What Hormones Are In Contraceptives – And What Are They Doing to Your Body?

What Hormones Are In Contraceptives – And What Are They Doing to Your Body?

What Hormones Are In Contraceptives – And What Are They Doing to Your Body?


Hormonal methods of birth control, such as birth control pills, skin patches, and vaginal rings all contain oestrogen and progestin. There are also progestin-only birth control pills, implants (such as Implanon and Nexplanon), and shots (such as Depo-Provera).

Hormonal methods of birth control prevent eggs from being released from the ovaries, thicken cervical mucus to prevent sperm from entering the uterus, and thin the lining of the uterus to prevent implantation.


But what other chemicals and hormones do traditional forms of non-barrier, hormonal-based birth control carry, and what side effects can you expect when using them?


What Are Hormonal Contraceptives’ Side Effects?

Some women experience these symptoms most commonly:


·         Weight gain

·         Headaches

·         Sore breasts

·         Irregular periods

·         Mood changes

·         Decreased sexual desire

·         Acne

·         Nausea


Types of Hormonal Birth Control and Side Effects

1)      Birth Control Pills

Most oral contraceptives, also referred to as "the pill," contain a combination of female hormones, oestrogen and progestin (a progesterone-like medication). The combination pill reduces the risk of pregnancy by:

2)      Preventing ovulation

3)      Keeping the mucus in the cervix thick and impenetrable to sperm

4)      Keeping the lining of the uterus thin


Possible side effects of the pill include:

1)      Nausea, breast tenderness, bloating, and mood changes, which typically improve within two to three months without treatment.

2)      Breakthrough bleeding or spotting. This is particularly common during the first few months of taking oral contraceptives. This almost always resolves without any treatment within two to three months. Forgetting a pill can also cause breakthrough bleeding.

3)      Women taking the pill should notify their healthcare provider if they experience abdominal pain, chest pain, severe headaches, eye problems, or severe leg pain as these could be symptoms of several serious conditions including heart attack, blood clot, stroke, liver, and gallbladder disease.

4)      Complications — When the pill was first introduced in the 1960s, the doses of both oestrogen and progestin were quite high. Because of this, cardiovascular complications occurred, such as high blood pressure, heart attacks, strokes, and blood clots in the legs and lungs.


2) Injectable Birth Control

Depo-Provera – or DMPA - is injected deep into a muscle, such as the buttock or upper arm, once every three months. A preparation that is given subcutaneously (under the skin) is also available.

DMPA prevents ovulation and thickens the cervical mucus, making the cervix impenetrable to sperm. If the first dose of DMPA is given during the first seven days of the menstrual period, it prevents pregnancy immediately. A woman who receives her first DMPA injection after the seventh day of her period should use a second form of contraception (eg, condoms) for seven days. DMPA is very effective, with a failure (pregnancy) rate of less than one percent when the injection is given on time.

Possible Side Effects from Injectable Birth Control include:

1)      The most common side effects of DMPA are irregular or prolonged bleeding and spotting, particularly during the first few months of use. Up to 50 percent of women completely stop having menstrual periods (amenorrhea) after one year of DMPA use. Menses generally return within six months of the last DMPA injection. DMPA is associated with weight gain in some women.

2)      Use of DMPA is associated with decreased bone mineral density in current users. This effect is mostly reversed after DMPA is stopped. Studies have not shown an increased risk of bone fractures in women who have used DMPA in the past.

3)      Because DMPA is long-acting, it may not be ideal for women who wish to become pregnant shortly after stopping the medication. Although most women are able to conceive within 10 months, fertility may not return for up to 18 months after the last injection.



3) Birth Control Skin Patch

Birth control skin patches contain oestrogen and progestin, similar to oral contraceptives. The patch is as effective as oral contraceptives, and may be preferred by some women because it does not require daily dosing. However, the failure rate of the patch is higher for obese women (e.g., who weigh more than 90kg).


Xulane’s effectiveness is similar to that of oral contraceptive pills. However, the patch may deliver a higher overall dose of oestrogen than the pill.

Some studies found that this was associated with an approximate doubling of the risk of blood clots while others found no increase in risk. Further study is needed to define this risk.

The patch is worn for one week on the upper arm, shoulder, upper back, abdomen, or buttock. After one week, the old patch is removed and a new patch is applied; this is done for three weeks. During the fourth week, no patch is worn; the menstrual period occurs during this week.


4) Vaginal Ring

Nuvaring is a flexible plastic vaginal ring that contains oestrogen and a progestin, which is slowly absorbed through the vaginal tissues. This prevents pregnancy, similar to an oral contraceptive. It is worn in the vagina for three weeks, followed by one week when no ring is used; a menstrual period occurs during this time. The ring's position inside the vagina is not important.

Most women cannot feel the ring, and it is easy to insert and remove. It may be removed for up to three hours if desired, but should be left in during intercourse (the ring is not usually felt by the sexual partner).

Risks and side effects are similar to those of oral contraceptives.

There is scientific controversy regarding the progestin hormone in the ring, and whether it also may be associated with a higher risk of blood clots, approximately double, such as with the patch.


5) Birth Control Implant

A single-rod progestin implant, Implanon or Nexplanon, has been approved for use in the United States and elsewhere. It is inserted under the skin into the upper inner arm by a healthcare provider (picture 3). It is effective for up to three years, but can be removed if pregnancy is desired sooner. Insertion and removal can be done in an office or clinic.


The implant is one of the most effective methods of birth control. It provides three years of protection from pregnancy as progestin is slowly absorbed into the surrounding tissues. It is effective within 24 hours of insertion.

Irregular bleeding is the most bothersome side effect. Fertility returns rapidly after removal of the rod.



6) IUD With Progestin

There are three intrauterine devices (IUDs) that contain a hormone, called levonorgestrel. One is called Mirena and can be left in place for up to five years. A device similar to Mirena (containing the same amount of hormone) is called Liletta and is approved for three years, but will likely be extended for up to five years of use like Mirena. The third option is called Skyla and can be left in place for up to three years.

All are highly effective in preventing pregnancy.


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Source credit: https://www.uptodate.com/contents/hormonal-methods-of-birth-control-beyond-the-basics