- What are the different types of hormonal contraception?
- How do hormonal contraceptives work?
- What are the differences between the combined contraceptive pill and the mini pill?
- Does the patch or ring work differently to the pill?
- How effective are hormonal contraceptives?
- Do hormonal contraceptives cause side effects?
- What do I do if I forget to take my pill/change my patch or ring?
- Do I need to use contraception after giving birth?
- Can I use contraception if I am breastfeeding?
- How do I choose which hormonal contraceptive to use?
- Can I use hormonal contraceptives long term?
There are seven different types of hormonal contraception. These include the oral combined contraceptive pill (otherwise known as the pill), the mini-pill (also known as the progestogen-only pill), the contraceptive patch, the vaginal ring, IUD (coil), the contraceptive implant and the contraceptive injection.
Hormonal contraceptives work in three ways to alter your monthly cycle in order to prevent pregnancy. They primarily work by preventing your ovaries from releasing an egg, therefore preventing ovulation. They also thicken the mucus at the neck of the womb (the cervix). Finally, hormonal contraceptives stop the lining of the womb from growing, therefore preventing a fertilised egg from implanting itself there.
The main difference between the combined contraceptive pill (the pill) and the mini pill is that the combined pill contains two hormones (progestogen and oestrogen) and the mini-pill contains only progestogen. The mini pill is taken for the full 28 days of your cycle with no seven-day break, as opposed to most combined pills, which are taken for 21 days. As a progestogen-only pill, the mini pill is a more suitable alternative for women who are sensitive to oestrogen.
Apart from the method with which the hormones are delivered to your system, there is no difference in the way that the patch or the ring work in your body to prevent conception. These methods are simply alternatives to the pill, and they both contain artificial progestogen and oestrogen and work in the same way as the pill. Unlike the mini-pill, there is no progestogen-only patch or ring currently available.
When used correctly, hormonal contraceptives are almost 100% effective in preventing pregnancy, making them among the most effective forms of contraception. Both the ring and the patch use oestrogen and progestogen and work in the same way as the pill. As it contains only oestrogen, the mini-pill is slightly less effective than the combined pill, although its efficacy rate has proven to be up to 99% effective for most women.
As with all medications, there may be some side effects when taking hormonal contraceptives, though those that do occur will usually be mild and temporary. The possibility of side effects will depend on which hormonal contraceptive you are using and will differ depending on the person using them. You may need to try more than one type of hormonal contraceptive to determine which is best suited to you.
If you are taking the combined pill and miss a pill, it is recommended that you take the missed pill as soon as possible and then take the next scheduled pill at the normal time, even if this means taking two pills at the same time. It is recommended that you use a barrier contraceptive, such as a condom, for the next seven days as an extra precaution.
As the mini pill contains only progestogen, the importance of taking the pill on time is much greater, as contraceptive effectiveness will be lost quicker. With both the combined pill and the mini pill, starting a new course of pills late will greatly reduce your contraceptive protection, and you will therefore have to use barrier contraceptives. Likewise if you forget to replace your patch or ring you should apply or insert a new one immediately and use a barrier contraceptive such as a condom for seven days afterwards
Unless you are ready for another child, using contraception after giving birth is essential to protect you against pregnancy, although this will largely depend on whether you are breastfeeding or not. If you are not breastfeeding, are having sexual intercourse and are not using protection, you are able to get pregnant within as little as three weeks after pregnancy. It is therefore usually recommended that you start using contraception 21 days after giving birth if you are sexually active, for effective protection against pregnancy.
The short answer is yes, though breastfeeding will determine the type of contraception that you will be able to use. The mini pill and the contraception injection can be used as they both contain progestogen only. If you are breastfeeding you will not be able to use combined hormonal contraception such as the pill, the ring or the implant, due to the risk of the oestrogen affecting milk production.
There has been evidence to suggest that breastfeeding alone can act as a form of contraception, although this will depend on a number of circumstances such as how long you have been breastfeeding and if your normal monthly cycle has resumed. However, most doctors will generally recommend that you use additional contraception to ensure you are protected.
It's best to seek the advice of a professional before taking or using a hormonal contraceptive for the first time, or if you are changing to a new contraceptive. This will help to reduce the risk of side effects and will help you to compare and find out which contraceptive is right for you.
Many GPs are used to prescribing the same pill, and may not offer the full range of options. You may wish to take an online consultation with us to help you discover which options might be suitable for you. Alternatively, you could use our Live GP service to discuss your options.
You can take the pill, mini-pill or use the patch and ring over a long term period, although you are recommended to review your contraception every six months with a healthcare professional, as changes in your health and body may affect your choice of contraception.