Hormonal birth control: pills, rings and IUDs shown in illustration
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7 Hormonal Birth Control Methods & How They Work

If you think about birth control, you might automatically picture the pill. In fact, this is just one type of hormonal contraception and there are lots more hormonal and non-hormonal options out there. In this post, we’re going to look at the different types of hormonal birth control methods, how they work, their effectiveness, and more.

1. The hormonal IUD or coil

There are a couple of hormonal birth control methods that exceed 99% effectiveness, the hormonal IUD (intrauterine device) is one of these. This is because the hormonal IUD is a long-acting reversible contraceptive, and requires little input from the person using it. ‘Set it and forget it’ is a term that’s often used when referring to these types of hormonal birth control. 

Whilst highly effective, IUDs are also known as invasive, they require a healthcare professional for fitting and once inserted sit in the uterus for as long as five years, after which they also require removal from a medical expert. Some users of the IUD report side effects of cramping in the weeks following insertion.

The hormonal IUD works in two ways. The device makes cervical mucus thicker, meaning it’s harder for sperm to reach an egg. The IUD also contains a synthetic version of the hormone progesterone which inhibits ovulation

2. The contraceptive implant

Like the IUD, the implant is highly effective and it also requires fitting and removal by a healthcare professional. Unlike the IUD, the implant isn’t fitted inside the uterus, instead, it’s most commonly inserted in the fleshy part of the upper arm, where it can stay for up to three years, before being removed.

The contraceptive implant works in the same way as the hormonal IUD, releasing synthetic progesterone to stop an egg cell from being released (ovulation), while also thickening cervical mucus to make it harder for sperm to swim into the uterus.

3. The birth control injection 

The injection is less long-lasting than the previous two methods, but doesn’t require you to think about it every day. Shots are given every 8-13 weeks and are administered on fleshy parts of the body such as the buttocks, thighs, upper arms, or abdomen. 

Usually, the injection is given by a doctor or nurse, though in some cases you might be able to carry out the shot yourself. This hormonal birth control method works in the same way as the IUD and the implant, releasing hormones to stop ovulation, while also thickening cervical mucus to impede the swimming of sperm into the uterus. In terms of birth control effectiveness, the birth control shot is >99% effective with perfect use, and 96% effective with typical use. 

4. The contraceptive patch

A more temporary option than the methods touched on so far, the birth control patch is a small square of adhesive material that’s worn on the skin. The hormones inside the patch are released by contact with the skin. You wear a new patch every week for three weeks and then take a week’s break before starting the process over again. Some women report experiencing skin irritation when wearing the patch, and another downside is that you have to remember to change it. 

If used perfectly, the patch is 99% effective, however, with typical use it’s closer to 91% effective, meaning, on average, 9 women out of 100 will get pregnant while using the patch in a year. The patch contains both synthetic estrogen and progesterone, and works by suppressing ovulation and thickening cervical mucus. 

5. The NuvaRing

Number five on our list is the contraceptive ring or NuvaRing. This is a silicon ring, containing hormones, that’s worn inside the vagina. The ring is worn for three weeks, with a week’s break being taken after the third week of wearing.

The ring works in a similar way to the patch, with hormones suppressing ovulation and thickening cervical mucus. With typical use the ring is 91% effective, if used perfectly it’s 99% effective at preventing pregnancy.

6. The birth control pill

Now let’s turn to perhaps the most recognized form of birth control out there, the birth control pill. After changing the contraceptive landscape in the 1960s, the pill has stayed a major player on the scene. Today there are more varieties of the pill containing different doses of hormones, but the basic science behind how the pill works remains the same. 

Like the patch and the ring, the birth control pill contains synthetic estrogen and progesterone to prevent ovulation and thicken cervical mucus. Typically, you take the pill for three weeks and then, like the patch and the ring, take a break, during which you either take sugar pills or take no pills. It’s normal to experience withdrawal bleeding during this break in hormones. If used perfectly the pill is more than 99% effective, but with typical use it is 93% effective.

The pill requires a prescription from a medical provider and you can connect with a provider and request birth control online through a digital healthcare company like Nurx.

7. The mini pill

The lesser-known relative of the birth control pill, the mini pill, or progestin-only pill, is an option often used by women who need to avoid synthetic estrogen, as it only contains a synthetic version of the hormone progesterone. Unlike the combined pill, the mini pill doesn’t prescribe a break between packets. It’s common to experience irregular bleeding, spotting, or no bleeding at all while taking the mini pill.

The mini pill works by thickening cervical mucus making it harder for sperm to swim into the uterus, and some brands also inhibit ovulation. When used perfectly the mini pill is 99% effective at preventing pregnancy. With typical use, it’s 92% effective. 

Thinking about going hormone-free?

We hope you’ve enjoyed reading about the different hormonal birth control methods out there and how they work. There is no one-size-fits-all when it comes to contraception, what works for you, might not work for your friend. Many women find that a hormonal method suits them well, while other women experience unwanted birth control side effects. These women often seek out hormone-free birth control methods. One of these options that’s growing in popularity is Natural Cycles. The first birth control app to be given certification as a medical device, Natural Cycles is cleared by the US FDA and CE marked for use as contraception in Europe. 

The app works by using basal body temperature measurements, alongside some key data like period dates, to determine your fertile window. The app’s algorithm then learns the pattern of your cycle and can predict and confirm ovulation. With this knowledge, you can then choose to use protection or abstain on fertile days. Natural Cycles is 93% effective with typical use and 98% effective with perfect use.

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Written By

Jennifer Gray

Jennifer Gray is an award-winning writer with more than five years’ experience covering reproductive topics ranging from birth control to planning pregnancy. She is passionate about providing women with accurate information grounded in science they can use to take charge of their own health - while also dispelling myths that exist within the field of women’s health. She holds a Master of Science from the University of Edinburgh and currently lives in Ireland.

Jack in a suit and tie holding a microphone and giving a presentation.

Scientifically Reviewed

Jack Pearson

Dr. Jack Pearson is a previously HCPC registered Embryologist with a PhD in reproductive medicine. Prior to joining Natural Cycles leading Medical Affairs, he worked for more than 10 years in a clinical setting working at some of the busiest fertility clinics in the UK. Today he spends most of his time working with experts at the world’s leading institutions to carry out important research with the vision to further the field of female health. He earned his PhD from the University of Sheffield specializing in Sperm Metabolism and currently lives in London.

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