Hormonal contraception
Hormones affect your body, how you feel and your cycle. Some women tolerate hormone preparations better than others. That is why it is important to discuss with your doctor which preparation suits you best.
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In this blog you can read about the different choices you can make if you opt for hormonal contraception.
Hormones and the composition of combination preparations
The most commonly used methods of contraception contain hormones. The hormones used for this are estrogen and progesterone.
Pills that contain both hormones are called combination preparations. This is what is usually meant by "the pill", but also for example the Nuvaring is a combination preparation.
The function of the hormones is that the estrogen hormone ensures that you have a predictable menstruation. The progestogen ensures that you do not get pregnant. That is why there are pills with only progesterone, but not with only estrogen.
The composition of the combination preparations differs:
- The dosage of estrogen can vary (20, 30 or 50 micrograms of estradiol);
- The type of progesterone may vary (there are many different types, including levonorgestrel, desogestrel or norethisterone);
- The pills can have the same composition throughout the cycle (monophasic preparations) or change in composition during the cycle (triphasic preparations). The aim of a multiphasic pill is to imitate the woman's normal cycle as closely as possible;
- The type of estrogen can vary: Synthetic estrogen (ethinylestradiol, this is in most types of pills). Or natural estrogen (estradiol, this is in Qlaira and Zoely).
The stop week
Most pills have 21 pills per strip. You take these for 3 weeks and then you have a stop week. In the stop week you have your period. Some pills have 24 tablets or 28 tablets with a number of placebo tablets in the strip.
With the combination pill you can also skip your stop week and therefore your period by starting the next strip immediately after the previous strip. You can also postpone the stop week.
If you choose contraception with only progesterone (Mirena, Cerazette, Implanon, injection) then it is good to know that you cannot influence the timing of your period yourself because you cannot skip, shift or postpone a stop week. In addition, your period can change or even stop altogether. Some women suffer from irregular bleeding (spotting) which can occur very frequently in some cases.
Thrombosis and side effects
The main risk when using a combination preparation is the risk of thrombosis. The preference is therefore always for a pill with a low dose of estrogen. Then the chance of thrombosis is as small as possible.
The most common side effects of estrogens are headaches, breast tenderness and nausea. If you suffer a lot from these, you can choose a low-dose preparation (for example microgynon 20, Yaz, Yasmin, Nuvaring, Mercilon). Or you can choose a preparation with only progesterone (Mirena, mini pill or Cerazette, Implanon, injection pill).
The most common side effects of progesterone are irregular bleeding, headache, nausea, acne, mood swings.
Different hormonal contraceptive forms
There are also several other ways in which you can use contraception:
- Oral (pill that you have to swallow)
- Vaginal (Nuvaring)
- Hormonal coil (Mirena)
- Dermal (contraceptive patch, Evra)
- Subcutaneous (contraceptive implant, Implanon)
Forgot the pill
You can sometimes forget to take the pill. If you remember to take it within 12 hours, there is no problem. After that, it depends on the moment in your cycle whether you can still rely on it or not. In general, the more often you forget to take the pill, the greater the chance that the pill becomes unreliable. If you have trouble remembering to take the pill, you may be better off choosing a contraceptive method that you do not have to take every day.
You should also remember that the pill is less reliable if you have to vomit, have diarrhea and in combination with certain medications.
If you are unable to find a solution, it may be advisable to discuss the options with your doctor so that you can ultimately make the best choice.
What can we do for you?
Women's Healthcare Center provides expert care and support for women. Our team of specialisten will do everything they can to help you get the right diagnosis and find the best treatment options.
