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Birth Control

What You Don't Know About Hormonal Contraceptives

Hormonal contraceptives are extremely popular due to their ease of use and efficacy. All require a doctor's prescription due to possible drug interactions and health risks, especially among older women and smokers. These methods of birth control can cause numerous side-effects and health risks.

Combined Estrogen & Progestin Methods
  • Combined Oral Contraceptives
  • Extended Cycle Pills
  • Ortho Evra, or "The Patch"
  • Nuva Ring, or "The Vaginal Ring"
  

Progestin-Only Methods

  • Progestin-Only Pills, or the "Mini-Pill"
  • Depo-Provera (DMPA), or "The Shot"
  • Implanon (Implant)

How Hormonal Methods Work

All hormonal contraceptives have at least three mechanisms of action. Artificial female hormones are the active ingredient in all hormonal contraceptives — estrogen and progestin. Some products contain both hormones and others progestin only. Using both hormones together is somewhat more effective than progestin alone, but the estrogen component is responsible for most of the serious health hazards associated with hormonal methods.

  1. Hormonal contraceptives prevent ovulation. No egg is released so sperm cannot fertilize it. It is widely agreed that this is a major mechanism of hormonal birth control.

  2. A woman may ovulate anyway. Hormonal contraceptives may also prevent fertilization by changing the consistency of natural secretions in the vagina, making it harder for the sperm to reach the egg. It is not clear how effective this mechanism is in preventing fertilization.

  3. A woman may ovulate anyway, and sperm may still reach the egg, resulting in fertilization. When this occurs, hormonal contraceptives make it difficult for the embryo to implant in the uterus by keeping the edometrium (lining of the uterus) thinned. This results in the death and expulsion of the embryo. Most scientists agree this does occur, but it is not clear how often. Some doctors do not prescribe hormonal contraceptives because they find this post-fertilization mechanism objectionable. Large doses of oral contraceptive drugs are used as a 'morning after pill' or Emergency Contraceptive Pills (ECPs).

Health Risks

There are numerous side-effects and health risks involving hormonal contraceptives. Here are a few you may not have known...

  • All methods of birth control can fail, even if you use them perfectly, resulting in pregnancy. One in ten Pill users get pregnant each year.
  • No hormonal methods protect you from sexually transmitted disease.
  • Hormonal contraceptives increase your risk of acquiring HIV or the AIDS virus if your partner is infected.
  • Loss of sex drive is a common side-effect and may be permanent.

The most important potential side effects and health risks are listed here, but not all are provided due to space limitations.

Problems caused by
Estrogen component
Problems caused by
Progestin component
Nausea
Breast swelling & tenderness
Vaginal discharge
High blood pressure
Decreased libido (sex drive)
Headaches
Mood swings
Fluid retention
Permanent dark patches on face
Drug interaction problems
Eye or vision problems
Gallbladder disease
Embolism (rare)
Heart attack (rare)
Stroke (rare)
Breast tumor growth (rare)
Weight gain
Depression
Bone loss
Fatigue and tiredness
Acne and/or oily skin
Headaches
High blood pressure
High cholesterol
Insulin resistance
Constipation
Bloating
Irregular menstrual bleeding
Breast tenderness
Supression of immune system
Heart attack (rare)
Breast tumor growth (rare)

Source: Contraceptive Information Resource, www.contracept.org.

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