are on the pill and feeling nauseated, consider taking it during lunchtime or before bedtime.
If you are concerned about forgetting to take your pill, here are some helpful reminders:
Set a daily alarm on your phone or use a dedicated app for this purpose.
Place the pill in a spot you will notice every day.
Link taking the pill to another daily routine or habit to help you remember.
What happens if the pill is not taken on time?
If you forget to take the pill:
Take the missed pill as soon as you remember and then take the next one at your regular scheduled time.
If you have missed the pill for two consecutive days, consider yourself fertile. Consult your healthcare provider; you may need to restart the course.
If you were sexually active during this period, it is advisable to take a pregnancy test in 2-4 weeks.
Note:
Missing a pill can increase the likelihood of experiencing irregular bleeding or an unusual menstrual cycle.
Emergency pill:
The morning-after pill, Plan B, or emergency pill is a hormonal type of contraception that works by preventing the release of an egg from the ovaries. For efficacy, the pill should be used as soon as possible, and within less than 72 hours after a risky exposure.
Cons:
Some may experience side effects such as nausea, vomiting, fatigue, breast tenderness, or changes in menstrual bleeding patterns.
Does not protect against STIs.
Can sometimes cause temporary irregularities in menstrual cycles.
Excessive use can reduce its effectiveness over time.
Ineffective if taken after ovulation.
Pros:
Emergency contraception can significantly reduce the risk of pregnancy if taken promptly after unprotected sex or contraceptive failure.
Accessible without a prescription.
Discreet and does not require a doctor's appointment.
Hormonal injection
Hormonal injections prevent unplanned pregnancies by steadily releasing hormones into the body and thickening the cervical mucus, making it difficult for the sperm to move through. Each injection administered by healthcare providers lasts 2 to 3 months.
Pros:
Highly effective long-term method of birth control.
Reduces menstrual bleeding and cramps.
Does not interrupt flirting, foreplay, and intercourse.
Reduces risk of noncompliance (forgetting to take a dose).
Cons:
Some women may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches.
It may cause irregularities and changes in menstruation patterns such as a heavier or lighter flow and a shorter or longer period.
Not suitable for individuals who smoke and those with a history of breast cancer, blood clots, and liver and heart conditions.
Does not protect against STIs.
Hormonal implants
Hormonal implants prevent unplanned pregnancy by steadily releasing hormones into the body and thickening the cervical mucus, making it difficult for the sperm to move through. Placed under the skin of the upper arm under local anesthesia by a medical provider, hormonal implants typically last between 3 to 5 years and can be removed at any time.
Note: May cause skin irritability when implanted.
Cons:
Some women may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches.
May cause irregularities and changes in menstruation patterns such as a heavier or lighter flow, a shorter or longer period.
Not suitable for individuals who smoke and those with a history of breast cancer, blood clots, and liver and heart conditions.
Does not protect against STIs.
Pros:
Highly effective long-term method of birth control.
Reduces menstrual bleeding and cramps.
Does not interrupt flirting, foreplay, and intercourse.
Reduces risk of noncompliance (forgetting to take a dose).
Intrauterine devices (IUD)/ Intrauterine systems (IUS)
Hormonal IUD:
Hormonal intrauterine devices (IUD) are T-shaped birth control devices that are inserted into the uterus by a healthcare provider. Hormonal IUD can last around 5 to 7 years and can be removed anytime. They work by steadily releasing hormones into the uterus, which thickens the cervical mucus and inhibits sperm mobility, preventing sperm from reaching the egg and fertilizing it.
Non-hormonal IUD
Non-hormonal intrauterine devices (IUDs) are T-shaped birth control devices that are inserted into the uterus by a healthcare provider. Typically, they can last between 5 to 10 years and can be removed anytime. Non-hormonal IUDs are made of copper and plastic and work by releasing copper to create an inhospitable environment that inhibits sperm from reaching the egg and fertilizing it.
Cons:
May cause infection after insertion.
Insertion can be uncomfortable.
Partners may feel the string of the device.
Should be regularly checked by a physician to make sure that the device is still in place.
May cause irregular spotting or bleeding.
Does not protect against STIs.
Some women may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches. (Hormonal IUD)
Pros:
Highly effective long-term method of birth control that can be removed whenever one decides to.
Fertility returns to normal when the device is removed.
Most people do not feel the presence of an IUD/IUS.
Does not interrupt flirting, foreplay, and intercourse.
Hormonal Patch
A hormonal patch is a device placed on the abdomen, buttocks, upper outer arm, or upper torso. It prevents pregnancy by steadily releasing hormones into the bloodstream and suppressing ovulation. Typically, patches are changed once a week for 3 weeks followed by a patch-free week to allow for menstruation.
Cons:
May cause skin irritation at the application site.
Not suitable for individuals who smoke and those with a history of breast or uterine cancer and blood clots.
Some people may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches.
Does not protect against STIs.
Pros:
Effective if used properly.
Does not interrupt flirting, foreplay, and intercourse.
Regulates menstrual cycle.
Vaginal Ring
The vaginal ring is a one-time-use type of hormonal contraception that prevents pregnancy by thickening the cervical mucus and suppressing ovulation. It is inserted into the vagina and remains in place for 3 weeks, after which it should be removed before menstruation, with a new ring to be inserted during each cycle.
Pros:
Regulates periods and lightens flow.
Highly effective.
Can be inserted by the user.
Does not interrupt flirting, foreplay, and intercourse.
Cons:
Some people may experience side effects such as nausea, breast tenderness, irregular spotting, bloating sensation, decreased libido, weight gain, mood changes, or headaches.
Discomfort during insertion.
Not suitable for individuals who smoke and for those with a history of breast cancer, blood clots, and liver and heart conditions.
Does not protect against STIs.
Insertion:
Wash and dry your hands.
Relax your pelvic muscles.
Find a comfortable position (lying down, squatting, or standing with one foot on the chair).
Remove the ring from the package.
Pinch the sides of the ring with your thumb and index finger until they touch in the center, forming an oval shape.
Insert the ring as far into the vagina as possible.
Removal:
Clean and dry your hands.
Relax your pelvic muscles.
Insert your finger to locate the ring.
Hook your finger around the edges.
Gently pull the ring out.
Written by:
Fatima Khalil | Sexual health coordinator
Fatima Khalil is the coordinator of sexual health education and outreach at Marsa Sexual Health Center and is currently pursuing a degree in child education. With more than 7 years of experience in the field of Sexual and Reproductive Health and Rights, she has developed several guidelines and educational materials on proper services provision, sexually transmitted infections, and women's health.