We have all heard of the birth control pill, right? And many of you women out there probably take some form of birth control. But do you really understand how it works or what the different options are? Learn about the basics of hormonal contraceptives in this lesson.

Female Reproductive System

Okay, so we have all heard of ‘The Pill’, the most popular form of contraception for women. But do you know how the pill works? Or why it works? What do you really know about this tiny little pill that many women take every day? And what other options are there in addition to the pill?

Well, the pill, and similar methods of contraception, all work by affecting the hormones that run the female reproductive system. You know, that system that causes all those crazy changes you go through during puberty? Those awkward stages of breast development, the onset of your period (or more properly referred to as your menstrual cycle), and of course, who can forget teenage acne!

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Because they affect the hormones, these methods are called Hormonal Forms of Contraception, and they alter the levels of the female hormones, estrogen and progesterone, to prevent fertilization and pregnancy.

So, what are Hormones? Simply put, they are like the messengers of your body. They help one organ or tissue communicate with another by relaying signals. They are like the text messages of the body, but instead of traveling through cyberspace, they travel through the bloodstream.

For example, reproduction in females involves a lot of different steps. First, there is the recruitment of an egg each month from the female’s ovary.

Then, there is the maturation and growth of that egg, and then release of the mature egg from the ovary so that it can begin its trek down to the uterus. And of course, the uterus itself has to be ready for the egg’s arrival. Then, if the egg comes into contact with a male’s sperm and is fertilized, it implants in the uterus and grows into a baby.

But how does the body know when to recruit the egg? Or when it’s mature and ready to be released? Or if the uterus is ready for it? Well, all that is done through communication. And that is where our hormones come in. The ovaries use hormones to communicate (or text) the status of the egg to the brain and to the uterus. That way it can coordinate all the different reproductive functions.

Hormonal Contraceptives

Now that you have the basics, where do hormone-based contraceptives fit in? Well, to figure that out let’s go back to the goal: to prevent fertilization and pregnancy. Okay, so that simply means they want to somehow prevent the female’s egg from coming into contact with the male’s sperm. Simple enough, so how do we do that?

Some possibilities include:

  • Preventing the egg from being recruited and matured
  • Preventing the egg from being released
  • Preventing the egg from reaching or implanting in the uterus
  • Preventing the sperm from reaching the egg

And how can we prevent all these things? How about by altering the levels of those hormones that run the reproductive system? You know, estrogen and progesterone. By playing with the levels of these hormones, scientists have found ways to trick the reproductive system.

When a woman gets pregnant the body naturally stops the recruitment, maturation, and release of eggs. Essentially, many hormonal contraceptives are fooling the body into thinking it’s pregnant so that it doesn’t recruit an egg each month.

Birth Control Pills

The most common forms of hormonal contraceptives are known as Birth Control Pills, or oral contraceptives (OCs), or, of course, what many refer to simply as ‘The Pill.’

But there is more than just one pill. OCs can come as a Combination Pill, which has both estrogen and progesterone in it – hence the term ‘combination’ – or as a Mini Pill, which is progesterone only, so it’s kind of like a mini version of the combination pill since it has only one hormone in it instead of two.

Now, the key to OC’s is taking them exactly as directed. If this is done, the chances of becoming pregnant are less than one percent. This means taking the pill at the same time every day, not just a few days a month. Also, another important thing to remember is the OCs, unlike barrier methods of contraception (like condoms), do not offer protection against STDs.

So, what’s the difference between combination pills and the mini-pills?

First of all, pills with both estrogen and progesterone are more popular and a little more forgiving than the mini pill. While both need to be taken at the same time of day, if you are off by an hour or so with the combination pill it isn’t as big of a deal as it is with the mini-pill. The mini-pill’s effectiveness may decrease if not taken at the same hour each day.

There are also more options with the combination pills. The most popular is taking an active, hormone containing pill every day for three weeks, and then taking a one week break, mimicking the natural cycle the body follows. However, you can also take active pills for multiple months at a time before taking a break. So, just like combination pills have multiple hormones they also have multiple ways in which they can be taken. Mini-pills, however, are taken every day, with no break in between, making them a little less flexible.

Both pills reduce the menstrual cramps that come with PMS (thank goodness, right ladies?). And even better, combination pills can also be used to treat acne and excessive menstrual cramps. However, they can also have more side effects than the mini-pill due to the presence of estrogen. You can remember this because more hormones = more side effects, since they have more hormones in them than the mini-pill.

And, importantly, the presence of that second hormone, estrogen, also makes it unsafe for nursing mothers, because estrogen can be passed to the baby, while progesterone-only pills are currently considered safe to take for nursing mothers.

Side Effects

Before we wrap up, let’s go back to that side effects comment. What kind of side effects might come with birth control pills? Or any type of hormonal contraceptive? Well, some of the more common side effects may include breakthrough bleeding or spotting while on the pill, nausea and swollen breasts during the first few months, and potential weight gain, which is primarily seen with some of the progesterone-only methods.

Some less common side effects include:

  • Depression or nervousness
  • Headaches or migraines
  • Dizziness
  • Changes in sex drive
  • The appearance of faint brown patches on the face (don’t worry, nothing too noticeable; they look sort of like faded freckles)

I know it sounds like a lot, but most of the above side effects are pretty harmless and don’t occur in most women. Of course, there are some more serious side effects one should watch for. These include blood clots, stroke, and heart attacks, especially in older women, smokers, and those with a predisposition to heart or circulatory disease. For these reasons, it is often recommended that those with a family history of heart or circulatory disease don’t take hormonal-based contraceptives.

Lesson Summary

So remember, Hormones are the chemical messengers of your body that communicate messages from one organ or tissue to another. And, your reproductive system relies heavily on hormones to function normally. Hormonal Forms of Contraception alter the hormones of the female reproductive system, estrogen and progesterone, to prevent fertilization and pregnancy.

Some ways they do this are:

  • By preventing the female’s egg from becoming recruited, matured, and/or released from the ovary
  • By preventing the egg from reaching or implanting in the uterus
  • By preventing the male’s sperm from reaching the egg

The most popular forms of hormonal contraception are Birth Control Pills (oral contraceptives). These can have both estrogen and progesterone in them, in which case, they are referred to as Combination Pills; or they can have only progesterone, and then they are called Mini Pills.

So, let’s take a quick moment to review some of the differences. Combination pills can be taken around the same time each day, but mini pills have to be taken at the same time each day, making consistency more important with the mini pills.

Both pills reduce menstrual cramps, but combination pills can treat both severe cramps and acne. However, combination pills also come with some more side effects than the mini pill does.

And what are those side effects again? Well, briefly, some women may experience:

  • Breakthrough bleeding or spotting
  • Nausea and swollen breasts
  • Weight gain
  • Depression or nervousness
  • Headaches or migraines
  • Dizziness
  • Changes in sex drive
  • The appearance of faint brown patches on the face

Most of these are not severe and are nothing to worry too much about. However, some women may be at risk of blood clots, heart attack, and stroke with some forms of hormonal contraceptives, especially if they are smokers or have a family history of circulatory disease. And remember, it’s always a good idea to discuss all options and questions about contraceptives with your physician.

Learning Outcomes

When this lesson is done, you should be able to:

  • Define hormones as they pertain to contraception
  • Identify the two types of birth control pills
  • Recognize the possible side effects
  • Describe how hormonal contraception works