Progestin-Only Birth Control Methods

No Estrogen Contraception

Why Use Progestin-Only Birth Control?

Progestin-only birth control are contraceptive methods that only contain the hormone progestin -- this means that they do not have any estrogen. These methods are a good alternative if you want to use a hormonal birth control method, but you can not use a combination contraceptive. Progestin-only methods tend to be safer options if you:

Who Can Use Progestin-Only Birth Control?

Progestin-only birth control can be used by most women without any problems. These methods are also a good option for:

Advantages and Disadvantages of Progestin-Only Birth Control:

Typically, hormonal birth control (including progestin-only birth control) tends to be more effective than other types of contraception (like condoms, diaphragms, or natural methods). If you want to use progestin-only birth control, you will need to make an appointment with your doctor -- these are considered to be prescription methods, so they cannot be bought over the counter. Progestin-only birth control methods are also reversible. This means that you can become pregnant after stopping them. Just keep in mind that with Depo Provera -- it may take up to a year (or more) to regain fertility after your last Depo Provera injection. Also, as with any hormonal contraceptive, you may experience certain side effects if you use progestin-only birth control.

Progestin-Only Birth Control Methods:

There are six types of progestin-only birth control methods available. These include:

1
Progestin-Only Birth Control Pills:

Progestin-Only Birth Control Pills
Progestin-Only Birth Control Pills. Photo Courtesy of R. Pelton

Progestin-only birth control pills (also known as the mini-pill or POPs) are a type of birth control pill that does not contain any estrogen. Progestin-only pills are only come in 28-day packs -- so you have to take one of these pills every day for each 4-week cycle. All 28 pills contain progestin -- there are no placebo pills.

  • The mini-pill only comes in one progestin formulation (but is sold under different names) in the United States: norethindrone (.35 mg).

2
Depo Provera:

depo_provera.jpg
Depo Provera. Photo © 2014 Dawn Stacey

Depo Provera is a birth control shot. Each depo injection slowly releases the progestin medroxyprogesterone acetate and will give you pregnancy protection for 11 to 14 weeks. So, if you use Depo Provera, you will receive 4 injections each year. Depo Provera injections also offer the added non-contraceptive benefit of being able to help lower the pain associated with endometriosis. That being said, if you are going to use Depo Provera, you should consider the following:

3
Mirena IUD:

mirena_IUD.jpg
Mirena IUD. Photo © Dawn Stacey

The Mirena IUD is a small, T-shaped, flexible device. After it has been inserted, it continuously releases a small amount of progestin over a 5 year period. Because Mirena has progestin, it is a little more effective than the ParaGard IUD. The Mirena IUD has strings that hang down through your cervix into your vagina. The strings can allow for you to check that the IUD is still in place. Your doctor can also use the strings to remove your Mirena -- which needs to happen after 5 years or any time before you have reached the 5-year time limit. The Mirena IUD has also been FDA-approved to help treat heavy periods.

4
Nexplanon:

Nexplanon. Photo Courtesy of Merck

Nexplanon is an implant -- it is the newer version of Implanon. This is  a progestin-only birth control implant that contains 68 mg of the progestin, etonogestrel. It consists of a thin, flexible plastic implant about the size of a matchstick. Nexplanon is inserted under the skin in the arm -- once inserted, it provides you with pregnancy protection for up to 3 years. Nexplanon is radiopaque (this means that it can be seen in an x-ray -- so your doctor can make sure it has been properly placed). Insertion requires a local anesthetic and only takes a few minutes. The progestin-only implant should be removed after 3 years -- or anytime before you reach the 3 year limit.

5
Skyla Progestin-Only IUD:

Skyla Progestin-Only IUD
Skyla Progestin-Only IUD. Photo © Dawn Stacey

Skyla is another IUD option. It is a little bit smaller than Mirena and ParaGard, so it may be easier to insert. The Skyla IUD must be inserted by a qualified doctor. It slowly releases the progestin, levonorgestrel, over a 3-year period as a way to prevent pregnancy. Like IUDs and Nexplanon, Skyla is considered to be an effective long-term reversible contraceptive.

6
Noristerat Injection:

Noristerat Injection
Noristerat Injection. Photo © Dawn Stacey

The noristerat injection is a reversible method of prescription birth control. It is not available in the United States, but is common in the United Kingdom, Europe, Africa, and Central America. This progestin-only birth control injection contains the synthetic progestin norethisterone enantate. The noristerat injection is designed to be a short-term birth control method -- women usually choose this option when being immunized against rubella or while waiting for their partner's vasectomy to become effective. The noristerat injection will continuously release progestin into your bloodstream over a period of eight weeks -- so it provides pregnancy protection for up to two months.

Source:

Shoupe D (editor). "Contraception." 2011. Oxford, UK: Wiley-Blackwell.

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