Hormone Birth Control Facts

Answering Your Hormone Birth Control FAQs

It amazes me how often I receive questions and emails about hormone birth control. Some of you are concerned about side effects while others just want to understand what hormones are used in these methods. In any case, it is clear that many of you want to know all the facts about hormone birth control. To help you all sort through this information, I have created this page that contains many of your questions. This page will also be included as part of my birth control FAQs section -- a place on my site where you can hopefully find the answers to all of your questions about contraception. Since I will post additional questions that I receive to this page, it will serve as a “living document.” If you find yourself wondering about hormone birth control and can’t seem to find a good answer to satisfy you, please email me. Your question can end up right here!

Some Addition Resources About Hormone Birth Control:

Here Are Answers to Some of Your Questions:


Hormone Birth Control Facts
The Pill and Acne. Lea Paterson/Science Photo Library/Getty Images

Some hormone birth control methods, in addition to being highly effective contraceptives, can actually provide additional non-contraceptive benefits. Certain combination birth control pills have been very successful at treating acne. In some cases, the Ortho Evra Patch has also helped control acne breakouts.

Since there are so many myths about the pill floating around, it is important that you understand this method before you choose to use it. As with any medication, not all women will react the same way when using the pill. That being said, it is a popular option given its effectiveness as well as its potential additional benefits.



Progestin Types. Photo © 2009 Dawn Stacey

There are eight types of progestin that can be found in combination birth control pills. The blend of estrogen amount with each progestin type can affect your body chemistry differently. The variations in estrogen/progestin combinations may also offer slightly different benefits and/or side effects.

It is difficult to compare pill brands because they may use different types and strengths of progestin. So, even if two brands have the same type of progestin, they have different amounts. Due to this, the potency of each pill can widely vary.

Having some knowledge about progestin differences as well as about estrogenic effects (level of estrogen activity), androgenic effects (the progestin’s potential to cause side effects) and progestational selectivity (how the progestin fuels progesterone receptors) may help you and your doctor choose the best pill brand for you. Understanding how progestin and estrogen combinations work may help to minimize specific side effects by switching to or initially choosing a particular pill brand.



Photo Courtesy of Microsoft Office

This is one of the questions I am asked all the time. Women want to know the truth - does using Depo Provera cause weight gain?

Though you may not want to hear it, weight gain is commonly cited as a reason why many women stop their Depo use. Research shows that Depo Provera use is linked to significant weight gain, but the actual degree of weight increase can depend on how long you have used the product. The longer you use it, the more weight you may gain. Clinical trials report that you could expect a weight gain of about five pounds during the first year of use, and this could go up higher with each subsequent year.



Photo Courtesy of Microsoft Office

To answer this question, you need to know a little bit about ethinyl estradiol. Your birth control pill contains ethinyl estradiol -- a manmade form of estrogen. Your body (more specifically, your liver) has the ability to break down ethinyl estradiol very quickly. Because this hormone is metabolized very fast, you need to add more of it into your body every day to ensure that there is enough estrogen to stop your body from ovulating. When you forget to take a pill, the pill’s effectiveness can be compromised because there may not be enough ethinyl estradiol in your system. Generally speaking, most birth control pills have about a 1- to 2-hour window period where effectiveness is not lowered. This means that although you should strive to take your pill at the same time each day, you have about a 1-2 hour grace period (so, if you normally take your pill at 8:00 PM, you can realistically take it anywhere between 6:00 PM until 10:00 PM). Keep this in mind when traveling between time zones as well as during time changes.



Mirena IUD. Photo Courtesy of J. James

Unfortunately, poorly conducted IUD studies from the 1970s and 1980s have led many women to come to this erroneous conclusion that IUD use increases your risk of infertility or pelvic inflammatory disease (PID). These studies were not properly carried out, and their claims do not appear to be true. In fact, present-day research reveals that IUD use (whether in the past or current) is not related to an increased risk of tubal blockage (one of the common causes of infertility). Studies also show that PID occurrence in women using IUDs is extremely low and is similar to PID incidence in the general population. The Mirena IUD may actually lower your PID risk.

The World Health Organization backs up this research -- its official stance is that there’s no increased risk of infertility among IUD users who are in stable, monogamous relationships. That being said, it is thought that infertility (due to tubal blockage) can be a result from an untreated sexually transmitted infection. So remember, IUDs don’t protect against STDs. If you have several sexual partners or do not know the sexual history/health status of your current partner, in addition to your IUD, it may be a good idea to use condoms to protect yourself from contracting an STD.



Yaz. Photo Courtesy of DELC

The answer to this question is maybe. Yaz is a newer birth control pill brand and is different from other pills because it contains the progestin drospirenone. Whether or not Yaz is the best pill for you depends on your health history. Drospirenone suppresses the hormones that regulate your body's water and electrolytes, so it can cause higher potassium levels. This means that if you have liver, kidney, or adrenal disease or take medications that increase or retain potassium levels, Yaz may not be for you.

I have also received many questions (fueled by media announcements of Yaz lawsuits) about the safety of Yaz (and Beyaz) with respect to blood clot risk. The FDA has responded to these concerns by announcing that pills containing drospirenone may be linked to a higher blood clot risk than birth control pills that contain other progestins. The FDA is also requiring new labeling for drospirenone-containing pills. With that being said, it is important to point out that research is mixed about this increased risk -- some studies have found up to a three-fold increase in blood clot risk while others have found no additional risk. You should also know that you increase your blood clot risk with the use of any birth control pill, yet this risk is still lower than the risk of developing blood clots during pregnancy and after giving birth.

Yaz may offer you some benefits worth thinking about. It has been FDA-approved to help treat the physical and psychological symptoms of PMDD as well as moderate acne. So, overall, you should be aware of all the information surrounding the use of Yaz. The possible increased risk of developing blood clots is still relatively low... especially if you are (medically) a good fit for this pill. With the help of your doctor, discuss the pros and cons of using Yaz as this may help you to decide if the benefits of Yaz use outweigh the risks.



Pill Brand to Stop Spotting
Stop Spotting on the Pill. Photo © 2014 Dawn Stacey

Breakthrough bleeding on the pill can be caused by several things. The most common reason you may spot on the pill is because your body is adjusting to the hormone levels. You can also experience breakthrough bleeding if you miss a pill (or two or three), if you use the pill to skip your period, if you smoke while using the pill, or if you are using a continuous cycle pill brand. If you are still having breakthrough bleeding, it may be time to talk to your doctor to determine if there is a pill brand, with a different estrogen/progestin combination, that may be less likely to cause this side effect.