Hormonal Methods of Birth Control

Reviewed/Revised May 2023
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Birth control means preventing pregnancy (contraception). You can get pregnant even if you use birth control, but properly using birth control significantly lowers the risk of getting pregnant.

Hormones are chemical messengers one part of your body sends to another part of your body. These messengers control important body functions. Sex hormones, such as estrogen and progestin, help control a woman's menstrual periods and fertility. Doctors can use these hormones (or artificial versions of them) to prevent pregnancy.

What are hormonal methods of birth control?

Hormonal birth control works in two ways:

  • It keeps your ovaries from releasing eggs

  • It thickens the mucus in your cervix so sperm can't get through

If eggs aren't released or sperm can't get to them, you can't get pregnant.

Hormonal birth control methods include:

  • Birth control pills

  • Skin patch

  • Vaginal ring

  • Implant

  • Shot

How well does hormonal birth control work?

Hormonal birth control is one of the most effective methods of birth control if you use it correctly.

Your chance of getting pregnant goes up if you don't take your pills correctly, especially if you miss pills the first week after your period.

Who can use hormonal birth control?

Most women can use hormonal birth control.

You shouldn't take oral birth control (pills) that contains estrogen and progestin if you:

  • Are 35 or older and have migraine headaches

  • Have migraine headaches with an aura (symptoms that happen before a migraine headache, such as seeing lights or having unusual feelings in your skin)

  • Have or have had blood clots in your legs or lungs

  • Have high blood pressure

  • Have had diabetes for more than 20 years or diabetes that has affected your kidneys, nerves, or eyes

  • Have high fat levels in your blood called triglycerides

  • Have a heart disease

  • Are 35 or older and smoke more than 15 cigarettes a day

  • Have had an organ transplant that is causing problems

  • Have a liver disease

  • Have had jaundice (yellow skin and eyes) when using birth control before

  • Have gallbladder problems

  • Have or have had breast cancer

If you’ve had weight-loss surgery, you shouldn’t use the pill, but you can use a skin patch or vaginal ring.

What are the different types of hormonal birth control?

Talk to your doctor about which hormonal birth control is right for you.

Birth control pills

Birth control pills contain both progestin and estrogen or only progestin to prevent you from getting pregnant. Progestin-only pills don’t work quite as well. Doctors usually give them only if you can’t have estrogen.

You must take a pill every day. If you skip a pill, you may get pregnant. The more pills you skip, the greater the chance of pregnancy. When you stop taking the pills, you may be able to get pregnant right away or it may take a few months.

Side effects of birth control pills may include:

  • Bleeding at unexpected times, particularly in the first few months of use

  • Feeling sick to your stomach, bloating, and throwing up

  • Sore breasts

  • Blood clots in your legs or lungs

  • Headaches

  • Depression

  • Dark patches on your skin (melasma)

  • Slightly higher chance of getting cervical cancer

  • Weight gain

Skin Patch

A birth control skin patch is a thin, sticky patch that slowly releases estrogen and progestin to prevent you from getting pregnant. Typically you wear a patch for 7 days and then put on a fresh one for another 7 days. After you have used 3 patches, you wait a week before starting again.

  • You may have to use a backup method of birth control (such as a condom) during the first week you use the patch

  • You may find it easier to remember to use a patch once a week than to take a birth control pill every day

  • Side effects of the patch are similar to the pill

  • The patch may not work as well if you're overweight

  • You may have pain or itching on your skin under or around the patch

Vaginal ring

A vaginal ring contraceptive is a small plastic ring that is placed in your vagina. The ring releases estrogen and progestin to prevent you from getting pregnant. Typically you leave the ring inside you for 3 weeks and then take it out for 1 week. During that week you may have a period. After the week has passed, you put in a fresh ring. Some doctors have you leave the ring in for 5 weeks and then replace it with a fresh one.

  • You may have to use a backup method of birth control (such as a condom) during the first week you use the ring

  • You may find it easier to remember to use a ring once every 3 to 5 weeks week than to take a birth control pill every day or put on a patch every week

  • On the other hand, because you can't see or feel the ring, it's easy to forget to remove and replace it

  • Side effects of the ring are similar to the pill and patch

Birth control implant

A birth control implant is a match-sized rod placed under your skin that releases progestin to prevent you from getting pregnant.

  • An implant works for 3 years

  • As soon as the implant is removed, you can get pregnant

  • Your doctor will put the implant under your skin with a needle-like tool and remove it through a small cut in your skin

Side effects of implants may include:

  • Not getting your period

  • Bleeding at unexpected times

  • Headaches

  • Weight gain

Birth control shot

A birth control shot is a shot of long-acting progestin given every 3 months to prevent you from getting pregnant.

  • It may take up to 18 months after you stop the shots before you can get pregnant

Side effects of the shot may include:

  • Bleeding at unexpected times, especially at first

  • Not getting your period

  • Weight gain

  • Headaches

  • Less bone density (how healthy and strong your bones are)—though bone density usually returns to normal when you stop getting the shot

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