Hormonal Birth Control Methods

illustrations of hormonal birth control methods

Hormonal birth control methods use one hormone (progestin) or two (estrogen and progestin) to prevent pregnancy. 

You take combined hormone methods (the pill, the patch, and the ring) every day, week, or month, and they may make your periods shorter, lighter, or make them come on a more regular schedule.

Progestin-only methods (the hormonal IUD, the implant, and the shot) last for years or months between insertions/shots, and may make your periods shorter, lighter, or take them away entirely, but won’t schedule when they come.

Learn more about hormonal methods by clicking the boxes below. 

The Pill

The birth control pill is a pill that a person who can get pregnant takes at approximately the same time each day. You take one pill each day for 3 weeks (21 days), then go 1 week (7 days) without hormone pills before starting a new pack. You usually get your period during the hormone-free week. Depending on the brand of pill there may be a week of placebo or sugar pills to take during the week without hormone pills if you want to stay in the habit of taking a pill every day. You can choose to skip the hormone-free week and immediately start the next pack of hormone pills to delay or skip periods.

Most pills contain 2 hormones (estrogen and progestin), which prevent the ovaries from releasing an egg (ovulation), thicken cervical mucus (making it difficult for sperm to swim through the cervix into the uterus), and thin the lining of the uterus so that it is harder for a fertilized egg to implant and become a pregnancy.  

The progestin-only pill (the mini-pill) is a type of birth control pill that only contains one hormone, progestin. It does not have a hormone-free week, placebo pills, or sugar pills. Instead, you take one pill at approximately the same time every day for the entire 28-day pack, then start a new pack the day after you finish the last one. Because of this, it doesn’t regulate or schedule your period and you may have irregular periods or no periods at all while you use it.

Things to consider:

  • It can make periods lighter, shorter, more regular, and reduce cramps.
  • It can reduce acne.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • There are lots of brands to choose from so you can switch between them if you need to (like if you have side effects you don’t like with one brand).
  • You need a prescription to use the pill. 
  • You may have side effects.
  • Taking it at the same time every day can be difficult or inconvenient.
  • It does not reduce the chance of getting or passing STIs.
  • Some other health concerns can make serious side effects of estrogen more likely.

Effectiveness

The pill is 99.7% effective with perfect use and 92% effective with typical use. Perfect use means taking it exactly as directed all the time. Typical use is the average effectiveness for people who use it taking into account that some people start and stop using it, miss pills, or otherwise don’t use it as directed. 

Did you miss a pill? Visit the “Stay on Schedule” tool for options on what to do next.  

The Patch

The birth control patch is a thin, square patch (similar to a patch used to quit smoking) that a person who can get pregnant sticks on the skin of their butt cheek, abdomen, back, or shoulder. You wear the patch for 1 week at a time for 3 weeks (21 days), then go 1 week (7 days) without a patch before starting a new pack. You usually get your period during the patch-free week. You can choose to skip the hormone-free week and  immediately start the next cycle of patches to delay or skip periods.

The patch contains 2 hormones (estrogen and progestin), which prevent the ovaries from releasing an egg (ovulation), thicken cervical mucus (making it difficult for sperm to swim through the cervix into the uterus), and thin the lining of the uterus so that it is harder for a fertilized egg to implant and become a pregnancy. 

Things to consider:

  • You only have to remember to change the patch once a week. 
  • It can make periods lighter, shorter, more regular, and reduce cramps.
  • It can reduce acne.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • You need a prescription to use the patch. 
  • You may have side effects.
  • It does not reduce the chance of getting or passing STIs.
  • Some other health concerns can make serious side effects of estrogen more likely.  
  • It only comes in one colour and doesn’t match everyone’s skin.
  • The patch may be less effective if you weigh more than 190 pounds. 

Effectiveness

The patch is 99.7% effective with perfect use and 92% effective with typical use. Perfect use means taking it exactly as directed all the time. Typical use is the average effectiveness for people who use it taking into account that some people start and stop using it, forget to change it on time, or otherwise don’t use it as directed. 

Did your patch fall off too early or did you wear it longer than scheduled? Visit the “Stay on Schedule" tool for options on what to do next.

The Ring (Nuva Ring)

The ring is a small, flexible, transparent ring that a person who can get pregnant inserts into their vagina*. You leave it in for three weeks (21 days), then remove it and go 1 week (7 days) without a ring before starting a new ring. You usually get your period during the ring-free week. A new ring is then inserted for the next three-week cycle. You can choose to leave the ring in a full four weeks, skip the hormone-free week, and immediately start the next ring to delay or skip periods. If the ring comes out or you take it out while it is scheduled to be in, it is still effective as long as you put it back in within 3 hours.

The ring contains 2 hormones (estrogen and progestin), which prevent the ovaries from releasing an egg (ovulation), thicken cervical mucus (making it difficult for sperm to swim through the cervix into the uterus), and thin the lining of the uterus so that it is harder for a fertilized egg to implant and become a pregnancy. 

Things to consider:

  • You only have to remember to change the ring once every 4 weeks. 
  • Because it has a lower dose of hormones than some hormonal birth control, you may be less likely to have hormonal side effects.
  • It can make periods lighter, shorter, more regular, and reduce cramps
  • It can reduce acne.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • You need a prescription to use the ring. 
  • You may have side effects.
  • It does not reduce the chance of getting or passing STIs.
  • Some other health concerns can make serious side effects of estrogen more likely.  

Effectiveness

The ring is 99.7% effective with perfect use and 92% effective with typical use. Perfect use means taking it exactly as directed all the time. Typical use is the average effectiveness for people who use it taking into account that some people start and stop using it, forget to change it on time, or otherwise don’t use it as directed. 

Did you forget to insert a new ring on time, or leave one in longer than scheduled? Visit the “Stay on Schedule” tool for options on what to do next.

The Hormonal IUD (IUS)

The hormonal IUD (intrauterine device) or IUS (intrauterine system) is a small device that a health care provider inserts into the uterus of a person who can get pregnant. You can have it removed any time. It is effective for up to 5 years, with new studies showing that some models can be effective up to 7 years (if inserted after age 25). 

The IUD being inside the uterus changes the chemistry of the uterus to be unfriendly to sperm. The hormonal IUD also contains one hormone, progestin, that thickens cervical mucus to make it difficult for sperm to swim through the cervix into the uterus and thins the lining of the uterus so that it is harder for a fertilized egg to implant and become a pregnancy.

Things to consider

  • Once it is in place, you don’t have to do anything to make it work for several years. 
  • If you can’t use birth control that contains estrogen, you may still be able to use it.
  • Your periods may be lighter, shorter, less painful, or you might not have periods at all while you use it.
  • Because it has the lowest dose of hormones of any hormonal birth control, you may be less likely to have hormonal side effects.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • You need a prescription for the IUD and a health care provider needs to insert it.
  • The insertion process can feel invasive and is usually painful.
  • You may have side effects.
  • You may not be comfortable with the possibility of not having periods. 
  • It does not reduce the chance of getting or passing STIs.
  • It can be more expensive all at once than other methods.

Effectiveness

The hormonal IUD is 99.4 to 99.9% effective depending on the model. Because you do not need to do anything to make it work once it is inserted, perfect use and typical use are the same.

The Implant (Nexplanon)

The implant is a small (4cm) plastic rod that a health care provider implants under the skin of the upper arm of a person who can get pregnant. You can have it removed any time. It is effective up to 3 years, with some studies showing it can be effective up to 5 years (if inserted after age 25). 

It contains one hormone, progestin, that prevents the ovaries from releasing an egg (ovulation) and thickens cervical mucus to make it difficult for sperm to swim through the cervix into the uterus.

Things to consider

  • Once it is in place, you don’t have to do anything to make it work for several years.
  • If you can’t use birth control that contains estrogen, you may still be able to use it. 
  • Your periods may be lighter, shorter, less painful, or you might not have periods at all, or they may be longer, heavier, or irregular while you use it.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • You need a prescription for the implant and a health care provider needs to insert it. 
  • The insertion process involves a device like a large needle and piercing the skin of your arm.
  • You may not be comfortable with the possibility of not having periods or you may have periods that are irregular, longer, or heavier.
  • You may have side effects.
  • You need a health care provider who is trained on removing the implant to take it out.
  • It does not reduce the chance of getting or passing STIs.
  • It can be more expensive all at once than other methods.

Effectiveness

The implant is 99.95% effective. Because you do not need to do anything to make it work once it is inserted, perfect use and typical use are the same.

The Shot (Depo Provera)

The birth control shot is an injection a person who can get pregnant gets in their arm or buttcheek once every 3 months (12-13 weeks). It contains one hormone, progestin, that prevents the ovaries from releasing an egg (ovulation), thickens cervical mucus to make it difficult for sperm to swim through the cervix into the uterus, and thins the lining of the uterus so that it is harder for a fertilized egg to implant and become a pregnancy.

Things to consider

  • You only need to do something once every 12-13 weeks. 
  • If you can’t use birth control that contains estrogen, you may still be able to use it.
  • Your periods may be lighter, shorter, less painful, or you might not have periods at all while you use it.
  • It allows the person who can get pregnant to be fully in control of birth control.
  • You need a prescription to use the shot and a health care provider to do the injection.
  • Some people may take longer to start releasing eggs again after stopping the shot than after stopping other birth control methods.
  • You may not be comfortable with the possibility of not having periods, or you may have periods that are irregular.
  • You may have side effects.
  • If you have side effects, you can’t stop the shot quickly to get rid of them, because the effects of the shot last for 3 months.
  • The shot can cause decreases in bone mineral density. 
  • It does not reduce the chance of getting or passing STIs.

Effectiveness 

The shot is 99.7% effective with perfect use and 92% effective with typical use. Perfect use means taking it exactly as directed all the time. Typical use is the average effectiveness for people who use it, taking into account that you can miss shots, get them late, or otherwise not use it as directed.

Has it been 14 or more weeks since your last shot? Visit the “Stay on Schedule” tool for options on what to do next.

*Not everyone uses these words for their body parts or relates to them in the same way. We have used these words as they are commonly known and encourage you to use the language that feels best for you.

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