Hormonal methods of birth control (contraception) contain either estrogen and progestin, or progestin only; they are a safe and reliable way to prevent pregnancy for most women. Hormonal methods include an implant, an intrauterine device (IUD), injections, pills, a vaginal ring, and a skin patch.
How do I know which one suites me?
It can be difficult to decide which birth control method is best due to the variety of options available. The best method is one that will be used consistently and does not cause bothersome side effects. Other factors to consider include:
- Efficacy (how well it works to prevent pregnancy)
- How long the drug or device can be used
- Whether and how it affects your monthly period
- Type and frequency of side effects
- Privacy concerns
- Whether or not it also protects against sexually transmitted diseases
- How quickly your fertility will return if you stop taking it
How soon after stopping the birth control can I fall pregnant?
The length of time it takes to become pregnant after use of a hormonal method of birth control depends upon which method was used, as well as some individual factors.
Most women return to their normal level of fertility within a cycle or two. For some, it may take several months before ovulation becomes regular and the woman can become pregnant, especially if her periods were irregular before starting birth control. However, hormonal birth control does not increase the risk of infertility.
What is the intrauterine device (IUD)?
It’s a small, T-shaped, plastic device that is inserted into and left inside the uterus. There are two types of IUDs:
- The hormonal IUD releases progestine. Different brands of hormonal IUDs are approved for use for up to 5 years and for up to 3 years.
- The copper IUD does not contain hormones. It is approved for use for up to 10 years.
How does it work?
Both types of IUDs work mainly by preventing fertilization of the egg by the sperm. The hormonal IUDs also thicken cervical mucus, which makes it harder for sperm to enter the uterus and fertilize the egg, and keep the lining of the uterus thin, which makes it less likely that a fertilized egg will attach to it.
What are the benefits of a IUD?
- Once it is in place, you do not have to do anything else to prevent pregnancy.
- No one can tell that you are using birth control..
- It does not intefere with sex or daily activities.
- It can be inserted immediately after an abortion, a miscarriage, or childbirth and while breastfeeding.
- Almost all women are able to use an IUD.
- If you wish to become pregnant, or if you want to stop using it, you can simply remove the IUD.
- The hormonal IUD helps to decrease menstrual pain and heavy menstrual bleeding.
- The copper IUD also is the most effective form of emergency contraception.
Birth Control Pill
What is the birth control pill?
The birth control pill is a pill you you have to take every day the same time each day. It contains hormones that prevent pregnancy. There are many types of birth control pills. Dr Groenewald can help you choose the right one for you.
What is the emergency birth control pill?
If you have sex without using any birth control, if the birth control method did not work (for instance, the condom broke during sex), or if you are raped, you can use emergency birth control to prevent pregnancy. Emergency brth control is available in form or as a copper IUD. The pills must be taken or the IUD inserted within 5 days of having unprotected sex.
What are the types of emergency birth control pills?
There are 3 types: 1. Progestine – only pill 2. regular birth control pills taken in certain amounts, and 3) ulipristal.
The contraceptive implant (Implanon NXT®) is a soft plastic stick about 4 cm long. The implant slowly releases a hormone, progestogen, into your body. Progestogen is similar to the hormone produced by the ovaries.
How effective is the implant?
It is more than 99% effective at preventing pregnancy and can last for up to three years.
How do I use the implant?
The implant is inserted (injected) under the skin of your inner upper arm by a trained doctor or nurse. A local anaesthetic is used so that you will not feel pain when this is happening.
What is good about the implant?
- It is the most effective method of contraception
- Once inserted (put in) you can forget about it for 3/three years
- It can last up to three years
- Many users have no vaginal bleeding (period) at all or very light bleeding
- Periods may be less painful
- Acne can improve
- It is another choice if you have problems taking the hormone oestrogen. The Pill (combined pill) and vaginal ring contains oestrogen and progestogen. The implant only contains progestogen.
- You can use it while breast feeding
- It is easy to remove
- Once removed your fertility quickly returns to normal
The injection contraceptive varies to the birth pill as it is administered once every 3 months, deep into a muscle, such as in the buttock or upper arm, or subcutaneously (under the skin).
How does it work?
The injection prevents ovulation and thickens the cervical mucus, making the cervix impenetrable to sperm. If you get your first dose during the first seven days of your menstrual period, it prevents pregnancy immediately. If you get your first dose after the seventh day of her period, you should use a second form of birth control (eg, condoms) for seven days. It is very effective, with a failure (pregnancy) rate of less than 1 percent when repeat injections are given on time.
Benefits compared with birth control pills
There are a number of women who prefer DMPA to the pill, including those who:
- Have difficulty remembering to take a pill every day.
- Value the privacy with DMPA use.
- Cannot use estrogen.
- Also take seizure medications, which can be less effective with combination hormonal contraceptives.
Mirena is a hormonal intrauterine device (IUD) that can provide long-term birth control (contraception). The device is a T-shaped plastic frame that’s inserted into the uterus, where it releases a type of the hormone progestin.
How does it prevent pregnancy?
To prevent pregnancy, Mirena:
- Thickens mucus in the cervix to stop sperm from reaching or fertilizing an egg
- Thins the lining of the uterus and partially suppresses ovulation
How long is the Mirena effective?
Mirena prevents pregnancy for up to five years after insertion. It’s one of several hormonal IUDs with Food and Drug Administration approval.
Who is advised to get the Mirena?
Because of many non-contraceptive benefits, Mirena is often prescribed for women with:
- Heavy menstrual bleeding
- Cramping or pain with periods
- Abnormal growth of the lining of the uterus (endometrial hyperplasia)
- Abnormal growth of uterine-lining tissue into the muscular wall of the uterus (adenomyosis)
Sterilisation works by stopping the egg and the sperm meeting. In female sterilisation (tubal occlusion) this is done by cutting, sealing or blocking the fallopian tubes which carry an egg from the ovary to the uterus (womb).
Is sterilization permanent?
Yes, Sterilisation is a permanent method of contraception, suitable for people who are sure they never want children or do not want more children. There are reversal operations but they are not always successful. Success will depend upon how and when you were sterilised. Reversal is rarely available on the NHS and can be difficult and expensive to obtain privately. Hysteroscopic sterilisation cannot be reversed.
Do I need my partner’s permission?
By law you do not need your partner’s permission but some doctors prefer both partners to agree to a sterilisation after information and counselling.
Is there an alternative?
You may want to find out about long-acting reversible contraception (LARC) which is as effective as sterilisation, but reversible. Ask Dr Groenewald about your options.