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Birth Control: Pros and Cons of Hormonal Methods

Overview

The following tables list some pros and cons of using hormonal birth control methods.

Combination pills, skin patch, or vaginal ring (estrogen plus progestin)

Pros and cons of combination pills, patch, or ring

Pros

Cons

  • No interruption of foreplay or intercourse.
  • Reduced bleeding and cramping with periods, which lowers the risk of anemia.
  • Fewer or no periods.
  • Reduced pain during ovulation.
  • Reduced risk of pelvic inflammatory disease (PID).
  • Reduced fibrocystic breast changes.
  • Reduced risk of ectopic pregnancy.
  • May reduce acne.
  • May reduce ovarian cysts.
  • May reduce symptoms of endometriosis.
  • May protect against ovarian and endometrial cancer.
  • Can be used after an abortion.
  • Patches or vaginal rings don't require taking a daily pill.
  • Some birth control pills reduce symptoms of premenstrual dysphoric disorder (PMDD).
  • Does not protect against sexually transmitted infections or HIV.
  • May not be as effective when taken with certain medicines.
  • May delay return of normal cycles.
  • Pills must be taken every day.
  • Patches may not fully protect you from pregnancy if they are exposed to direct sun or high heat. This can release a high dose of hormone from the patch, which leaves less for the patch to release later in the week.
  • Patches deliver more estrogen than low-dose birth control pills do. Some research has found that women using the patch are more likely to get dangerous blood clots in the legs and lungs. The risk may be higher if you smoke or have certain health problems. Talk to your doctor about your risks before using the patch.
  • A small number of women have some mild to moderate skin irritation from the patch.

Progestin-only pills, implant, or shot

Pros and cons of progestin-only pills, implant, or shot

Pros

Cons

  • No interruption of foreplay or intercourse.
  • Fewer or no periods (especially with shot or implant).
  • Reduced cramps and pain during ovulation.
  • Shot reduces bleeding with periods, which lowers the risk of anemia.
  • Reduced risk of pelvic inflammatory disease.
  • Does not contain estrogen, so can be used by women who can't take estrogen.
  • May be used by women over 35 who are smokers.
  • Reduces risk of ectopic pregnancy.
  • May protect against endometrial and ovarian cancer.
  • Implant gives rapid return to fertility following removal.
  • Shot and implant are extremely effective.
  • Shot protects for about 3 months.
  • The implant works for 3 years. In some cases the implant can be used longer.footnote 1 Talk to your doctor about how long you can use it.
  • Shot reduces symptoms of endometriosis.
  • Shot reduces frequency of seizures in women who have a seizure disorder.
  • Shot reduces number of sickle cell crises in women who have sickle cell disease.
  • Shot or implant does not require taking a daily pill.
  • Does not protect against sexually transmitted infections or HIV.
  • Causes more irregular periods or spotting between periods.
  • May not be as effective when taken with certain medicines.
  • Makes diabetes more likely if you have had gestational diabetes during pregnancy.
  • Progestin-only pills are less effective than combination pills, but the shot and implant are extremely effective.
  • Pills must be taken at the same time each day.
  • Implant must be inserted and removed by a trained health professional.
  • Implant may cause headaches.
  • Shot may delay return of normal cycles for 6 to 8 months after the medicine is stopped. But there is no delay with pills or implant.
  • Shot causes slight weight gain.
  • Shot may decrease levels of HDL ("good") cholesterol.
  • Shot can cause reversible bone mineral loss.

Intrauterine devices (IUDs)

These advantages and disadvantages apply to both hormonal and non-hormonal IUDs.

Pros and cons of IUDs

Pros

Cons

  • Protects from pregnancy for 5 to 10 years, depending on the type. In some cases an IUD can be used longer. footnote 2 Talk to your doctor about how long you can use it.
  • Does not require interruption of foreplay or intercourse.
  • Does not require co-operation of sex partner.
  • More than 99% effective in preventing pregnancy.
  • It's easy to use.
  • Most cost-effective method of birth control over time.
  • Can be removed whenever you have problems or want to stop using it. Fertility returns with the first ovulation cycle following IUD removal.
  • Can be inserted after a normal vaginal delivery, a caesarean section, or a first-trimester abortion.
  • Hormonal IUD can relieve heavy menstrual bleeding and cramping in most women.
  • Does not provide protection against sexually transmitted infections or HIV.
  • Costs several hundred dollars for insertion. But this cost may be covered by your provincial health plan or private health insurance. And when an IUD is used long-term, it costs less than other methods over time.
  • Only a health professional can remove the IUD. Never try to remove the IUD yourself or allow a partner to try to remove it.

References

Citations

  1. Thaxton L, Lavelanet A (2019). Systematic review of efficacy with extending contraceptive implant duration. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 144(1): 2–8. DOI: 10.1002/ijgo.12696. Accessed December 7, 2022.
  2. Ti AJ, et al. (2020). Effectiveness and safety of extending intrauterine device duration: A systematic review. American Journal of Obstetrics and Gynecology, 223(1): 24–35.e3. DOI: 10.1016/j.ajog.2020.01.014. Accessed August 29, 2022.

Credits

Current as of: August 2, 2022

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine