Hormonal Birth Control: Choosing the Best Method for You

Written by Dr. Seif Sadek

There are two different types of birth control: hormonal and non-hormonal. If you take the pill, have the patch, vaginal-ring, depo-injection, progesterone IUD or progesterone implant...you currently rely on a hormonal birth control method. Anything else (like condoms or the copper IUD) is non-hormonal. 

There is no one size fits all birth control (or anything TBH) so you have to find what works best for you. We can help! 🙌

There are two subcategories of hormonal contraception: progesterone only, and combined birth control (estrogen and progesterone).⬇️

Progesterone only (pills, depo-injections, IUD/Implant)

Progesterone only contraception has several effects on the body that help prevent a pregnancy.  Firstly, your cervical mucus thickens, making it difficult for sperm to enter the uterus. It also stops you from ovulating (but may not if you are gaining or losing weight).  

Progesterone also thins the lining of the uterus. This is why some stop getting their period during use. However, in the first month, a quarter of people will experience irregular bleeding. Again- different bodies, different reactions!

The Pill 💊

With perfect use of the pill (you never forget to take a pill and take them at the exact same time every day👏) less than 1% of users will get pregnant. So, if you never forget a pill (thanks to the Aavia app and pill case 😉), this birth control might work for you. For those that take the pill inconsistently, 9 out of 100 people will accidentally get pregnant during the first year of taking it. 

Injections 💉

The progesterone injections work similarly to the pill. It stops ovulation, thickens your mucous, and thins your lining. One-shot will work for approximately 13 weeks or three months. If you are more than two weeks late for a repeat injection, use a backup form of birth control (like condoms) for at least one week. A great benefit of the injection is that it helps with symptoms of sickle cell disease and seizure disorders. 

The IUD/Implant 🔥

The IUD and the implant are the most effective forms of hormonal birth control available. It works mainly by stopping the sperm from fertilizing the egg, it also thickens your mucus and thins the lining of the uterus. Most people experience irregular bleeding the first couple of months of using the IUD and will stop getting a period after a year of use. The same is true for the implant, although some women experience more frequent and longer periods.

Estrogen and progesterone birth control (combined pills, patches, ring)

Combined hormonal birth control methods release estrogen and progesterone into the whole body. These hormones prevent pregnancy mainly by stopping ovulation and thickening of the cervical mucus. With perfect use, only 0.1 percent of people become pregnant within the first year.

There are usually two ways of using combined birth control; either continuous or cyclical.

Continuous 📆

With continuous birth control, all the pills taken have hormones in them and potentially lead to your period being lighter or stopping altogether. This method is usually utilized for endometriosis or period-associated symptoms such as migraines. However, you may occasionally experience times of irregular bleeding or spotting due to the lining becoming unstable.

Cyclical 📅

When using the cyclical method, there are usually several days where the pills are hormone-free leading to you getting a period. This method is less likely to cause irregular bleeding or spotting.

Both methods are used with the patch or the vaginal ring. During the hormone-free week the patch is not placed, or the ring is removed.

For all the combined methods if the pills, patch, or ring is missed for more than 48 hours, a backup contraception method is needed for at least a week to protect you from getting pregnant. The Aavia app and pill case can help prevent that! 😏

Treating specific menstrual symptoms

Many people start birth control as a way to alleviate period symptoms like cramping or acne. 

Here’s is a table that shows the different symptoms people experience with their period and the specific birth control that can potentially help with those symptoms.