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All types of birth control and side effects: Pill, Implant, Barrier, Side Effects & Effectiveness


Side effects, risks, alternatives, and the shot

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The oral contraceptive pill is a hormonal method of preventing pregnancy. Side effects are common, and they vary from person to person.

The pill is a type of birth control. It works by preventing the body from producing an egg, which means that there is nothing for sperm to fertilize, and pregnancy cannot occur.

Birth control pills can also help with irregular, painful, or heavy periods, endometriosis, acne, and premenstrual syndrome (PMS).

The specific side effects vary widely among individuals, and different pills cause different side effects. Some common side effects include spotting, nausea, breast tenderness, and headaches.

There are two main types of birth control bill. Combination pills contain estrogen and progestin, which is a synthetic form of the natural hormone progesterone, while the mini pill contains progestin only.

This article looks at 10 common side effects of the pill, as well as its risks, long-term effects, and alternatives. It also discusses the cost of birth control pills and how to get them.

Birth control pills affect a person’s hormone levels, leading to various side effects. These effects usually resolve within 2–3 months, but they can persist.

In the United States, around 12.6% of females aged 15–49 years take oral contraceptive pills. They are safe for most females to use.

If the side effects last for a long time or are very uncomfortable, it is best to talk to a healthcare provider about trying a different brand or a different method of birth control.

The sections below will look at some common side effects of oral contraceptives.

1. Spotting between periods

Breakthrough bleeding, or spotting, refers to when vaginal bleeding occurs between menstrual cycles. It may look like light bleeding or brown discharge.

Spotting is the most common side effect of birth control pills. It happens because the body is adjusting to changing levels of hormones, and the uterus is adjusting to having a thinner lining.

Taking the pill as prescribed, usually every day and at the same time each day, can help prevent bleeding between periods.

Learn more about spotting and birth control here.

2. Nausea

Some people experience mild nausea when first taking the pill, but this usually subsides. Taking the pill with food or at bedtime may help.

Birth control should not make people feel sick all the time. If the nausea is severe or lasts for a few months, it is best to talk to a healthcare provider.

3. Breast tenderness

Taking birth control pills often causes the breasts to feel tender, especially soon after a person starts taking them. Wearing a supportive bra can help reduce breast tenderness.

Along with increased breast sensitivity, the hormones in the pill can make the breasts grow bigger. Learn more here.

A person should talk to their healthcare provider about severe breast pain or other breast changes, especially a new or changing breast lump.

4. Headaches and migraine

The hormones in birth control pills can cause or increase the frequency of headaches and migraine.

Changes in the female sex hormones (estrogen and progesterone) can trigger migraine. Symptoms can depend on the dosage and type of pill. For example, low dose pills are less likely to cause this symptom.

On the other hand, if a person’s migraine is associated with PMS, taking the pill may actually reduce their symptoms.

5. Weight gain

Birth control pills often list weight gain as a possible side effect, though research has not yet confirmed this.

In theory, birth control pills could lead to increases in fluid retention or water weight. They could also lead to increases in fat or muscle mass. However, some people may instead report weight loss when taking the pill.

According to a 2017 article, there has not been enough research to confirm whether the hormones in birth control pills lead to weight gain or weight loss.

6. Mood changes

Hormones play an important role in a person’s mood and emotions. Changes in hormone levels, which taking the pill may cause, can affect a person’s mood.

Some research, including a 2016 study of 1 million females in Denmark, suggests a link between hormonal contraception and depression.

If a person is concerned about mood changes, they can talk to their healthcare provider. If the symptoms are linked to taking the pill, changing pills may help.

Learn more about the link between depression and birth control here.

7. Missed periods

Taking birth control pills can cause very light periods or missed periods. This is because of the hormones they contain.

Depending on the type of birth control, people can use the pill to safely skip a period. Learn more here.

If a person suspects that they may be pregnant, it is best to take a pregnancy test. The birth control pill is very effective, but pregnancies can occur — especially with improper use.

Many factors can cause a late or missed period, including:

  • stress
  • illness
  • travel
  • hormonal problems
  • thyroid problems

Learn about the possible causes of late periods and some reasons that birth control causes missed periods here.

8. Decreased libido

The pill can affect sex drive, or libido, in some people. This is due to hormonal changes.

Other people might experience an increased libido by, for example, removing any concerns they may have had about pregnancy and easing any symptoms of PMS.

9. Vaginal discharge

Changes in vaginal discharge may occur when taking the pill. This may be an increase or a decrease in vaginal lubrication or a change in the nature of the discharge.

If the pill causes vaginal dryness and a person wants to engage in sexual activity, using lubrication can help make this more comfortable.

These changes are not usually harmful, but alterations in color or odor could point to an infection.

Learn about what the different colors of vaginal discharge indicate here.

10. Eye changes

Some research has linked hormonal changes due to the pill with a thickening of the cornea in the eyes. This does not suggest a higher risk of eye disease, but it may mean that contact lenses no longer fit comfortably.

People who wear contact lenses can talk to their ophthalmologist if they notice any changes in their vision or lens tolerance.

The pill is safe for most females to use. However, research has linked its use with certain risks. Therefore, before taking birth control pills, it is important to discuss individual risk factors with a healthcare provider.

According to the Office on Women’s Health, there is evidence to suggest that taking birth control pills may raise a person’s risk of blood clots and high blood pressure, or hypertension. This can lead to heart attack or stroke.

If a blood clot enters the lungs, it can cause serious damage or death. These side effects are serious but rare.

Some research suggests that birth control increases the risk of some forms of cancer and decreases the risk of others.

The pill may not be safe for people who:

A person should see a healthcare provider if the following symptoms occur, as these may indicate a serious health concern:

  • severe abdominal pain
  • chest pain, shortness of breath, or both
  • severe headaches
  • eye problems, such as blurred vision or a loss of vision
  • swelling or aching in the legs and thighs

Birth control pills are safe for most females to use long-term or indefinitely.

However, usage can increase the long-term risk of certain health problems. The following sections will look at these potential effects in more detail.

Cardiovascular problems

Combination pills can slightly increase the risk of serious cardiovascular problems, such as heart attack, stroke, and blood clots. The risk is higher with certain pills. A healthcare provider can advise on suitable options.

Anyone who has uncontrolled high blood pressure or a personal or family history of cardiovascular problems should ask their healthcare provider about alternative methods of contraception.


The natural female sex hormones (estrogen and progesterone) affect the risk of some types of cancer. Likewise, hormone-based birth control methods can increase or decrease the risk of different cancers.

According to the National Cancer Institute, taking birth control pills can affect a person’s risk of certain cancers in the following ways:

  • Breast cancer: The risk of breast cancer is slightly higher in people who use hormonal birth control pills than in people who have never used them.
  • Ovarian and endometrial cancer: These cancers seem to be less likely to occur in people who take the pill.
  • Cervical cancer: Taking the pill for longer than 5 years is linked with a higher risk of cervical cancer. However, most types of cervical cancer are due to the human papillomavirus.
  • Colorectal cancer: Taking the pill is linked to a lower risk of colorectal cancer.

For people who cannot use or do not wish to take the birth control pill, other options are available.

The effectiveness of different methods of birth control vary. With typical use, around 9 out of 100 people using birth control pills will become pregnant within a year.

It is important to note that birth control pills do not prevent sexually transmitted infections (STIs). Only barrier methods of protection, such as condoms and dental dams, can prevent STIs.

The sections below will look at some alternative forms of contraception.


Condoms are barrier methods of birth control. There are many types and brands. Most are made from latex, but people with a latex allergy can find polyurethane or lambskin versions.

With typical use, 18 out of 100 people who rely on male condoms for contraception will become pregnant within a year.

People can purchase condoms online here.


A diaphragm is another barrier method of contraception. This is a shallow, dome shaped cup that, when a person places it in the vagina, can prevent sperm from reaching the cervix. People often use diaphragms with spermicide.

With typical use, around 12 out of 100 people who use diaphragms with spermicide will become pregnant within a year.

Vaginal rings

Vaginal rings are plastic rings that release hormones into the vagina to suppress ovulation.

To use a vaginal ring, a person can insert it for 21 days, remove it for 7 days to allow menstruation, and then insert a new ring.

As a hormonal method of birth control, the vaginal ring can have similar side effects to those of the pill.

With typical use, around 9 out of 100 people using vaginal rings will become pregnant within a year.

Intrauterine devices

Intrauterine devices (IUDs) are small devices that a healthcare provider can insert into the uterus. IUDs can be hormonal or non-hormonal. Hormonal IUDs can last between 5 and 7 years, while non-hormonal IUDs can last for up to 10 years.

With typical use, fewer than 1 out of 100 people who use an IUD will become pregnant within a year.

Hormonal IUDs can have similar side effects to those of the pill. Non-hormonal or copper IUDs can cause spotting, irregular periods, heavier periods, and worsened cramps.

The implant

The contraceptive implant is a small, plastic rod that a healthcare provider can insert into the upper arm. It releases a hormone to prevent pregnancy and can last for 3 years.

With typical use, fewer than 1 out of 100 people with the implant will become pregnant in a year.

As a hormonal method, side effects can be similar to those of the birth control pill.

Birth control injections

Birth control injections, also known as the shot, are hormonal injections that a person can receive every 3 months to prevent pregnancy.

With typical use, around 6 out of 100 people receiving these injections will become pregnant within a year.

The pill and the shot are both hormonal methods of birth control. The main differences are in the method of administration. They might also produce different side effects.

Like the pill, the shot suppresses ovulation and thickens the cervical mucus to reduce the chance of sperm reaching egg cells. It is a progestin-only contraceptive.

The shot is slightly more reliable at preventing pregnancy than the pill. This is because the user does not have to remember to take it every day. However, they must remember to get a shot every 3 months for it to be effective.

Many of the side effects are the same, including:

  • spotting
  • breast tenderness
  • changes in mood
  • headaches
  • missed periods
  • possible weight gain

Long-term use of the shot may lead to bone loss. This might increase the risk of osteoporosis and bone fracture in later life.

Learn more about the benefits and risks of the shot vs. the pill here.

According to Planned Parenthood, for most brands, one pack of birth control pills costs anywhere from $0 to $50. One pack lasts for 1 month.

People might also need to pay for an appointment with a healthcare provider before getting a prescription for birth control pills. This can cost between $35 and $250.

Most insurance companies will cover these appointments under the Affordable Care Act.

Also, most insurance companies will cover all methods of birth control, including the pill. Some plans only cover certain brands or generic forms, however. A person can speak to their insurance provider to find out which types of pill they cover.

People without health insurance may be able to cover the cost of birth control through Medicaid or another governmental program.

In the U.S., a person will need a prescription for birth control pills. Family planning clinics can provide prescriptions.

During an appointment, a healthcare provider will ask about the person’s medical history and physical health to help them work out the most appropriate pill to prescribe.

In some states, a person can get a prescription online or directly from a pharmacist.

Birth control pills contain hormones that affect the body in many ways. Therefore, side effects are common.

Side effects vary widely among individuals and different types of pill. They usually ease within 2–3 months of starting to take the pill.

Each person reacts differently to each pill. A person may need to try a few different types of pill before finding the one that is right for them.

When a person stops taking the pill, their body will return to how it was before they took the pill.

If the side effects are severe, get in the way of daily life, or last for longer than 3 months, it is best to talk to a healthcare provider about trying a different brand or a different method of contraception.

Read the article in Spanish.

Side Effects of Hormonal Contraceptives


Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor


Am Fam Physician. 2010 Dec 15;82(12):1509.

See related article on adverse effects of hormonal contraceptives

What are hormonal contraceptives?

Hormonal contraceptives are medicines or devices that can reduce your risk of getting pregnant. They contain hormones called estrogen (ESS-tro-jen) and progestin (pro-JEST-tin). Some contraceptives contain a combination of these hormones, and others contain only progestin. Some types of combination methods are contraceptive pills (also called birth-control pills or “the pill”), a patch that is worn on the skin, and a ring that is placed in the vagina. Progestin-only methods include pills, shots, implants that are placed under the skin, and intrauterine devices (also called IUDs).

What are the side effects?

Most women do not have serious side effects from hormonal contraceptives. If you do have side effects, they will probably go away on their own after a few months. You might have:

  • Weight gain

  • Headaches

  • Sore breasts

  • Irregular periods

  • Mood changes

  • Decreased sexual desire

  • Acne

  • Nausea

Some types of hormonal contraception are more likely to cause certain side effects than others.

What should I do if I have side effects?

If you have side effects that last more than three months, talk to your doctor about switching to another method.

How can I lower my chances of having side effects?

If you are taking the pill, be sure to take one every day. This lowers your risk of bleeding between periods. Progestin-only pills must be taken at the same time each day. The contraceptive patch and ring should be changed according to the schedule given by your doctor.

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This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.


Copyright © 2010 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact
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Birth control methods | Office on Women’s Health


Number of pregnancies per 100 women within their first year of typical use1

Side effects and risks*

*These are not all of the possible side effects and risks. Talk to your doctor or nurse for more information.

How often you have to take or use

Abstinence (no sexual contact)


(0 for perfect use)

No medical side effects

No action required, but it does take willpower. You may want to have a back-up birth control method, such as condoms.

Permanent sterilization surgery for women (tubal ligation, “getting your tubes tied”)

Less than 1

  • Possible pain during recovery (up to 2 weeks)
  • Bleeding or other complications from surgery
  • Less common risk includes ectopic (tubal) pregnancy

No action required after surgery

Permanent sterilization implant for women (Essure®)

The Essure® birth control device will no longer be sold or distributed in the United States after December 31, 2018.

Less than 1

  • Pain during the insertion of Essure; some pain during recovery
  • Cramping, vaginal bleeding, back pain during recovery
  • Implant may move out of place
  • Less common but serious risk includes ectopic (tubal) pregnancy

No action required after surgery

Permanent sterilization surgery for men (vasectomy)

Less than 1

  • Pain during recovery
  • Complications from surgery

No action required after surgery

Implantable rod (Implanon®, Nexplanon®)

Less than 1

  • Headache
  • Irregular periods
  • Weight gain
  • Sore breasts
  • Less common risk includes difficulty in removing the implant

No action required for up to 3 years before removing or replacing

Copper intrauterine device (IUD) (ParaGard®)

Less than 1

  • Cramps for a few days after insertion
  • Missed periods, bleeding between periods, heavier periods
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.

No action required for up to 10 years before removing or replacing

Hormonal intrauterine devices (IUDs) (Liletta, Mirena®, and Skyla®)

Less than 1

  • Irregular periods, lighter or missed periods
  • Ovarian cysts
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.

No action required for 3 to 5 years, depending on the brand, before removing or replacing

Shot/injection (Depo-Provera®)


  • Bleeding between periods, missed periods
  • Weight gain
  • Changes in mood
  • Sore breasts
  • Headaches
  • Bone loss with long-term use (bone loss may be reversible once you stop using this type of birth control)

Get a new shot every 3 months

Oral contraceptives, combination hormones (“the pill”)


  • Headache
  • Upset stomach
  • Sore breasts
  • Changes in your period
  • Changes in mood
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Take at the same time every day

Oral contraceptives, progestin-only pill (“mini-pill”)


  • Spotting or bleeding between periods
  • Weight gain
  • Sore breasts
  • Headache
  • Nausea

Take at the same time every day

Skin patch


May be less effective in women weighing 198 pounds or more2

  • Skin irritation
  • Upset stomach
  • Changes in your period
  • Changes in mood
  • Sore breasts
  • Headache
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Wear for 21 days, remove for 7 days, replace with a new patch

Vaginal ring (NuvaRing®)


  • Headache
  • Upset stomach
  • Sore breasts
  • Vaginal irritation and discharge
  • Changes in your period
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35

Wear for 21 days, remove for 7 days, replace with a new ring

Diaphragm with spermicide (Koromex®, Ortho-Diaphragm®)


If you gain or lose than 15 pounds, or have a baby, have your doctor check you to make sure the diaphragm still fits.

  • Irritation
  • Allergic reactions
  • Urinary tract infection (UTI)
  • Vaginal infections
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Sponge with spermicide (Today Sponge®)


(among women who have never given birth before)



(among women who have given birth)3

  • Irritation
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Cervical cap with spermicide (FemCap®)


  • Vaginal irritation or odor
  • Urinary tract infections (UTIs)
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 48 hours
  • Using a spermicide often might increase your risk of getting HIV

Insert each time you have sex

Male condom


  • Irritation
  • Condom may tear, break or slip off
  • Allergic reactions to latex condoms

Use each time you have sex

Female condom


  • Irritation
  • Condom may tear or slip out
  • Allergic reaction

Use each time you have sex

Withdrawal — when a man takes his penis out of a woman’s vagina (or “pulls out”) before he ejaculates (has an orgasm or “comes”)


  • Sperm can be released before the man pulls out, putting you at risk for pregnancy

Use each time you have sex

Natural family planning (rhythm method)


  • Can be hard to know the days you are most fertile (when you need to avoid having sex or use back-up birth control)

Depending on method used, takes planning each month

Spermicide alone


Works best if used along with a barrier method, such as a diaphragm

  • Irritation
  • Allergic reactions
  • Urinary tract infection
  • Frequent use of a spermicide might increase your risk of getting HIV

Use each time you have sex

Birth Control With the Most Side Effects

  • Some kinds of birth control are better than others at preventing pregnancy and some come with fewer side effects.
  • Depo-Provera, an injectable contraceptive, is reported to have the most side effects.
  • Oral contraceptives are reported to have the next highest number of side effects, whereas IUDs and the NuvaRing are reported to have the least.

With so many forms of

birth control
available, it can be difficult to know which one to choose.

You might be wondering if it’s better to choose a brand name or a generic? How about hormonal or non-hormonal? Should you go for a shot, implant, or the pill? The list of options goes on and on.

According to Dr. Kecia Gaither, an OB/GYN, “each woman’s physiology is different — it’s difficult to gauge which birth control option has the most side effects for one particular woman.”

That’s why it takes a bit of trial and error to find the birth control method with the least amount of side effects that works best for you.

If your current birth control method isn’t working for you, or if you’re thinking of trying one out, you might want to take note of the following methods that doctors say have the most side effects.

Depo-Provera is an injection that you receive every three months.

i viewfinder/Shutterstock

1. Depo-Provera

Depo-Provera is an injectable contraceptive that you receive every three months. This form of birth control contains the hormone progestin, which typically suppresses ovulation by keeping your ovaries from releasing an egg. Progestin also thickens cervical mucus, preventing sperm from reaching the egg.

Dr. Rebecca Levy Gantt, MD, OB/GYN, told INSIDER that the patients in her practice report the most side effects of any birth control method with Depo-Provera. She said the side effects are unpleasant and have caused many women to stop using this form of birth control. Gaither agrees with Levy, and both doctors report that patients can experience any of the following:

  • Hair loss
  • Weight gain
  • Acne
  • Depression
  • Swelling
  • Cravings
  • Injection site reactions
  • Hot flashes
  • Decreased sex drive
  • Joint pain
  • Decrease in breast size

The pill is taken by mouth once a day.


2. Oral contraceptives

Oral contraceptives, or “the pill,” have been around for decades. They are oral pills taken once every day, or almost every day, of a regular cycle to prevent pregnancy. There are many different brands of oral contraceptives and each comes with slightly different doses of estrogen and progesterone (two female sex hormones).

Gaither said the pill follows Depo-Provera in terms of the amount and severity of side effects. Some of the more common side effects include:

  • Breast tenderness
  • Nausea
  • Mood changes
  • Headaches
  • Vomiting
  • Stomach bloating
  • Diarrhea
  • Weight changes
  • Bleeding or spotting between menstrual periods
  • Changes in menstrual flow
  • Vaginal discharge

IUDs are inserted into a woman’s uterus.

Image Point Fr/Shutterstock

3. IUD

No form of birth control is free of side effects, but the IUD (intrauterine device) seems to have the least noticeable ones. That’s what makes it such a popular option among women of all ages.

An IUD is a tiny device a doctor puts into your uterus to prevent pregnancy. It is meant as a long-term form of birth control but can be taken out at any time.

There are two types of IUDs: copper (non-hormonal) and hormonal. Both come with their own side effects, but for the most part, they are less than many other forms of birth control.

Levy said that nine out of 10 women love the IUD, but “of course there’s always the one in ten who gets acne and depression and asks me to remove it.” Some of the side effects reported by women include:

  • Pain when IUD is inserted
  • Heavier menstrual cycles (for women using the copper version)
  • Cramping
  • Spotting between periods
  • Irregular periods

NuvaRing is a ring that is inserted into the vagina.


4. NuvaRing

Levy said the NuvaRing, which is a low dose combination of estrogen and progesterone, has very few side effects. You insert the ring in the vagina, where it remains for 21 days, and then you take it out for seven days so you can have your period.

She has found that since the side effects are low, many women love it, provided they are comfortable placing things in the vagina.

Although it is generally well-tolerated, there can be some side effects. These include:

  • Breakthrough bleeding
  • Headache
  • Depression
  • Decreased sex drive
  • Breast tenderness
  • Vaginal infection, irritation, or increased vaginal secretion

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Contraception Explained: Options for Teens & Adolescents

​​​Contraceptives help protect people from getting pregnant and from catching infections during sexual activity. It is important for all adolescents to learn about contraception so they have information they’ll need to make safe and healthy decisions.

The American Academy of Pediatrics (AAP) recommends parents talk to their adolescents about how not having sexual intercourse is the best way to prevent STIs, HIV infection and pregnancy. However, these discussions should also address reliable contraception options.

Pediatricians start talking about sexual behaviors, birth control, and ways to
prevent sexually transmitted infections (STIs) at about the 11-year-old checkup. They can provide or prescribe contraception in the office or give referrals to other resources in the community.

Long-Acting Reversible Contraceptives

Long-acting reversible contraceptives (LARCs) are the
most effective contraceptives to prevent pregnancy. Less than 1% of users become
pregnant during the first year using them. LARCs can have other medical benefits, too including helping with heavy or painful periods​.

There are two kinds of LARCs. They are the intrauterine device (IUD) and the subdermal implant. LARCs are not “barrier methods” and do not help prevent sexually transmitted infections. That’s why adolescents who use LARCs, must also use a
condom or other type of barrier protection during sexual activity to prevent infections.

Subdermal Implant

Intrauterine Device (IUD)

  • What It Is: A small, flexible, T-shaped birth control device. It is inserted into the uterus by an experience provider. There are two types:

    • Copper T IUD (99.2% effective at preventing pregnancy): Does not contain hormones. Does not need to be replaced for 10 to 12 years.

    • Levonorgestrel IUD (99.8% effective at preventing pregnancy): Contains a hormone. Does not need to be replaced for 3 to 7 years.

  • Advantages:

    • Provides safe, long-term birth control.

    • Don’t have to remember to do anything every day, week, or month to stay protected from unintended pregnancy.

    • May have less cramping and lighter periods with the levonorgestrel IUD. Many adolescents stop having periods over time.

  • Disadvantages:

    • Can cause pain or cramping for a short time after insertion.

    • Levonorgestrel IUD: May include irregular bleeding or spotting. This often gets better after a while.

    • Copper T IUD: May lead to increased menstrual cramping, spotting, and heavier bleeding. This usually improves with time.

    • Do not protect against sexually transmitted infections.

Short-Acting Contraceptives

There are many kinds of short-acting contraceptives. They are more than 90% effective in preventing pregnancy. They must be used with a
condom or other type of barrier protection to prevent sexually transmitted infections.

Progestin Injection

  • Advantages:

    • 94% effective at preventing pregnancy.

    • Long-lasting protection; only requires visits to the doctor every 3 months.

    • The shot also protects against endometrial cancer and iron deficiency anemia.

    • May have less cramping and lighter periods. (Many teens stop having periods after several doses).

  • Disadvantages:

    • May cause weight gain.

    • May include irregular bleeding or light spotting at first.

    • Could affect bone density. Bone strength usually gets better after stopping.

    • May increase the risk of blood clots.

    • Do not protect against sexually transmitted infections.

Contraceptive Vaginal Ring

  • What It Is: The ring has hormones (etonogestrel/ethinyl estradiol) that prevent the ovaries from releasing an egg. You place the ring in your vagina once a month. It stays in place for 3 weeks, and you remove it for 1 week. During that week, the user has a period.

  • Advantages:

  • Disadvantages:

    • Some users forget to replace the ring each month.

    • May cause headaches, nausea, vaginal discharge, or breast tenderness.

    • May increase the risk of blood clots.

    • Do not protect against sexually transmitted infections.

Transdermal Patch

  • What It Is: The patch contains hormones (norelgestromin and ethinyl estradiol) that are absorbed through the skin (transdermal). The hormones prevent the ovaries from releasing an egg. You remove the patch and put on a new one each week for three weeks. Then, you do not wear a patch for one week. During that week, the user has a period.

  • Advantages:

  • Disadvantages:

    • Adolescents might forget to change the patch each week.

    • May increase the risk of blood clots.

    • Other people might see the patch if it is not covered by clothes. This may bother some teens.

    • May cause headaches, nausea, skin irritation, or breast tenderness.

    • Do not protect against sexually transmitted infections.

Oral Contraceptive Pills

  • What It Is: There are two types of oral contraceptive pills. The combined oral contraceptive pill contains estrogen and progesterone, the two female sex hormones that control the menstrual cycle. The progestin-only pill (also called the mini-pill) contains just one hormone. It is rarely prescribed for adolescents.

  • Advantages:

  • Disadvantages:

    • Serious but rare side effects may include blood clots, stroke, hypertension and migraines.

    • May cause headaches, nausea, or breast tenderness.

    • Must be taken every day at around the same time. This can be hard for some adolescents to remember. The doctor will explain what an adolescent should do if she misses a dose.

    • Do not protect against sexually transmitted infections.

Barrier Methods of Protection

All genders should use barrier methods in addition to one of the methods of protection listed above for all types of sexual activity. Barrier methods help prevent sexually transmitted infections, HIV, and pregnancy. Sexually transmitted infections have been on the rise for people ages 15 to 24 years of age.

External Condom (Male Condom)

What It Is: A latex, synthetic, or natural material designed to fit over the penis.


  • 82% effective at preventing pregnancy.

  • Available without a prescription.

  • Easy to use.

  • Inexpensive.

  • One of the only methods that protects against STIs.

  • Can be used with other methods for infection protection and added pregnancy prevention.


  • Needs to be used correctly each time.

  • Can break or slip off during sex.

  • People allergic to latex may have to use polyurethane or polyisoprene condoms.

Internal Condom

Dental Dam

  • What It Is: A latex or synthetic (nitrile or polyurethane) sheet that is a barrier users place over the penis, vulva, vagina, mouth, anus, or any part of the body.

  • Advantages:

  • Disadvantages:

For an Emergency:

Other Methods:

There are some methods that do not work as well at preventing pregnancy. They also do not protect people from catching sexually transmitted infections.


  • In this method, the penis is taken out of the vagina before ejaculation.

  • 78% effective at preventing pregnancy.

  • Even if done correctly, the penis releases fluids into the vagina before ejaculation. This fluid contains thousands of sperm, and sometimes viruses or bacteria.

Fertility awareness methods

  • A woman keeps track of her period, takes her temperature each morning, and inspects the color and texture of cervical mucus every day. During the week she has signs of ovulating, she does not have sex.

  • 76% effective at preventing pregnancy.


  • This is a gel, cream, or foam that a woman inserts deep into her vagina before having sex.

  • It can be messy and difficult to use. It can be used with other methods to help prevent pregnancy, but it may increase the risk of HIV infection for those at high risk.

  • 72% effective at preventing pregnancy.


It may feel awkward to talk with your child about contraception, but it is important part of protecting their health and wellbeing. Your pediatrician is available for support and guidance.

More Information

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Side effects of birth control on mental health

This article is also available in: Deutsch

Top things to know:

  • Hormonal changes may be a factor in the risk for depression

  • Hormonal birth control may increase the risk for being diagnosed with depression, but effects on mood are mixed and vary by birth control type

  • For people who have depression, hormonal birth control is not associated with worsening symptoms

What you may have heard

You may hear people say hormonal birth control negatively affected their mood, making them feel depressed, anxious, or irritable. You may also hear people say that hormonal birth control improved their mood, making them feel more calm or stable. Of course each person’s body—and brain—is unique and their response to hormonal birth control can be different. 

Hormonal birth control comes in several forms, including the implant, the intrauterine device (IUD), the shot, the pill, the patch, and the ring. Progestin-only hormonal birth control contains just progestin (a synthetic form of the body’s naturally-occurring hormone, progesterone). Combined-hormonal birth control contains both progestin and a form of estrogen. 

Several large studies have explored whether there is a connection between different types and formulations of hormonal birth control and changes in mood or mental health with some conflicting results. 

A 2016 study of more than one million women in Denmark really brought the possible connection between birth control and mental health to mainstream attention (1). This study analyzed nationwide health records and showed that hormonal birth control users were more likely to be diagnosed with or treated for depression (1).

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Two large studies in the United States and Finland showed something different. In these studies, people using hormonal birth control of any type reported fewer symptoms of depression and anxiety (2,3). 

What does this mean when it comes to selecting a birth control type that’s right for you? Considering the effects that birth control could have on your mood or mental health is important. We will dive into what we know and what we don’t know about different methods of birth control and the impact they have on mood and mental health.

How hormones impact your mental health

There is reason to believe that hormones play a role in depression. Women are about twice as likely as men to have depression—a difference that begins during puberty (4). One small study showed that people with depression had lower estrogen levels during the follicular phase (the time when estrogen levels normally rise between the start of a period and ovulation) (5). Changes in estrogen levels may explain why some people experience depressive symptoms more frequently in the premenstrual phase, postpartum, and in perimenopause (6). 

When a person uses hormonal birth control, it can change the natural level of hormones in their body and could possibly cause changes to their mental health.

Environmental and societal factors likely affect the risk for depression as well (7). A family history of mood or psychiatric disorders, adversities in childhood, stressful life events, and social isolation all make it more likely that someone will be diagnosed with major depression (4).

Why hormonal impact on mood is hard to measure

Studies on hormonal contraception and mood effects have had inconsistent results. Some of this inconsistency is likely because studies are designed and carried out differently and have different ways of measuring mood and mental health outcomes (8). 

There are few randomized controlled trials on the subject, which involve taking a group of people and randomly assigning them to either take hormonal birth control or not. Most of the studies done on mood and hormonal birth control are based on groups of people who chose for themselves what type of birth control they wanted to use. This leaves open the possibility that the outcomes of the study aren’t related to the birth control itself, but to some other factor that would lead people to choose that method (9). Some studies try to account for personal, familial, or societal factors that can increase a person’s risk for depression, but it can be hard. 

Research studies vary in how they measure mood and mental health outcomes. Some studies look at medical records to see if people using hormonal birth control were more likely to be diagnosed with depression or prescribed an antidepressant. Some studies have people complete surveys asking questions about symptoms of depression or anxiety and compare scores before and after hormonal birth control or between groups of birth control users. Other studies rely on the subjective experience of users and whether symptoms such as depression or mood swings are reported as side effects. These various outcomes can make it hard to compare studies. 

Study results are often reported as the average for the group of participants, and do not take into account the experience of individuals. Even in a study that concludes that hormonal birth control does not affect mood, there will be small numbers of individuals in that study that have improvement or worsening of their mood (8). 

Here’s what the research tells us about each birth control type


The implant is a progestin-only method of birth control. There is a single-rod implant containing the progestin etonogestrel, and a two-rod implant containing levonorgestrel (10).

In the large Danish study mentioned previously, current users of the implant were more likely to be prescribed antidepressants for the first time than people who weren’t currently using it, but the rate of depression diagnosis among implant users was not reported in the study (1). This study does not specify which implant people were using.

People using the etonogestrel implant in a large Swedish study were more likely to be prescribed an antidepressant, particularly for adolescents (11). The same study showed an increased risk for antidepressant prescription among people using levonorgestrel-only methods, which included both the hormonal IUD and implant (11).

In a study of people using the etonogestrel implant for up to two years, 14% reported mood swings and 7% reported depression that was attributed to the implant (12).

The key takeaway: The implant may increase the chance of being treated for depression, but more studies are needed to understand if implant users report mood changes during use.

Hormonal IUD

The hormonal IUD is a progestin-only method containing levonorgestrel (10).

In the Danish study, current users of the hormonal IUD were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who weren’t currently using it (1). The risk for being diagnosed with depression and prescribed an antidepressant was higher for adolescent hormonal IUD users than adults in the study (1).

The Swedish study showed an increased risk of being prescribed an antidepressant among people using a levonorgestrel-only birth control method, which included both the hormonal IUD and implant (11).

Conversely, a large Finnish study showed that people using the hormonal IUD were just as likely to have symptoms of depression or anxiety as people not using this method (3). 

Two studies of people who received the hormonal IUD to treat heavy periods, showed scores on depression surveys either remained the same or improved, but this could be due to an improvement in quality of life when heavy periods become more manageable (13,14). 

The key takeaway: The hormonal IUD may increase the chance of being diagnosed with or treated for depression, but does not appear to have a negative effect on mood when hormonal IUD users are asked to report symptoms.

The shot

There are several types of birth control shots available. All the studies mentioned in this section involve the progestin-only shot containing medroxyprogesterone acetate (10).

The Danish study showed current users of the shot were more likely to be prescribed antidepressants for the first time than people who weren’t currently using it, but the rate of depression diagnosis among shot users was not reported in the study (1). In the Swedish study, shot users were more likely to be prescribed an antidepressant (11).

A study of 183 people using the shot for up to three years showed that they were more likely to report depressive symptoms compared to people using another method of birth control or no method (15). People who stopped using the shot during the study reported depressive symptoms at higher rates, which subsided after stopping (15). It’s worth noting, however, that shot users in this study were also more likely to report depressive symptoms before starting the shot (15).

One study followed almost 400 users of the shot for a year (16). Among the 170 people who continued using the shot for a year, there was a decrease in depressive symptoms from the time they started it (16). Among the 218 people who stopped using depo during the year-long study, there was no change in depressive symptoms (16). 

Adolescents using the shot do not appear to be at increased risk for depression based on three small studies (9). 

In one two-year study, shot users were less likely to report mood swings compared to people not using hormonal contraception (17).

The key takeaway: The shot may increase the chance of being treated for depression, but results are mixed when people report mood symptoms while taking it—some people may have improved mood while others have worsened mood.


Combined oral contraceptives (COCs) are pills that contain both synthetic estrogen—usually in the form of ethinyl estradiol—and a progestin (10). 

In the Danish study, current users of COCs were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who weren’t currently using them (1). 

The large Swedish study looked at the likelihood of being prescribed an antidepressant medication while taking different formulations of the birth control pill. It found that users aged 16-31 were more likely to be prescribed an antidepressant when taking birth control pills containing the combination ethinyl estradiol/lynestrenol and ethinyl estradiol/drospirenone (11). People using pills containing ethinyl estradiol/norethindrone, ethinyl estradiol/levonorgestrel, and ethinyl estradiol/desogestrel were less likely to be prescribed an antidepressant (11). People taking ethinyl estradiol/norgestimate were just as likely as non-users of hormonal birth control to be prescribed an antidepressant(11). 

Several studies have found that birth control pills users are not more likely to report symptoms of depression (3,18,19), although one of these studies did show a decrease in general well-being among pill users (18). Another showed that people using birth control pills for reasons other than for birth control were more likely to experience depression (19).

One study found that COC users tracking daily mood had small increases in anxiety, irritability, and mood swings in the intermenstrual phase (roughly cycle days 5-22 of a 28-day cycle), but improvement in depression in the premenstrual phase (the seven days leading up to the start of the next period) compared to people on a placebo pill (20). At the end of the three-month study, there was no difference in depression scores between the birth control pill and placebo groups (20). 

Some people may experience improvement in nervousness and mood swings while taking COCs (17), but people who have experienced negative mood effects while on birth control pills in the past may be more likely to experience depressed mood and mood swings (21).

Adolescents and the pill

Adolescents using COCs in the Danish study had a higher risk for being diagnosed with depression and prescribed an antidepressant than adults in the study (1).

Adolescents (age 16-19) in the study Finnish study were more likely than people not using hormonal birth control to be prescribed an antidepressant for every COC formulation they studied (11).

A study of adolescents in the U.S. who were currently or had ever used the pill showed an increased risk for ever having experienced depression, but no increased risk for current depression (22). But when other factors such as age, smoking, BMI, family socioeconomic status, and whether the adolescents were sexually active were considered along with the use of birth control pills, there was no increased risk for depression (22).

A small study where adolescents were randomly assigned to use COCs containing ethinyl estradiol/levonorgestrel or placebo for three months showed no difference in depression scores between the two groups at the end of the study (23). 

The key takeaway: The pill may increase the chance of being diagnosed with or treated for depression, but the specific pill formulation may make a difference. Overall, it appears as though COCs do not have a harmful effect on mood reported by users, but this may vary between individuals.


The patch is a combined hormonal birth control containing ethinyl estradiol/norelgestromin (10). Very few studies on birth control and mental health specifically include the patch.

In the Danish study, current users of the patch were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who weren’t currently using them (1). The risk for being diagnosed with depression and prescribed an antidepressant was higher for adolescent patch users than adults in the study (1).

The Swedish study showed the people using the patch containing were more likely to be prescribed an antidepressant than people not using hormonal birth control (11).

The key takeaway: The patch may increase the chance of being diagnosed with or treated for depression, but studies are needed to determine if patch users report mood changes during use.


The ring is a combined hormonal birth control containing ethinyl estradiol/etonogestrel (10). Few studies on birth control and mental health specifically include the ring.

In the Danish study, current users of the ring were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who weren’t currently using them (1). The risk for being diagnosed with depression and prescribed an antidepressant was higher for adolescent ring users than adults in the study (1).

Studies have shown that ring users may be less likely than pill users to report depression, irritability, and mood swings as side effects (24).

The key takeaway: The ring may increase the chance of being diagnosed with or treated for depression, but more studies are needed to see if ring users report mood changes during use.


Mini-pills are progestin-only birth control pills. They may contain norethindrone, desogestrel, drospirenone, lynestrenol, or other forms of progestin (10).

In the Danish study, current users of the mini-pill were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who weren’t currently using them (1). The risk for being diagnosed with depression and prescribed an antidepressant was higher for adolescent mini-pill users than adults in the study (1).

In the Swedish study, people age 16-31 taking norethindrone or lynestrenol mini-pills were just as likely as people not taking hormonal birth control to be prescribed an antidepressant, although adolescents (age 16-19) taking norethindrone mini-pills were more likely to be prescribed antidepressants (11). People taking the progestin-only pill containing desogestrel were more likely to be prescribed an antidepressant (11).  

The key takeaway: The mini-pill may increase the chance of being diagnosed with or treated for depression, but the specific formulation may make a difference. Studies are needed to see if mini-pill users experience changes in their mood while using it.

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What if you already have depression?

The U.S. Center for Disease Control (CDC) and the World Health Organization (WHO) guidelines put no restrictions on the use of any type of birth control for people who have depression (25,26). The use of combined hormonal birth control, the hormonal IUD, implant, and the shot is not associated with worsening of symptoms among people with depression or bipolar disorder (27,28). One study actually showed less depressive symptoms among combined hormonal birth control users compared to people not using hormonal methods (27). 

There aren’t believed to be any interactions between SSRIs (selective serotonin reuptake inhibitors), which are commonly prescribed for depression, and hormonal contraception (29). The CDC puts no restriction on the use of any hormonal birth control for people who are taking SSRIs (25). 

Other supplements and medications used for depression, such as tricyclic antidepressants, bupropion, and St. John’s Wort may interact with hormonal contraception (25,29).

It’s important to speak with your healthcare provider about what supplements and medications you are taking and whether there are possible interactions with hormonal birth control.


COCs are a recommended treatment for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (30). Continuous COCs (not having any hormone-free days) may be a particularly good choice for people with PMDD to avoid fluctuations in hormones (31).

Postpartum mood disorders

More research is needed to better understand the impact of hormonal contraception on the risk for postpartum depression, postpartum anxiety, and other postpartum mood disorders. Breastfeeding may impact the type of hormonal birth control a person is prescribed, as well as their risk for postpartum depression regardless of birth control use. 

A study of more than 16,000 people who had given birth two to eight months prior showed no relationship between reporting depressive symptoms and use of any birth control method (32).

One study showed no increased risk for a depression diagnosis among people who had given birth in the previous 12 months and were using the implant or ring, but these users were more likely to be prescribed an antidepressant than people not using a hormonal birth control method (33). Use of COCs did not change the risk for a depression diagnosis in the postpartum period (33). People using the mini-pill containing norethindrone and the hormonal IUD were less likely to have a postpartum depression diagnosis (33). 

Two studies of people who received the shot shortly after giving birth showed no increase in depression based on self-reported surveys (34). However, these studies only followed shot users for up to three months after delivery, while postpartum depression can occur up to 12 months after delivery. 

Choosing a method

Whether you are thinking about starting birth control or are already using a method, talk to your healthcare provider about any concerns you have about your mental health. Your healthcare provider can help you decide on the best birth control for you, or whether trying a new method might help.

Using Clue app to track your emotions when you start a new birth control can help you identify if anything is changing. 

The Pros and Cons of the Birth Control Pill

Women have been enjoying the benefits and advantages of the birth control pill since it was approved by the U.S. Food and Drug Administration (FDA) on May 9, 1960. The pill is actually one of the most researched and studied of all medications. Most women can safely use birth control pills, but pill use may carry some risks and/or side effects.

Here’s a quick rundown of the pros and cons of using oral contraceptives, including common side effects. Read beyond the chart for more specific information.

Illustration by Cindy Chung, Verywell

Pros of the Birth Control Pill

Benefits of the pill include:

  • The pill is a very convenient method of contraception.
  • The pill may offer some protection against pelvic inflammatory disease (which, if left untreated, can cause infertility).
  • It can lead to lighter periods or help regulate periods.
  • It is a safe birth control method.
  • Birth control pills can decrease menstrual cramps.
  • It allows for sexual spontaneity.
  • The pill can help you time your period—combination pills can be taken to regulate (change the timing and frequency) of your period or be used to skip your period altogether.

Noncontraceptive Benefits

Combination birth control pills that include both estrogen and progestin can also provide health benefits. They may offer you some protection against:

Cancer Protection and the Pill

Research suggests that birth control pills lower the risk of ovarian cancer by 27% and the risk of endometrial cancer by 50% compared to those who have never taken oral contraceptives.

Protection against developing these cancers can last up to 30 years after stopping combination birth control pills. Plus, this protection increases with each year of use. So, if you use combination pills for 6 years, your pill use can lower your the risk of ovarian or endometrial cancer by up to 60%.

Research suggests that taking birth control pills may slightly increase the risk of developing breast cancer. Studies show that there is an 15—20% reduction in the risk of developing colorectal cancer among women who use the pill.

Cons of the Birth Control Pill

If you use birth control pills, you may experience some unwelcome side effects. The good news is that most of these side effects will go away by the second or third month of use—as your body adjusts to the progestin and/or estrogen in the pill.

Birth control pill side effects may include:

  • Headaches
  • Breast tenderness
  • Nausea (sometimes with vomiting)
  • Bleeding between periods

Additionally, combination birth control pills could:

  • Cause depression
  • Change sexual desire

Progestin-only birth control pills may lead to irregular spotting and bleeding (at least, more frequently than with combination pills).

Side Effects

You should read the paper insert that comes inside your specific pill pack for more detailed information about the use and risks of your birth control pills. Additionally, the insert should also explain when to take your birth control pills (and what to do if you miss a pill…or two).

You can take your birth control pill with an evening meal or at bedtime to help decrease nausea and/or vomiting. Try not to stop taking your pill—even if you are feeling really nauseous.

Side effects are a common reason why people stop taking birth control. Talk to your doctor about what you are experiencing and if changing to a different brand of pill may help.

Talk to your doctor if you are still experiencing side effects from your birth control pills after three months—this may mean that your birth control pill brand may need to be changed.

Risks and Complications

Serious problems do not occur very often with the pill. Typically, birth control pills are much safer than pregnancy and childbirth.

Women who use combination birth control pills may have a slightly greater chance of certain medical issues than nonusers. The risk increases:

  • With women who smoke
  • Being age 35 or older
  • Having conditions associated with a heart attack (such as high cholesterol, high blood pressure, diabetes, and conditions that increase the risk of blood clotting)

The most serious complication of combination birth control pill use has to do with developing a blood clot in your heart, lungs, brain, or legs. Women using combination pills who are confined to bed rest or are wearing a cast seem to have a higher likelihood of developing a blood clot.

If you are planning to have a major operation, you should inform your surgeon that you are using combination birth control pills.

If you have a history of depression, you may not be able to continue to take birth control pills if your depression worsens.

Additional birth control pill cons/risks to be aware of include:

  • There is a link between pill failure and weight. This means that the effectiveness of the pill may be compromised if you are overweight.
  • You must also pay attention to the medications you are taking while using the pill. Certain medications can lower the pill’s effectiveness.
  • Drospirenone-containing pill brands like Yaz and Beyaz can suppress the hormones that regulate your body’s water and electrolyte-levels, so these pills may have an interaction with medications that increase potassium.
  • When you visit any doctor, it is very important that you include your pill brand under the “list of medications” that you are currently using.

A Word From Verywell

When deciding whether or not to use the pill, you and your doctor should discuss the pros and cons as they relate specifically to you. Be sure you also discuss possible interactions with other medications you might be taking if you both feel that the pros outweigh the cons, and you are a good candidate for the pill.

Most women who stop using the pill do so for reasons that are unrelated to side effects. That being said, keep in mind that it may take some trial and error with various pill brands until you find the brand that works best with your body.

90,000 Most Effective Contraceptive Practices: The UK Experience

Photo Credit, Getty Images

Finding the right contraceptive can be tricky given the many choices available on the market.

The UK National Health System (NHS) offers 15 different contraceptives to its patients, but none are 100% effective.

For example, the UK Advertising Standards Commission banned Facebook ads for the Natural Cycles app after the ads were found to be misleading.

An ad that predicts the days of a woman’s susceptibility to fertilization was advertised as highly accurate and clinically tested.

The Commission found that Natural Cycles was exaggerating the effectiveness of the product. There are at least a few known cases of unwanted pregnancies in women who have used the application.

The effectiveness of some contraceptives reaches 99%, but in others it barely exceeds 70%.

The effectiveness of contraception depends on which means you use and on whether you use them correctly. The NHS recommends that you follow the instructions for use carefully for maximum effectiveness.

Photo author, Natural Cycles

Photo caption,

This is what the Ntaural Cycles app looks like

Natural family planning

Natural family planning or fertility awareness means careful tracking of the menstrual cycle and signs that indicate the maximum predisposition of the female body to fertilization.

This method can be 99% effective when carefully followed, but drops to about 76% in typical use.

This method has no side effects. Fertile awareness is at the heart of numerous smartphone apps such as Natural Cycles, with an average efficiency rate of 93%.

Photo by Getty Images


There are two types of condoms – male and female.

Condoms are the only contraceptive that, in addition to controlling pregnancy, is also a means of protection against many sexually transmitted infections.

Male condoms are 98% effective. They are made from thin latex, polyisoprene or polyurethane.

There are several factors that can reduce the effectiveness of condoms. These include oil-based lubricants (which can damage latex or polyisoprene condoms), condom breakage, and antistomatitis creams.

Female condoms are 95% effective and are placed inside the vagina.

They are less effective, as they can tear, and also the penis can accidentally be caught between the condom and the vaginal wall.

Photo author, Getty Images

Photo caption,

This is what a female condom looks like


Oral contraceptives are theoretically more than 99% effective, but in practice, with “typical use” their effectiveness is reduced to 91%.

By far the most common use, oral contraceptives are taken at the same time every day for 21 days and then taken seven days off during your period.

The risk of pregnancy is increased if you do not take your pills at the same time, miss a day or days, or if you have severe stomach upset or vomiting.

Certain antibiotics, including rifampicin and rifabutin, can also reduce the effectiveness of oral contraception.

Tablets based solely on progestins (a type of female steroid hormone) and not containing the hormone estrogen are considered more than 99% effective when used correctly. They need to be taken every day without interruption. With typical use, the effectiveness of such contraceptives is estimated at 92%.

Photo by Getty Images

Contraceptive injections

Injections are considered to be more than 99% effective. Their duration varies from eight to thirteen weeks, depending on the drug used.

In “typical use” their efficiency is estimated at 94%. The injections do not interfere with other medications, but can lead to menstrual irregularities or even complete cessation of menstruation.

After cessation of injections, it may take up to a year for fertility to resume.

Photo Credit, Getty Images

Contraceptive Patch

The patch is 99% effective when used correctly and 91% when used “typical use”.

It secretes hormones into the woman’s body that help to prevent pregnancy, and it works for a week. The patch should be changed weekly for three weeks, and then taken off for a week, just like with oral contraceptives.

Photo Credit, Getty Images

Vaginal Ring

Like the patch, the vaginal ring is over 99% effective with ideal use and about 91% with “typical” use.

It is inserted inside the vagina and releases hormones into the bloodstream.Valid for a month.

The ring does not interfere with normal sex, and its effectiveness is not reduced in case of indigestion or vomiting. The main thing is not to forget to change it every month.

Photo by Getty Images

Contraceptive Implant

The implant lasts for three years and is considered to be more than 99% effective if used perfectly.

It is a small plastic rod that is sewn under the skin of the forearm and releases the corresponding hormones into the woman’s blood.

Certain medications (certain antibiotics, medicines for HIV or epilepsy) can make the implant less effective.

Photo by Getty Images

Hormone-releasing intrauterine system

Considered more than 99% effective and lasts from three to five years depending on the type.

This is a small T-shaped structure that is inserted into the uterus and releases the hormone progestogen.

NHS considers the intrauterine system “one of the most effective forms of contraception available in the UK” but recognizes that there is little risk of infection when inserted into the uterus.

Photo by Getty Images

Intrauterine device

The coil is considered to be more than 99% effective and can remain in a woman’s body for up to ten years, depending on the type.

It is in many ways similar to the intrauterine system. The difference is that it is made of copper and plastic. It is copper that helps prevent pregnancy.

There is a small risk that the uterus may reject the coil. It also does not work if the woman has previously had pelvic infections.

Diaphragms and contraceptive caps

When used correctly with spermicides, diaphragms and caps give 92-96% effectiveness.

Typical use gives no more than 71-88% percent effectiveness, which makes them less effective than other contraceptives.

Diaphragms and caps are made of silicone and are inserted into the vagina before intercourse.

The device must remain inside the vagina for at least six hours after sex, and its effectiveness directly depends on the woman’s attentiveness to the exact time of its insertion and withdrawal.

We understand the types of contraception, their pros and cons with an obstetrician-gynecologist

Questions of how to prevent unwanted pregnancies and protect themselves from sexually transmitted infections are of concern to every woman. Choosing reliable contraception is not an easy task and should be discussed with your doctor. Obstetrician-gynecologist of EuroMed Clinic Marina Pavlovna GLUSHENKOVA talks about existing methods of contraception, their pros and cons.

Contraception can be barrier, hormonal and intrauterine.Methods such as coitus interruptus and calendaring cannot be considered reliable and effective. Fortunately, in the 21st century there are many ways and means of protection against unwanted pregnancy and unpleasant diseases.

Barrier methods



  • reliable protection against sexually transmitted diseases (STDs) and unwanted pregnancy (if used correctly)
  • affordable price
  • no systemic effect on the body
  • ideal for those who have an irregular sex life
  • do not require preliminary examinations for the selection of


  • desensitization
  • Possible latex allergy


Spermicides are substances that immobilize sperm cells, due to which they do not penetrate into the uterine cavity.


  • partial protection against sexually transmitted infections (does not work for some viruses)
  • suitable for those who cannot use hormonal and intrauterine contraception


  • low efficiency (60–70%), this method cannot be used as an independent method
  • very strict control of compliance with rules of use
  • Possible irritation, allergic reactions of the genital skin

Intrauterine methods

Copper intrauterine system (coil)

The coil thickens cervical mucus and forms a barrier to sperm.Copper acts toxic to sperm cells, immobilizing them, and also inhibits ovulation.


  • prolonged action, allowing you to forget about contraception for several years
  • no systemic effect on the body
  • can be used during lactation


  • should not be put nulliparous, because against the background of the spiral there is a risk of intrauterine synechiae, adhesions, which can lead to infertility; also in nulliparous, due to anatomical features, a narrower cervical canal, which makes it difficult to install the spiral.
  • the spiral does not protect against STDs, therefore, it is suitable only for women who have one permanent healthy sexual partner;
  • against the background of the use of a copper-containing coil, the risk of inflammatory diseases of the uterus and appendages increases by 5-6 times compared to women who do not have coils;
  • the spiral can provoke a longer and more painful menstruation;
  • if a woman has a history of multiple abortions, invasive interventions, curettage, there is a risk of cervical insufficiency, i.e.e. failure of the cervix, which can lead to expulsion (prolapse) of the spiral.

Protected hormone coils

The hormones contained in the system act in the uterine cavity, make the mucous membrane thinner, and immobilize sperm. All this makes it impossible for fertilization and the introduction of the ovum.


  • Reliable contraceptive effect within five years
  • No system action
  • has a therapeutic effect: indicated for patients with a history of hyperplastic endometrial processes, uterine myoma
  • can be used during lactation


  • No STD protection
  • Higher price compared to Copper Coil

Hormonal contraception

This is perhaps the most effective method of all that exists today.

Hormonal drugs differ in dosage (mini-dosage – estrogen content is not more than 30 mcg, micro-dosed – no more than 20 mcg, large dosages are not currently used), components, method of entry into the body.

There are two types of drugs: combined and the “mini-drank” group. Combined contraceptives contain estrogens (ethinylestradiol) and gestagens, “mini-pills” – only gestagens.

Preparations from the “mini-pili” group are indicated for lactating women who should not take estrogens, but only gestagens.Also, “mini-pili” can be taken by women who cannot tolerate the estrogenic component.

Types of drugs: tablets (taken orally), vaginal ring (hormones penetrate the vaginal mucosa) and patch (transdermal route – hormones enter through the skin).

Reception methods. The tablets must be taken daily, at the same time. It is especially important to take it at the same time for drugs from the “mini-drank” group. The tablets are generally taken for 21 days, after which they take a break for 7 days.

The vaginal ring is inserted into the vagina for 21 days, after which a break is taken for a week.

The patch is changed every 7 days.

The advantage of alternative routes of administration (ring, patch) is that you do not need to remember to take a pill every day and there is no primary passage through the liver and gastrointestinal tract, which reduces the burden on them. This is especially important if a woman has gastrointestinal problems or chronic cholecystitis.


  • reliable contraceptive effect (if a woman does not miss taking pills, the guarantee is almost 100%)
  • active protection of the ovaries and endometrium (mucous membrane) of the uterus from cancer
  • regulation of the menstrual cycle
  • reduction of painful sensations during menstruation
  • cosmetic effect (some OK help to cope with acne, normalize the skin condition)
  • therapeutic effect (the doctor will help you choose hormonal contraceptives, which are indicated for patients with uterine fibroids, with endometriosis).


  • the need for strict discipline, control of drug intake at the same time (especially important for “mini-pills”)
  • do not protect against STDs
  • any hormonal drugs affect metabolism (metabolism), which can lead to fluctuations in body weight, although in modern drugs this effect is minimal;
  • there is an effect on the vascular link, on the blood coagulation system, therefore, when taking contraceptives, constant control of hemostasis is necessary.If a woman has a predisposition to varicose veins, hypertension, or there have been cases of cardiovascular diseases in the family, accompanied by thrombosis, heart attacks, strokes, then the patient needs a comprehensive examination of the hemostasis system before taking hormonal contraceptives;
  • there is a period of adaptation to hormones. Within 2-3 months, nausea, headaches and pain in the mammary glands can sometimes be observed, there may be minor spotting in the middle of the cycle, changes in libido, mood swings.Therefore, medical supervision of the use of drugs is required during the first months of admission.
  • hormonal contraceptives have a number of contraindications: active smoking (more than 5 cigarettes per day), severe somatic diseases, severe decompensated diabetes mellitus, thrombosis, varicose veins, heart attacks, strokes, arterial hypertension, frequent migraines, etc.


Medical sterilization is a surgical technique that can be used by both men and women.This is a reliable method of 100% protection against pregnancy, a good choice for people who are definitely not planning more children.

After the operation, the ability to conceive in women can no longer be restored; in men, there may be a small (less than 30%) chance of restoring reproductive function through a second operation within five years after the intervention.

Female sterilization is a laparoscopic operation during which the fallopian tubes are cut, which reliably prevents pregnancy.

Male sterilization (vasectomy) is a simple operation that lasts about 20 minutes. During surgery, the vas deferens are ligated and cut. Sterilization does not affect erection, the amount of seminal fluid and the ability to experience orgasm.


  • 100% protection against unwanted pregnancy
  • the issue is resolved once and for all


  • irreversibility of the operation
  • need for surgery
  • there are legal restrictions for this operation

Medical sterilization as a special medical intervention in order to deprive a person of the ability to reproduce offspring or as a method of contraception can be carried out only upon the written application of a citizen over the age of thirty-five years or a citizen with at least two children, and in the presence of medical indications and informed voluntary consent citizen – regardless of age and the presence of children.
Article 57. Federal Law of November 21, 2011 N 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation”

Emergency contraception

In the case of unprotected intercourse, you can use the so-called emergency contraception. These drugs are aimed at contraception, they are not termination of pregnancy. The tablet contains a large dose of gestagenic drugs that cause rejection of the mucous endometrium.


  • Ability to avoid unplanned pregnancy even in a critical situation


  • This is a colossal dose of gestagens, which can lead to malfunctions, disruptions in the cycle. Such a remedy cannot be used on a regular basis – it is a huge stress for the body.

When choosing contraception, be sure to contact a gynecologist. Before prescribing this or that drug, the doctor will conduct an examination, which includes examination on a chair, taking a smear for oncocytology.Also, if there are signs of endocrinopathy (increased hairiness, acne), it is necessary to examine the hormonal background. Since hormones thicken the blood, affect hemostasis (blood coagulation system), it makes sense to conduct a comprehensive examination of the state of the hemostasis system. In addition, it is recommended to do an ultrasound examination of the pelvic organs (uterus and appendages) and mammary glands. All these procedures are minimally invasive, painless, they are easy to go through, and they will help to avoid possible complications against the background of long-term use of contraceptives.

How to take, their action, types and classification

Hormonal contraceptives include the use of estrogen and progestin analogs to prevent unwanted pregnancies. The contraceptive effect is mediated by negative feedback in the hypothalamus, which ultimately leads to a decrease in the secretion of follicle-stimulating (FSH) and luteinizing (LH) hormones by the pituitary gland.

Ovulation cannot occur without a sufficient amount of LH in the body.Low progestin levels reduce the likelihood of egg implantation by changing the structure of cervical mucus, reducing the mobility of the fallopian tubes and proliferation of the endometrium. Today, taking hormonal contraceptives is the most common form of contraception.

Types of hormonal contraceptives

The most famous oral preparations in the form of tablets, however, there are other types of funds designed to change the hormonal levels in the body.Among them:

  • plasters – patches with specialized impregnation;
  • injections – injections to prevent fertilization of the egg;
  • vaginal rings and intrauterine devices ;
  • implants – hormonal contraceptives that are installed by a doctor in a gynecological office.

In combined monophasic oral contraceptives, the dose of estrogen and progestin remains constant, while in multiphase preparations it changes during one cycle.

Reduced doses of multiphase OC mitigate some of the side effects. These include unpleasant symptoms such as breast tenderness, nausea, bloating, bleeding, and conditions such as venous thromboembolism. Due to the complications associated with taking OCs, their use is contraindicated in patients with severe symptoms of hypertension, coronary heart disease, a history of stroke.

In the “Harmony” clinic, experienced specialists receive patients who wish to individually select an effective contraceptive.After the examination and examination, the doctor writes out recommendations for preventing unwanted pregnancy. Since the funds are selected taking into account the personal characteristics of the patients, the effectiveness is very high, and the side reactions are minimal.

Drug review: the effect of hormonal contraceptives (COCs)

Oral contraceptive pills are the most popular group of medicines used by modern women to control conception.These drugs are a combination of estrogen and progesterone. They can be prescribed for polycystic ovary syndrome, endometriosis, and amenorrhea.

Side effects include the risk of venous thromboembolism, hypertension, and liver adenoma. For women over 35 who smoke or have estrogen-sensitive tumors, combined oral contraceptives are contraindicated. There are the following types of KOK :

  • Monophasic – Each tablet contains the same dose of estrogen and progestin.
  • Multiphase – Biphasic pills contain a fixed dose, such as ethinylemtradiol and escalating doses of norethindrone, while triphase tablets have different doses of each component over a typical 21-day cycle.

The indication for the use of this method is not only contraception, but also hyperandrogenism (acne, hirsutism), menstrual irregularities, control of symptoms in endometriosis and leiomyomas. Among the modern pharmaceuticals in this group, the most popular brands can be distinguished.


Optimal formula for young women. Since the content of the hormonal component is extremely low, these tablets practically do not pose a risk of developing vascular pathologies. Practice has shown that taking hormonal contraceptives of this spectrum is easily tolerated. Adverse reactions from the digestive system are rare. Regularly taken pills guarantee relief from pronounced premenstrual syndrome. They help to cope with such a difficult condition as hormonal acne, improve the condition of hair and nails.Taking a contraceptive, you normalize the cycle, reduce profuse bleeding, and regulate weight.


Contains ethinyl estradiol per tablet in an amount of 20 mcg and desogestrel 150 mcg. The medicine has a beneficial effect on the regulation of the menstrual cycle. Differs in the minimum number of adverse reactions. Like Jess, it is allowed to receive on 21 days after childbirth, if the woman does not breastfeed.


Monophasic oral contraceptive with low dosage of active ingredients.It has a good antiandrogenic effect, easily removes pimples, acne, blackheads and seborrhea from the surface of the body. Normalizes the fat balance of the skin, regulates hair growth.

Lindet 20

The content of hormones in these tablets is low, which in no way diminishes their effectiveness in preventing unwanted conception. There are practically no side reactions; in rare cases, minor headache and nausea are possible.


This is a new level of pharmaceuticals.In addition to eliminating skin problems, Yarina helps to normalize weight, reduce the level of increased BMI. Mitigates the symptoms of PMS.

Mini-Pills: Powerful Small Agent

The next group of drugs is progestin-only hormonal pills (mini-pills or mini-pills of contraceptives). It is a short-acting, reversible oral contraceptive containing low doses of norethindrone. It is ideal contraception for women who should not take estrogen supplements.

Among them:

  • nursing mothers;
  • 90,171 overweight women;

    90,171 individuals with individual estrogen intolerance and premenopausal women.


The basis of the pharmacology of this type is desogestrel (75 μg). An ideally mild product that is instantly absorbed, forming a biologically active metabolite, etonogestrel. The half-life is up to 30 hours.The order of taking the pills is indicated on the package.


Desogestrel is contained in the same dose as the previous drug. It does not have a negative effect on weight, with the right selection it even contributes to weight loss. A good option for women who are lactating. One of the most common side effects is smearing with blood, which disappears within 3 months from the start of administration.


Contains 500 mcg Linestrenol.Normalizes hormonal balance, favorably affects a woman’s sensuality, her libido. Suitable for nursing mothers.

Hormonal patch: pasted and went

The action of hormonal contraceptives of this kind is really as simple as possible. Outwardly, this plaster is similar to a classic adhesive plaster, it is easily applied to the skin, fixed with a sticky layer and adheres flawlessly, regardless of clothing and simple hygiene procedures. The advantages of using this patch are as follows :

  • no need to interrupt sex to attach the sticker to the body;
  • does not need to be examined before use.However, keeping in mind that this is a hormonal agent, you should use it with caution for the first time;
  • reduces the flow of menstrual blood in those who suffer from heavy bleeding;
  • reduces pain during menstruation;
  • sticker change takes place according to the instructions given by the manufacturer. One patch is applied once a week, this procedure is repeated for 3 weeks. Then 1 week – a break;
  • after the final removal, the woman quickly returns to normal and can plan a pregnancy on the advice of a doctor.

Studies have shown that patches are not inferior to combined oral contraceptives and mini-pills. It is enough to print the product, stick it on the clean skin of the shoulder, abdomen or buttocks.

The principle of operation of the of this product is as follows:

  • Prevention of egg production by the ovaries;
  • thickening of the mucous layer in the cervical region, which complicates the penetration of spermatozoa into the organ and makes fertilization impossible;
  • Thinning of the lining of the uterus, which prevents the introduction of the egg into the endometrial layer.

The use of hormonal contraceptives in the form of patches has been shown to be effective in 91% cases. Despite the good result, do not forget that the sticker does not provide protection against sexually transmitted infections, and therefore is recommended for use with other protective equipment. The disadvantage of this method of contraception is that it is noticeable, can become soaked in dust and look untidy on the skin. Not suitable for people with sensitive dermis, as it can provoke irritation.

Vaginal ring and injectable progestin

Indications for use are similar to those that accompany oral contraceptives. The vaginal ring is flexible, acting through a combination of ethyl estradiol and etonogestrel. Inserted into the vagina, held in place for 3 weeks, and then discarded. After the menstrual bleeding caused by the withdrawal syndrome, a new ring is inserted and everything is repeated again.

Injectable progestin is a synthetic form of progesterone.Used for contraception as well as in the treatment of abnormal uterine bleeding and signs of endometriosis. Available as an intramuscular or subcutaneous injection. Introduced once every three months. Its effectiveness is often higher than that of other contraceptives, is 94% .

Intrauterine device and subcutaneous implant

Considering all types of hormonal contraceptives, the intrauterine device (IUD) cannot be overlooked. The small contraceptive device is often T-shaped.The doctor inserts it into the woman’s uterus to prevent pregnancy. non-hormonal IUDs and hormonal modifications are available.

The material from which these contraceptives are made is diverse. It can be plastic, copper, silver and even gold. The price of intrauterine devices varies widely. These are long-term monitoring devices that can remain in place for 3-5 years or more. It all depends on the type and brand. The efficiency is very high and is 99% .As for the implant, it is injected subcutaneously into the forearm, acting for 3 years. The principle of action is the same, due to the content of progestin.

Emergency methods of contraception

The general classification of hormonal contraceptives contains one more name. It is an emergency contraceptive technique that involves a slight disruption in the body to prevent conception. As a rule, the drug is produced in the form of one, at least two tablets. Effective in case of unprotected intercourse if taken within 48-72 hours from the moment of sexual intercourse.The earlier the pill is taken, the higher its effectiveness. Due to the large dose of hormones, the cycle changes. Not recommended for frequent use.

Indications for immediate cessation of hormonal contraceptives

  • sensory disorders, visual disturbances;
  • migraines, frequent headaches;
  • epileptic seizures;
  • detection of tumors of unknown etiology;
  • growth of uterine fibroids;
  • jaundice, pregnancy, suspected thrombophlebitis.

Studies have shown that taking hormonal contraceptives in premenopausal women increases the risk of cervical cancer, but reduces the likelihood of endometrial and ovarian cancer. To find the most suitable method of contraception, make an appointment at the Harmony clinic. We are located at: Rostov-on-Don, st. Krasnoarmeiskaya, 170 (2nd floor).

Everything You Need to Know About Hormonal Contraception – Wonderzine

Are hormonal contraceptives dangerous

Hormones have an effect not only on the reproductive system, but on the whole organism as a whole: they change some metabolic processes.Therefore, there are contraindications to taking hormones based on possible side effects. Ever since the time of the first and second generations of high-dose hormonal contraceptives, there have been many horror stories about weight gain, “hair growth”, strokes, chemical addiction and other sad consequences of taking a high concentration of hormones. In new generations of products, the concentration of hormones is reduced tenfold and other substances are often used than before. This allows them to be used even for non-contraceptive medicinal purposes – therefore, it is wrong to transfer stories about the first generations of drugs to them.

The most common side effect of hormonal contraception is increased blood clotting, which can lead to a risk of thromboembolic disease. At risk are women who smoke and women whose relatives have had any thromboembolic complications. Since smoking in itself increases the risk of blood clots, most doctors will refuse to prescribe hormonal contraceptives for women who smoke after thirty-five years. The risk of thrombosis is usually higher in the first year of admission and in the first six months after hormone withdrawal, which is why, contrary to popular belief, frequent breaks in hormone intake should not be taken: it is not recommended to take them for less than a year and return to them earlier than after a year break, so as not to harm your health.Prevention of thrombosis, in addition to quitting smoking, is an active lifestyle, consumption of a sufficient amount of fluids and an annual blood test for homocysteine ​​and coagulogram.

While taking hormones, other types of intoxication can also have a negative effect: the use of alcohol and various psychoactive substances, including marijuana, psychedelics and amphetamines, can provoke problems with blood pressure, blood vessels of the heart and brain. If you are not going to reduce the use of toxic substances while taking hormonal contraception, you should inform your endocrinologist about your habits to avoid unnecessary risks.

The risks of cervical cancer while taking contraceptives increase when a woman has human papillomavirus, chlamydia, or a high risk of contracting sexually transmitted infections – that is, neglect of barrier contraception with non-regular partners. The pregnancy hormone progesterone suppresses the body’s immune response, so women who fall into this risk group can take hormonal contraceptives, but they need to undergo a cytological examination more often – if there are no complaints every six months.There is no convincing evidence that modern contraceptives increase the risk of liver cancer, although the first generations of drugs, due to the high dosage, had a bad effect on her health. Many women are afraid that taking drugs will trigger breast cancer. Most studies have failed to establish a reliable link between hormonal contraceptive use and the occurrence of breast cancer. Statistics show that women with a history of breast cancer, late menopause, childbirth after forty, or have not given birth are at risk.In the first year of HA use, these risks increase, but disappear as they are taken.

There is no evidence that a woman taking hormonal contraceptives has a reduced egg supply

It is believed that taking hormonal contraceptives can lead to depressive conditions. This can happen if the progestogen included in the combined contraceptive is not suitable for you: with this problem you need to consult a doctor in order to change the combined drug – most likely, this will help.But in general, depression and even observation by a psychiatrist is not a contraindication for taking contraceptives. However, both doctors should definitely be informed about the drugs that you are using, because some of them can weaken each other’s action.

There is a myth that hormonal contraceptives, due to inhibition of the reproductive system, lead to infertility, subsequent miscarriage and fetal pathologies. This is not true. The so-called ovarian sleep, or hyperinhibition syndrome, is reversible.At this time, the ovaries are resting, and the entire body is in a hormonally even state of “false pregnancy”. There is no evidence to prove that a woman taking hormonal contraceptives has a reduced egg supply. Moreover, hormone therapy is used to treat infertility, because after drug withdrawal and recovery, the ovaries work more actively. Taking hormonal contraceptives in the past does not affect the course of pregnancy and fetal development. In most cases, the risks and side effects from taking hormonal contraceptives are significantly lower than from terminating an unwanted pregnancy.

Also, hormonal contraceptives do not cause amenorrhea, pathological cessation of menstruation. After discontinuation of the drug, it often takes at least three months for menstruation to recover (if it has not been for more than six months, then it is better to see a doctor). The syndrome of hormonal contraception withdrawal is a condition that occurs after the termination of hormone intake, when the body returns to constant monthly hormonal changes. In the first six months after cancellation, the body can storm, and therefore during this period it is better to be observed by an endocrinologist.Without medical necessity, hormone intake cannot be interrupted in the middle of the cycle: sudden interruptions contribute to uterine bleeding and cycle disturbances.

In the endocrinological environment, there is a poetic phraseological unit that characterizes the status of “balanced” women’s health: the harmony of hormones. Modern hormonal contraceptives still have contraindications and side effects, but with proper selection, adherence to the rules of admission and a healthy lifestyle, they can not only eliminate the risk of unwanted pregnancy, but also significantly improve the quality of life of a modern woman – freeing her strength for the desired activity.

photos: sorapop – stock.adobe.com, texturis – stock.adobe.com, pioneer111 – stock.adobe.com, Africa Studio – stock.adobe.com, Dario Lo Presti – stock.adobe.com

Hormone therapy in gynecology: myths and reality

Modern gynecology cannot do without the use of hormonal drugs. At the same time, the appointment of hormonal drugs often scares people, since a lot of unreliable or outdated information is spread about them. We will try to understand the need to use these drugs and dispel the most common myths about hormone therapy.

Hormones are special chemical messengers that regulate the work of the whole organism. The main part of hormones is produced in the endocrine glands: thyroid and parathyroid glands, pituitary gland, adrenal glands, pancreas, ovaries in women and testes in men. Hormonal drugs are nothing more than synthetic analogues of our natural hormones.

In obstetrics and gynecology, hormone therapy has been used for a relatively long time and brings quite impressive results, especially today, with the advent of new highly effective hormonal drugs, devoid of serious side effects of their predecessors.

Hormone therapy is necessary in the following cases

  1. In improving the quality of life of women in peri- and postmenopausal women, as well as after surgical removal of the ovaries.
  2. In providing highly effective contraception, which has significantly reduced the number of abortions and their complications.
  3. In the development of new reproductive technologies, such as IVF, ICSI, etc.
  4. In the conservative treatment of gynecological diseases: uterine fibroids, endometriosis, endometrial hyperplasia and polyposis, polycystic ovary syndrome, menstrual irregularities, etc.

Menopausal hormone therapy

Hormone therapy is necessary to maintain the health of a woman during menopause, when the reproductive function of the body decreases and the production of hormones by the ovaries is extinguished. Deficiency of the hormone estrogen provokes disorders of the psychoemotional and physical condition. Often, a woman has problems in her sexual life: libido decreases, discomfort during sexual intercourse worries.

The basis of hormone replacement therapy is to compensate for the lack or absence of ovarian hormones with medications similar in structure and effect, which significantly improves the patient’s quality of life.

Hormonal contraception

Hormonal contraception (oral contraceptives, hormone-containing coils, patches, implants, injectable contraceptives) is a highly effective method of preventing unwanted pregnancy. For contraceptive purposes, synthetic analogs of estrogens and progesterone and their derivatives are used. In addition to the main protection function, these drugs normalize the menstrual cycle, reduce the likelihood of benign tumors (uterine fibroids, endometriosis, ovarian cysts), and also have a therapeutic effect in the presence of data and other gynecological diseases (polycystic ovary syndrome).

Hormones in the treatment of infertility

At present, the treatment of infertility and miscarriage is one of the priority areas of obstetrics. The importance of hormonal drugs in the IVF program can hardly be overestimated. Assisted reproductive technologies have become widespread and give a high percentage of positive results, that is, pregnancies that have occurred, primarily due to the success of pharmaceutical companies in the development and production of high-tech analogues of endogenous hormones.Thanks to them, it is possible to stimulate superovulation for the development of several dominant follicles. The effect of hormonal drugs, such as inhibition of ovarian function, is also used in IVF protocols to suppress its own gonadotropins and create an optimal background for stimulation by exogenous gonadotropins. After the transfer of the embryo into the uterine cavity, it is necessary to use progesterone preparations, since its lack reduces the likelihood of implantation, and can lead to termination of pregnancy in the early stages.In addition, thanks to artificial hormones, it is possible to improve the work of the ovaries and get rid of other problems that prevent conception (endometrial polyps, endometriosis, etc.).

Major misconceptions

Myth 1

Hormones are prescribed only for very serious illnesses.

To prescribe hormones, there is no need to wait for severe, advanced stages of the disease. Moreover, competent and timely hormonal correction can get rid of the problem or stop its development when using the minimum effective doses and in the shortest possible time.

Myth 2

If you do not take a hormonal pill in time, nothing bad will happen.

Hormonal drugs, especially contraceptives, must be taken strictly by the hour. For example, the hormonal contraceptive pill works for 24 hours, that is, it must be taken once a day to maintain an effective concentration of the substance in the blood serum. A delay of more than 12 hours can dramatically reduce the contraceptive effect, spontaneous ovulation and the onset of an unplanned pregnancy are possible.

Myth 3

When hormones are taken, they accumulate in the body.

It is fundamentally wrong, since the requirement for strict administration of hormonal drugs is precisely due to the fact that when the hormone enters the body, it immediately breaks down into chemical compounds, and they, in turn, are excreted from the body.

Myth 4

Hormones are not prescribed during pregnancy.

Discharged. If a woman had hormonal disorders before pregnancy, then during gestation she needs drug support so that the level of sex hormones is normal and the child develops normally.If necessary, other hormones are prescribed: thyroid hormones – for hypothyroidism, corticosteroid hormones – for certain systemic diseases, for suppressing androgens of the adrenal cortex, insulin – for diabetes, etc. Refusal of therapy during pregnancy due to fear of harming the fetus is not has a scientific basis, on the contrary, the fetus suffers in the absence of the necessary correction.

Myth 5

Hormonal medications have many side effects, primarily weight gain.

Preparations of the first and second generation of contraceptives could indeed cause the effect of weight gain due to the high content of hormones. Currently, manufacturers produce micro-dosage contraceptives with a modified structure of active substances, which practically does not provoke weight fluctuations. Hormonal drugs are prescribed for a fairly long period, the body adapts by the end of the first or second months, and most women do not feel any discomfort.

Myth 6

There is always an alternative to hormones.

Not always. There are situations when hormonal drugs are indispensable. For example, a young woman (up to 50 years old) had her ovaries removed, as a result she began to age rapidly and lose health. In this case, her body, up to 55-60 years old, needs mandatory support with hormone therapy. Of course, provided that the underlying disease (due to which the ovaries were removed) has no contraindications to this appointment.

Myth 7

Hormonal drugs should not be taken for a long time.

The main requirement is the correct selection of the hormonal preparation. It is possible to take a well-chosen drug, subject to annual monitoring, for years without interruption. Long-term use not only does not have a harmful effect on the body, but, on the contrary, helps to establish the menstrual cycle, prevents the development of benign diseases of the mammary glands, endometriosis, fibroids, ovarian cysts, and also improves the quality of hair and skin.

Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Carbatrol; Epitol; Equetro; TEGretol; TEGretol-XR

Trade names: Canada

APO-CarBAMazepine; DOM-CarBAMazepine; DOM-CarBAMazepine CR; Mazepine; PMS-CarBAMazepine; PMS-CarBAMazepine CR; PMS-CarBAMazepine-CR; SANDOZ CarBAMazepine CR; SANDOZ CarBAMazepine [DSC]; TARO-CarBAMazepine; TEGretol; TEGretol CR; TEVA-Carbamazepine


  • Cases of dangerous abnormalities in blood cell levels have occurred, such as aplastic anemia and a variant of low leukocyte counts.Tell your doctor right away if you feel very tired or weak, have a fever, chills, shortness of breath, unexplained bruising and bleeding, or purple spots on your skin.
  • If any signs of infection appear, such as fever, chills, flu-like symptoms, very severe sore throat, ear or sinus pain, cough, increased or discolored sputum secretion, pain when urinating, ulceration in the mouth or non-healing wounds, see a doctor immediately.
  • Possible severe skin reaction (Stevens-Johnson syndrome / toxic epidermal necrolysis). This can lead to serious and permanent health problems and sometimes death. Get immediate medical attention if you experience symptoms such as redness, skin swelling with blistering or scaling (with or without a high fever), eye redness or irritation, or ulceration in the mouth, throat, nose, or eyes.
  • People with a particular gene (HLA-B * 1502) are more likely to have serious and sometimes fatal skin reactions associated with this drug. This gene is most common among Asians, including South Asian Indians. If you have any questions, consult your doctor.
  • People with a particular gene (HLA-A * 3101) may be more likely to have serious allergic reactions associated with this drug. Allergic reactions can lead to death.If you have any questions, consult your doctor.

What is this drug used for?

  • Used to treat seizures.
  • It is used to treat pain syndrome caused by damage to the facial nerve.
  • This medication is used to treat bipolar disorder.
  • This medicinal product may be used for other indications. Consult your doctor.

What do I need to tell my doctor BEFORE taking this drug?

  • If you are allergic to this drug, any of its ingredients, other drugs, foods or substances.Tell your doctor about your allergy and how it manifested itself.
  • If you have kidney disease.
  • If you have any of the following health problems: bone marrow disease or porphyria.
  • If your body is unable to break down fructose, consult your doctor. Some of these drugs contain sorbitol.
  • If you are taking any drugs (prescription and over-the-counter, natural products, and vitamins) that should not be taken with this drug — for example, some drugs for hepatitis C, HIV, or other infections.There are many medicines that should not be taken at the same time as this medicine.
  • If you have taken a drug for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

  • Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
  • Avoid driving or other activities that require special attention until you can see how this drug affects you.
  • Perform blood tests as directed by your healthcare practitioner. Please consult your doctor.
  • Get your vision checked as directed by your doctor.
  • This drug may interfere with some lab tests. Tell all healthcare providers and laboratory staff that you are taking this drug.
  • Some pregnancy tests may give incorrect results when taking this drug. Consult your doctor.
  • Consult your doctor before using alcohol, marijuana, or other forms of cannabis, or prescription or over-the-counter drugs that may slow you down.
  • Consult a healthcare professional if you frequently drink grapefruit juice or eat grapefruit.
  • Do not stop taking this drug abruptly without talking to your doctor. This can increase the risk of seizures. If necessary, this drug should be stopped gradually, as directed by your doctor.
  • Talk to your doctor if your seizures change or get worse after you start taking this drug.
  • Like other drugs used to treat seizures, this drug in rare cases may increase the risk of suicidal ideation or behavior.This risk may be higher in people who have attempted suicide or have had suicidal thoughts in the past. See your doctor right away if you develop or worsen symptoms such as depression, nervousness, anxiety, irritability, panic attacks, or other mood or behavior disorders. In case of suicidal thoughts or attempted suicide, contact your doctor immediately.
  • A heart problem, such as heart failure and abnormal heart rhythms, has happened with this drug.Sometimes these heart problems have resulted in death. If you have a fast, slow heartbeat, or an irregular heartbeat, severe dizziness or fainting, shortness of breath, weight gain, or swelling in your arms or legs, see your doctor right away.
  • A very severe reaction called angioedema has occurred with this drug. Sometimes this reaction can be life-threatening. Symptoms may include swelling of the hands, face, lips, eyelids, tongue, or throat, difficulty breathing or swallowing, or uncharacteristic hoarseness.Seek medical attention immediately if any of these symptoms occur.
  • If you are 65 years of age or older, use this drug with caution. You may have more side effects.
  • Birth control pills and other hormonal contraceptives may be less effective. Use a different type of birth control, such as a condom, while taking this drug.
  • If used during pregnancy, the drug may have a harmful effect on the fetus.If you are pregnant or become pregnant while taking this drug, call your doctor right away.
  • Tell your doctor if you are breastfeeding. It is necessary to consult if the drug poses any risk to the child.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects.Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

  • Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
  • Signs of low sodium levels such as headache, trouble concentrating, memory impairment, confusion, weakness, seizures, balance problems.
  • Change of speech.
  • Hallucinations (a person sees or hears something that is not in reality).
  • Change in vision.
  • Difficulty walking.
  • Severe and sometimes deadly side effects have been reported in patients using drugs similar to this drug for seizures.If lymph nodes are swollen, fever, rash, chest pain, signs of kidney damage such as urinary retention or changes in urine output, signs of liver damage such as dark urine, feeling tired, not feeling hungry, nausea or pain stomach, light-colored stools, vomiting, yellow skin or eyes, see a doctor immediately.
  • A very severe, sometimes fatal, disorder, neuroleptic malignant syndrome (NMS), can occur.Call your doctor right away if you have a fever, muscle cramps or stiffness, dizziness, severe headache, confusion, changes in thinking, tachycardia, an abnormal heartbeat, or excessive sweating.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects.Call your doctor or get medical help if these or any other side effects bother you or do not go away:

  • Feeling dizzy, sleepy, tired, or weak.
  • Nausea or vomiting.
  • Dry mouth.
  • Constipation.

This list of potential side effects is not comprehensive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

Sustained-release capsules:

  • Take this medication with or without food.
  • Swallow whole. Do not chew, break, or crush.
  • You can pour the contents of the capsule into applesauce or other soft foods. Do not chew. Swallow immediately and drink with water or juice.

All other oral preparations:

  • Take with food.

Chewable Tablets:

  • Chew thoroughly before swallowing.


  • Shake well before use.
  • Care should be taken to measure liquid doses. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.
  • Do not mix with other liquid medicines.
  • Do not take this drug at the same time as any other liquid medicine.

Extended release tablets:

  • Swallow whole. Do not chew, break, or crush.
  • Do not take chipped or broken tablets.
  • The tablet shell can sometimes be seen in the stool. This is normal and not a cause for concern.
  • If you find it difficult to swallow this medication whole, consult your doctor.There may be other ways to take this drug.

What to do if a dose of a drug is missed?

  • Take the missed dose as soon as you can.
  • If it is time for your next dose, do not take the missed dose and then return to your normal dose.
  • Do not take 2 doses at the same time or an additional dose.

How do I store and / or discard this drug?

  • Store at room temperature, protected from light.Store in a dry place. Do not store in the bathroom.
  • Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
  • Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information about medicines

  • If your health does not improve or even worsens, see your doctor.
  • Do not give your medicine to anyone or take other people’s medicines.
  • Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
  • A separate patient instruction sheet is included with the product. Please read this information carefully. Reread it every time you replenish your supply. If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
  • If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Consumer Use and Limitation of Liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. For complete information on the possible risks and benefits of taking this drug, consult your doctor.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.


© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

90,000 Intrauterine device: the pros and cons of this method of contraception

One of the most effective contraceptives, gynecologists call the intrauterine device.This is a special device that is inserted into the uterine cavity and fixed there. The device is installed 1 time for several years. Gynecologists recommend installing this particular contraceptive for girls who have given birth who do not plan to become pregnant in the near future, as well as women for the purpose of treatment.

How does a spiral work?

The contraceptive protects against pregnancy by 99% and performs a therapeutic function. It is presented in the form of a T-shaped device with tails – this type is used more often today, although earlier they used the F-shaped and ring-shaped spirals.All devices can be divided into several types:

  • containing copper;
  • based on a hormonal component.

Coils with copper change the composition of cervical mucus, as a result, prevent the penetration of sperm into the uterine cavity. They prevent the egg from attaching to the uterine wall. IUD with copper in the composition prevents inflammation and the appearance of germs.

The spiral containing the hormonal component is made on the basis of levonorgestrel.This hormone not only prevents sperm from entering the uterus, but suppresses ovulation. The device is covered with a special membrane that blocks the levonorgestrel delivery, making it metered.

Who sets the spiral?

If a gynecologist has been prescribed the installation of an IUD, then it is carried out by the doctor himself. You can insert and fix the intrauterine device at the appointment with our specialists in Novosibirsk. The Carnelian Medical Center provides services for the introduction of the IUD, the gynecologist will tell you in detail how to choose a device, as well as about changes in the body after fixing the spiral.

Pros and cons of spirals as a contraceptive

The main advantage of using an intrauterine device is 99% protection against pregnancy. Immediately after insertion into the uterine cavity, the device begins its work. Reliable contraception is provided up to the moment the device is removed. In this case, fertility returns to the woman after the removal of the IUD. A few more pluses:

  • long-term use;
  • no discomfort;
  • additional healing effect.

The IUD is installed for 3, 5 or 10 years – this period is regulated by the doctor and the type of coil. Additional effects during the use of this contraceptive include: reduction of pain during menstruation, prevention of inflammatory diseases. Compared to hormonal contraceptives, the spiral does not change a woman’s blood pressure, nor does it change her emotional and hormonal background.

There are also disadvantages to this method of contraception:

  1. Lack of protection against sexually transmitted diseases.If we compare the IUD with a condom on this point, then the latter wins significantly. The spiral does not in any way prevent the entry of pathogenic bacteria into the uterine cavity, so you should not rely on it with a new partner – the device is suitable only if you have a permanent partner.
  2. Changes in the menstrual cycle. If the pain subsides a little, then the discharge becomes more. Abundant periods are accompanied by the appearance of clots.
  3. Possibility of developing inflammation in the first weeks after insertion.Due to the fact that a foreign body is introduced into the body, this can provoke a negative reaction.