Hormonal Contraceptives: Happy Birthday to the Pill
Editor’s Note: This article was originally written by patient expert Anjali.
The pill turns 50 today.
Over the course of these past 50 years, hormonal birth control has come a long way: many new forms of the pill exist, new methods of delivering the hormones exist, and there are projects in the works that aim to make hormonal methods for men.
In honor of this momentous birthday, over this month we will be taking a look at all the hormonal birth control methods - how they work, what’s available and who can use it.
HOW IT WORKS:
In general, hormonal methods work in a few different ways. They suppress ovulation (release of the egg), they thin the inner lining of the uterus, endometrium, so that an egg cannot implant itself there (also the reason that periods can be shorter and lighter on hormonal contraceptives), and they may thicken the cervical mucus making it harder from sperm to travel up to the fallopian tube.
With typical use, hormonal methods have a 97% efficacy rate at preventing pregnancy. Hormonal methods are not for everyone and should only be taken under the supervision of a medical provider. It should be noted that while great at preventing pregnancy, hormonal methods DO NOT prevent sexually transmitted diseases and should always be used in conjunction with condoms if you do not know the STD status of your partner(s).
It is also important to note that women who have clots, or smoke should NOT use hormonal contraceptive methods.
The pill is available in many forms today. You can get a standard monthly pack that includes 21 days (3 weeks) of active pills with hormones in them and 7 days of placebo pills. Some pill packs have only 21 pills and you are supposed to continue the next pack 7 days later. With these pills you will experience a period once a month. If you want to skip your period all together, you can take only the active pills in your pack and then start a new pack, and only take the active pills in that pack.
It is advised that in order to establish a routine, a woman should take a pill everyday at the same time. If one pill is missed, the recommendation is to take it as soon as you remember and continue to take the rest of the pack as normal. This means you will double up the day after the missed pill. If you miss two days, take both missed pills as soon as you remember, and continue the pack as usual. If three pills are missed, you should discontinue use of the pill for four more days (to make a week), use back-up contraception during this time, and begin a new pack after the seven days. If you are consistently missing pills, it might be time to talk to your provider about switching to another form of birth control.
The pharmaceutical industry, recognizing women’s desires to skip periods, now sell three-month supplies of the pill that allow you to have a period once every three months, or just four times a year.
The pill also comes in various combinations of hormones. Some monthly packs also have graduated levels of hormones and it is important to take these sequentially as directed. Depending on your situation, a progestin only or low hormone level might be suitable. Talking to your provider will give you a better idea of what is most suitable for you.