Birth Control: Pros and Cons of Hormonal Methods
Topic Overview
The following tables list some pros and cons
of using hormonal
birth control methods.
Combination pills, skin patch, or vaginal ring (estrogen plus progestin)
| Pros | Cons |
|---|
- No interruption of foreplay or
intercourse
- Reduced bleeding and cramping with periods, which
lowers the risk of
anemia
- Fewer or no periods (with certain
types of pill)
- Reduced pain during ovulation
- Reduced
risk of
pelvic inflammatory disease (PID)
- Reduced
fibrocystic breast changes
- Reduced risk of
ectopic pregnancy
- May reduce
acne
- May reduce
ovarian cysts
- May reduce symptoms of
endometriosis
- May protect against ovarian and endometrial
cancer
- Can be used after an abortion
| - Does not protect against
sexually transmitted infections or
HIV
- May not be as effective when taken
with certain
medicines
- May delay return of normal
cycles
- If used in early breast-feeding, may reduce milk
supply
- Pills must be taken every day.
- Patches may not
fully protect you from pregnancy if they are exposed to direct sun or high
heat. This can release a high dose of hormone from the patch, which leaves less
for the patch to release later in the week.
- Patches deliver more estrogen than low-dose birth control
pills do. Some research has found that women using the patch are more likely to
get dangerous blood clots in the legs and lungs. The risk may be higher if you
smoke or have certain health problems. The U.S. Food and Drug Administration
(FDA) suggests that you talk to your doctor about your risks before using the
patch.
|
Progestin-only pills,
implant, or shot
| Pros | Cons |
|---|
- No interruption of foreplay or
intercourse
- Fewer or no periods (especially
with shot or implant)
- Reduced cramps and pain during
ovulation
- Reduced bleeding and cramping with periods, which
lowers the risk of
anemia
- Reduced risk of
pelvic inflammatory disease (PID)
- Does not
contain
estrogen, so can be used by women who cannot take
estrogen
- May be used by women over 35 who are smokers
- May be used while breast-feeding
- Reduces
risk of
ectopic pregnancy
- Possible protection against endometrial
and ovarian cancer
- Implant gives rapid return to fertility following
removal.
- Shot and implant provide extremely effective birth control
protection.
- Shot protects for about 3 months; implant lasts 3
years.
- Shot reduces symptoms of
endometriosis.
- Shot reduces frequency of
seizures in women who have a seizure
disorder.
- Shot reduces number of sickle cell crises in women who have
sickle cell disease.
| - Does not protect against
sexually transmitted infections or
HIV
- Causes more irregular periods or spotting between
periods
- May not be as effective when taken
with certain
medicines
- Makes
diabetes more likely if you have had
gestational diabetes during pregnancy1
- Progestin-only pills are less effective than combination
pills, but the shot and implant are extremely effective.
- Pills
must be taken at the same time each
day.
- Implant may cause menstrual periods to stop or be very
light.
- Implant must be inserted and removed by a trained health
professional.
- Implant may cause headaches.
- Shot may delay return of
normal cycles for 6 to 8 months after the medicine is stopped, but there is no delay with pills or implant.
- Shot may
increase the risk of
chlamydia or
gonorrhea infection among women who are sexually
exposed to these bacteria.2
- Shot causes slight weight gain.
- Shot may decrease
levels of
HDL ("good") cholesterol.
- Shot causes bone mineral loss, so calcium supplementation is
necessary.
- Using the shot for 2 or more years can
cause bone loss, which may not be fully reversible after stopping the
medicine. This concern may be greatest during the teen years, when young
women should be building bone mass.3
|
Intrauterine devices (IUDs)
These advantages and disadvantages apply to both hormonal and non-hormonal IUDs.
| Pros | Cons |
|---|
- Does not require
interruption of foreplay or intercourse
- Does not require
cooperation of sexual partner
- More than 99% effective in preventing
pregnancy4
- Easy to use
- Most cost-effective method of
birth control over time
- Safe to use while
breast-feeding
- Can be removed whenever you have problems or want to
stop using it. Fertility returns with the first
ovulation cycle following IUD
removal.
- Can be inserted after a normal vaginal delivery, a
cesarean section, or a
first-trimester abortion
- Hormonal IUD can relieve heavy menstrual bleeding and
cramping in most women.
| - Does not provide protection against
sexually transmitted infections (STIs) or
HIV
- Costs several hundred dollars for
insertion. (This cost may be covered by your health insurance. Some community
clinics may offer insertion and removal at a reduced rate or free to low-income
clients.) If the IUD is expelled, it costs just as much to get a new one.
Having an IUD removed is also costly. But if an IUD is used for 5 years or
longer, it is the most cost-effective form of birth control.
- Only
a health professional can remove the IUD. Never attempt to remove the IUD
yourself or allow a partner to try to remove it.
- When inserted, an IUD can spread a genital infection into the uterus,
leading to
pelvic inflammatory disease (PID) in the first months
after insertion. This is why you are screened for STIs before getting an
IUD.
|
References
Citations
- Raymond EG (2007). Progestin-only pills. In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 181–191. New York: Ardent Media.
- Morrison CS, et al. (2004). Hormonal contraceptive
use, cervical ectopy, and the acquisition of cervical infections.
Sexually Transmitted Diseases, 31(9):
561–567.
- U.S. Food and Drug Administration (2004). Depo-Provera contraceptive injection (medroxyprogesterone acetate injectable suspension). Safety Alerts for Human Medical Products. Available online: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm154784.htm.
- Grimes DA (2007). Intrauterine devices (IUDs). In RA
Hatcher et al., eds., Contraceptive Technology, 19th
ed., pp. 117–143. New York: Ardent Media.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Kirtly Jones, MD, MD - Obstetrics and Gynecology |
|---|
| Last Revised | June 28, 2011 |
|---|
Last Revised:
June 28, 2011
Raymond EG (2007). Progestin-only pills. In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 181–191. New York: Ardent Media.
Morrison CS, et al. (2004). Hormonal contraceptive
use, cervical ectopy, and the acquisition of cervical infections.
Sexually Transmitted Diseases, 31(9):
561–567.
U.S. Food and Drug Administration (2004). Depo-Provera contraceptive injection (medroxyprogesterone acetate injectable suspension). Safety Alerts for Human Medical Products. Available online: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm154784.htm.
Grimes DA (2007). Intrauterine devices (IUDs). In RA
Hatcher et al., eds., Contraceptive Technology, 19th
ed., pp. 117–143. New York: Ardent Media.
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