FAQs About Hormonal Birth Control

How do birth controls with artificial hormones work?

Hormonal forms of birth control contain artificial estrogen and/or progestin to mimic the hormones your body produces. Your body then responds to these increased levels of hormones in different ways, all of which can prevent a pregnancy. The main way in which these forms of contraception are designed to work is by suppressing ovulation. The extra hormones also work to thicken your cervical mucus thereby creating a hostile environment for sperm. Both of these methods help to prevent fertilization. If the other two methods fail and an egg were to be fertilized, then the Pill may work to thin the uterine lining thereby blocking the implantation of a fertilized egg.

Is it necessary to use another form of birth control with hormonal contraceptives?
The birth control pill, Implanon (implant), and Depo-Provera (injection) are thought to be effective right away so long as you start them on the first day of your period. However, it can take as much as seven days before they are fully effective. While most women aren’t fertile during this time anyway, you may want to use an additional form of birth control, like the sponge, just in case. You will need to use another form of birth control for the first week if you start one of these methods on any day other than the first day of your period. Some doctors may also recommend that women on the birth control pill use an additional form of birth control for the whole first month.

Women who are using the mini-pill will need an additional form of birth control for the first cycle (28 days). Moreover, none of these forms of birth control protect against sexually transmitted diseases (STDs). Using a condom will help to prevent the transmission of many STDs as well as offer you extra protection against pregnancy.

After I go off my hormonal contraceptives, how long should I wait before I try to conceive?
It can take a while for a woman’s body to adjust back to a normal menstrual cycle when she has stopped taking hormonal forms of birth control. While some women may return to a normal menstrual cycle right away, others can take as long as a year. If you want to try to conceive, it may be a good idea to first wait until you’ve had two to three normal menstrual cycles. This will give your body time to adjust to life without the extra hormones, making it better able to deal with a pregnancy.

I no longer use birth control. Why am I having troubles conceiving?
Even though you are no longer taking hormonal birth control, the hormones may still have an effect on your body. Many women go through a temporary period of infertility after going off the contraception. On average, women using combination oral contraceptives tend to be infertile for two to three months after discontinuing the Pill while women who used Depo-Provera are usually infertile for six to 12 months after stopping. It is possible that you may not have any periods during this time.

Why have my periods stopped?
It is not uncommon for women who use the birth control pill to miss a period, especially for those taking progestin-only pills. If you have taken all of your pills, then there is a minimal risk of being pregnant, although it is still a good idea to take a pregnancy test to make sure. If you have missed a pill or missed two periods in a row, then there is a greater chance that you could be pregnant. Again, take a pregnancy test to confirm whether or not you’re pregnant.

Women using Depo-Provera are much more likely to have their periods stop. In fact, half of all women using this form of birth control stop getting their periods during the first year of use. Additionally, common side effects of Depo-Provera include weight gain, tender breasts and mild headaches, although these will disappear over time. Since these are also common pregnancy symptoms, it can be confusing for Depo-Provera users. If you think you might be pregnant, though, it doesn’t hurt to take a pregnancy test.

Even if you have gone off Depo-Provera or some other form of hormonal contraceptive, it can still take as long as a year before your periods return and are normal again.

I am using the combination birth control pill and didn’t get my period this month. How can I tell if I’m pregnant?
It is not unusual for combination pill users to miss a period. However, if you think there is a chance that you might be pregnant, then buy a home pregnancy test or make an appointment with your health care provider or pregnancy resource center for a pregnancy test after you miss your period.

I forgot to take my pill. What do I do?
Women taking combination birth control pills should take the missed pill as soon as they remember and then take the next pill as they normally would. In some cases, this means taking two pills on the same day. Although the risk of pregnancy is minimal, it is still a good idea to use a back-up method of birth control, such as the sponge, for the next seven days. If the forgotten pill occurred during day 15 to 21 of your pill cycle, then check with your doctor for special instructions. In some cases, you may be advised to skip the pill-free/ sugar pill week and just start a new package as soon as you finish your current set of hormonal pills.

Women using progestin only oral contraceptives should take the forgotten pill as soon as they remember and then take the next pill as they normally would. In some cases, this may mean that you take two pills on the same day. You will need to use a back-up method of birth control for the next two days.

I forgot to take two or more pills. What do I do?
If you have forgotten two pills, then take them as soon as you remember. You will need to use an additional method of birth control for the remainder of your cycle. If you miss your period, take a pregnancy test.

If you miss three or more pills, contact your health care provider for instructions. Depending on the type of pills you use, it may be necessary for you to discard this pack and start a new one or to double up on your pills.

Will the effectiveness of my birth control pill be affected if I vomit?
Vomiting within two hours of taking the pill will require you to take a replacement pill. You may also want contact your health care provider for any special instructions you may need. If you took your pill two hours or more before you vomited, then it is unlikely that you will need a replacement pill. You may want to contact your health care provider anyway in case there are special instructions.

Can I use the birth control pill to change the date my period comes?
It is possible to use oral contraceptives to alter the date of your period. However, it is best to talk with your health care provider first as this practice can reduce the efficiency of the Pill.

There are some types of birth control pill that allows a woman to only get her period less frequently, i.e. four times a year. These pills have longer stretches where you take the hormonal pill and fewer intervals without any pills.

Why have I been spotting and having irregular bleeding?
Birth control pill users, especially new users, often experience spotting halfway through their cycle. Increasing the strength of your oral contraceptives can stop this from happening. Additionally, spotting may be a sign that your pills are not as effective as they should be, therefore you should use an additional method of birth control when you have spotting. However, spotting is also a symptom of chlamydia, a sexually transmitted disease. If you think you are at risk for an STD, make an appointment with your health care provider to get tested.

Implanon and Depo-Provera users often have irregular menstrual patterns. No periods, light periods and prolonged or heavy periods are all normal side effects of these hormonal birth control methods. However, women experiencing prolonged or heavy bleeding should bring the issue to the attention of their health care provider.

Is it still possible for me to be pregnant if I take my pill every day?
Yes. While perfect use of the Pill has shown to be highly effective in preventing pregnancy, no method is 100% effective. Additionally, missing a pill or taking a pill a few hours later than normal, especially if you use the mini-pill, can decrease the effectiveness of your oral contraceptives. Moreover, certain medications including antibiotics can increase the likelihood of your contraceptives failing.

I didn’t know that I was pregnant and continued taking my pills. Will the hormones hurt my baby?
Although there is no conclusive evidence that a brief exposure to the artificial hormones contained in hormonal birth controls will cause harm to an unborn child, it is generally advised that you stop using this type of birth control if a pregnancy is suspected. Find more information on birth control pills and their effects on pregnancy at this Oral Contraceptives and Pregnancy page.

Is there anyone who shouldn’t use hormonal methods of birth control?
Not all women are suited to hormonal forms of birth control. If any of the following conditions apply to you, you may not be able to use this type of contraceptives:

  • You are, or suspect you are pregnant
  • Are breastfeeding and/or are less than 6 weeks postpartum
  • Have unexplained vaginal bleeding
  • Have active liver disease or a history of liver tumors
  • Are over the age of 35
  • Smoke
  • Have a history of heart disease, stroke, high blood pressure or some other condition that puts you at risk of a heart attack
  • Have a history of blood clotting problems
  • Have diabetes
  • Have breast cancer, history of breast cancer or an abnormal growth in the breast
  • Have cancer or a history of cancer of any reproductive organs
  • Have migraines or focal neurologic symptoms
  • Have a moral objection to hormonal methods of birth control

Are there any side effects or health complications associated with hormonal birth control?
There are a number of side effects and potential health risks associated with the use of hormonal contraceptives.

  •  Side Effects and Health Risks for Hormonal Contraception
    • Weight gain
    • Increase or decrease in acne
    • Nausea and vomiting (particularly for the first few cycles)
    • Dizziness
    • Headaches
    • Depression
    • Vaginal infections
    • High blood pressure
    • Loss of libido
    • Blood clots in legs, lungs, heart or brain
    • Stroke
    • Liver tumors (rare)
    • Heart attacks
    • Gallstones (rare)
    • Jaundice (rare)
    • Possibly cervical cancer
    • Spotting and irregular vaginal bleeding
    • Longer periods
    • Amenorrhea for extend periods
    • Headaches
    • Anxiety and nervousness
    • Pain in lower abdominals
    • Dizziness
    • Loss of libido
    • Clinical Depression
    • Increase or decrease in acne
    • Skin rash or darkened patches of skin
    • Appetite changes
    • Weight gain
    • Tender breasts
    • Increase or decrease in facial and body hair
    • Possibly hair loss
    • Vaginal discharge
    • Bone density loss
    • Enlarged ovarian follicles
    • Pain or itching (usually for a brief period of time)
    • Implanon users: infection at the site of implantation
    • Ectopic pregnancy
    • Certain cancers

How much weight is it normal to gain when I use a hormonal method of birth control?
While weight gain is a very common side effect of hormonal methods of birth control, how much a woman will gain tends to vary. Weight gain is due to an increase in appetite and easier fat deposition as a result of the increase in hormones. On average, women who use Depo-Provera tend to gain 5.4lbs during the first year of use and 8.1lbs after two years (it is not recommended to use Depo-Provera for more than two years). Women who use the birth control pill gain, on average, about 10lbs during the first year of use. However, these are only averages; some women may gain more while others may not gain any weight at all.

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