Making decisions about your reproductive health can be stressful, especially when social media accounts bombard you with a blend of accurate and inaccurate information about your choices.
To focus our lens specifically on hormonal birth control, we identified eight facts that we think you should know based on recent data.
Before we take a dive into these facts, let’s take a moment to identify the different forms of birth control that are available. Your options for hormonal birth control include:
For the sake of brevity, we’re going to use the term “hormonal birth control” and the acronym HBC in place of listing each individual form.
Estrogen and progesterone levels fluctuate throughout the menstrual cycle. They serve different purposes and trigger different responses. Knowing which balance is right for you and your cycle can be tricky. Work with a licensed medical provider to figure out your best option.
The original forms of HBC that the Food and Drug Administration (FDA) approved for contraception in 1960 contained two to three times the dose of hormones found in HBC available today. In the 1980s, lower-dose methods earned FDA approval and were introduced to the market.
Today, HBC methods more closely mimic levels that are considered natural. By mimicking natural levels, side effects like changes in body composition, water retention, and bloating are more closely aligned with the changes that would occur naturally throughout your cycle.
This does not mean you are going to develop depression if you use HBC. There is no causal relationship that has been established between HBC and depression. There is a relationship that exists, but the specifics of the correlation have not yet been discovered. We encourage patients to talk about this dynamic with JHU’s sexual and reproductive health providers if you find yourself concerned about these risks.
Never take more than one dose at a time. If you missed two days’ worth of doses, you should still only take one dose when you “catch up.”
In order to get full protection against unintended pregnancy, users are encouraged to take their pill at roughly the same time of day every day. That doesn’t mean you have to take your pill at the same minute each day, but the more consistent you are, the less likely you are to forget if you already took it. That reduces the opportunity for any major fluctuations of hormone levels. If you do miss a day or two, be sure to use condoms to prevent unintended pregnancy until you have taken seven days of HBC pills in a row.
One of the pros of IUDs and Nexplanon is that you don’t have to worry about taking a pill or staying on a schedule. With the shot, you only need to receive one injection every three months, and most clinicians will have you schedule your next appointment at the end of your current one. Similarly, vaginal rings only need to be removed every three weeks and replaced with a new ring after seven days, so the concern of “missing” a dose is less than other contraceptives that require more frequent application.
Depending on the balance of hormones, your period may change or stop entirely. Typically, periods will become significantly lighter or stop all together. It is helpful if you are familiar with your body and your typical cycle. That will give you the ability to identify if there have been changes. Talk with a clinician if you notice anything that raises concern.
HBC essentially pauses fertility. These hormones typically work by preventing the release of an egg, making it more difficult for the sperm to reach the egg, or preventing a fertilized egg from implanting. There is no evidence to suggest that HBC affects fertility in the long term.
Depending on the method you choose, your body may take a little time to get used to the changes in hormone levels. Spotting and cramping are common side effects of adjusting to new hormone levels. IUDs can be painful during the insertion, followed by cramping for a few days. People who choose the implant (Nexplanon) may experience tenderness, swelling, or aching in the days following the procedure. When starting oral contraceptives, you may notice changes in your period, cramping, mood swings, and headaches. If you do decide to begin using a form of HBC, there are ways to manage side effects while you adjust. Typically, these symptoms subside once your body has had a chance to adapt to the changing levels.
Each menstruating person’s body operates with different levels of progesterone and estrogen throughout their menstrual cycle. This means the method containing the levels of estrogen and progestin a person would need will vary depending on their body’s needs. If you want to learn more about your different options, meet with one of our health education specialists or a clinician.
Think of this list as a highlight reel. There is a lot more information that you can learn if you are interested in digging deeper.
If you do want to learn more about contraception and the services available to you at Hopkins, email one of our health education specialists, Megan Tassinari or Carol Spencer.