The Pros and Cons of Hormonal Contraceptives

A hormonal contraceptive pack against a geometric yellow and pink background.

Whether you’re a newlywed or a newlywed-to-be, contraceptives are important to think about if you’re not quite ready to have kids. Although the ubiquitous condom is a go-to pregnancy prevention for many couples, another common option are hormonal contraceptives—such as “the pill.” The choice of what contraceptive to use should be a decision made by both people in the relationship. Broach the subject with your husband to figure out what’s best for your situation. If you’re new to hormonal contraceptives, it’s a good idea to examine the pros and cons of the most utilized options. That way, you can make a better decision as to what’s most suitable for you and your marriage.

What Types of Hormonal Contraceptives Are Available?

While the pill is the most common choice for women, there are other options available that may require less daily discipline. That alone can be a key factor in what method you choose. Aside from the pill, which itself has two different forms, hormonal contraceptives come as an intrauterine device (IUD), injection, sub-dermal implant, vaginal ring, and patch.

What Are the Pros and Cons of Each Contraceptive Method?

With hormonal contraceptives, some pros and cons are shared across the board as hormones themselves have both benefits and downsides. For example, taking hormonal contraceptives can lessen the flow of your period (or eliminate it altogether), improve acne, reduce the risk of several cancers and illnesses, and even improve PMS and menstrual cramps. Specifically, hormonal methods can lower the risk of ovarian and uterine cancers, pelvic inflammatory disease, ovarian cysts, endometriosis, and iron-deficiency anemia. However, they can raise the risk of breast cancer in certain individuals and may be dangerous for anyone at a higher risk for blood clots and liver disease. One other benefit is that hormonal contraceptives allow you to be more spontaneous when getting busy. (For example, there is no need to pause during foreplay to search for a condom.)

On the downside, hormonal contraceptives are known to cause weight gain, namely because they tend to increase your appetite. However, more modern methods have less of this side effect, which can also be managed by eating healthier and upping your exercise. Another problem some experience is melasma (AKA, hyperpigmentation in patches around the face), but that may sometimes be resolved with the care of a dermatologist. Finally, it’s worth noting that hormonal contraceptives do not protect you from STDs (sexually transmitted diseases) but if you’re in a monogamous relationship, that may not be an issue.

But let’s examine the pros and cons of the individual methods as well:

The Pill

Pros: The pill comes in two forms—a combination pill (estrogen and progesterone) and a minipill (progesterone only). Both are quite easy to acquire, although you may need a prescription. The pill is often used as an off-script method to help regulate periods and menstrual flow, lessen the severity of menstrual cramps, and improve acne.

Cons: Requires discipline as it needs to be taken daily at nearly the same time. It can also become less effective when taken with certain food and/or medication such as grapefruit juice and St. John’s Wort. Some users also experience nausea, but that can be alleviated by taking the pill with food. Women over the age of 35, especially if they smoke, are often not recommended to take the pill, as it raises the risk of blood clots. However, the minipill version tends to be more suitable for these cases or anyone who is not able to take estrogen.

IUD

An IUD against a pink background.

Pros: If successfully implanted in the uterus, this small T-shaped device is one of the most least-demanding contraceptive methods as it can remain there for five to ten years. It is also one of the few methods that immediately protects you from pregnancy, whereas other means can take up to a week to become effective. And if you are not keen on hormones, an IUD is available in a copper version, which is hormone-free.

Cons: You need a doctor’s appointment to insert it, the process of which can be slightly painful. But after that, you don’t have to worry about it aside from checking once a month to make sure it’s still in place and hasn’t fallen out (you can do this yourself at home). Although IUDs tend to lessen period flow in most users, it can do the opposite as well.

Hormonal Implant

Pros: Implants are also a very low-maintenance pregnancy prevention method as they can be left alone for three years once inserted under your skin. Like other methods, the hormonal implant can help regulate your period, PMS, and reduce the risk of certain health issues.

Cons: Aside from all the regular hormonal contraceptive downsides such as mood swings and weight gain, the main one here is that it’s mildly invasive, especially if you’re not a fan of needles. But don’t worry—it’s not as scary as it sounds. The implant is a tiny rod that is rapidly injected subdermally by a doctor and is not too unpleasant.

Hormonal Patch

A woman putting her hormonal patch on.

Pros: Similar to a nicotine patch one would use to stop smoking, the hormonal contraceptive patch is easy to use and is noninvasive. Each patch lasts around one week, so you only need a bit of discipline (as compared to taking a pill every day).

Cons: If exposed to the sun or heat, the patch can release more estrogen than necessary, which can cause side effects and increase the risk of certain illnesses. And since there is a certain amount of hormones per patch, this will also make it less effective. Therefore, if you’re a fan of the tanning salon or the sauna, or live in a hot climate, this may not be the best option for you.

Hormonal Injection

Pros: Injections are also rather low-fuss, as they need to be repeated only once every three months. Many users tend to experience amenorrhea (loss of menstruation) which to some is a benefit.

Cons: Again, if you’re not a fan of needles, this may not be for you. It is also worth noting that while with extended use periods tend to lessen, you may experience irregular bleeding during the first three to six months.

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