Hormonal methods work by suppressing the hormones that cause ovulation. If the woman does not ovulate, fertilisation cannot occur. These methods are very reliable if properly used.
Depending on the hormones they contain, you can choose between:
- A combination of two female hormones, oestrogen and progestogen:
- Methods involving only one female hormone, progestogen:
1. Combination of oestrogen and progestogen
These combination solutions simulate a normal menstruation cycle. The oestrogen ensures regular menstruation. Every month, during the week-long break, bleeding occurs that is similar to menstruation, but is known as withdrawal bleeding.
You have to take the pill every day, preferably at the same time, for 21 or 22 days; this followed by a break, which lasts a maximum of seven days. Bleeding usually occurs for a few days during this time. Start a new strip on a fixed day of the week.
The pill can be taken without a week-long break, but the way this is done depends on the composition of the pill that you use. If you are unsure, talk to your doctor about this.
Most pills are single phase: the composition of each pill is the same. Two-phase and three-phase pills have two or three compositions respectively, one after the other; here again, there is a week-long break. So with the two-phase and three-phase pills you have to follow the sequence carefully.
This flexible ring in the vagina releases a constant low dose of hormones, the same hormones as those in the conventional pill. These hormones enter the bloodstream directly through the wall of the vagina.
As the hormones do not go through the liver first, the dose can be kept low. The hormones also avoid the stomach and intestine, so vomiting, diarrhoea or taking antibiotics does not affect the reliability of this method.
The ring can remain in place for three weeks. This is followed by a week-long break. You can insert and remove the ring easily yourself. With the vaginal ring, you only have to think about your contraception once per month.
It is possible to have intercourse both with and without the ring, but it cannot remain in the vagina for more than three weeks.
The contraceptive patch is applied to the skin. It is a thin, skin-coloured plaster that can be placed anywhere on the skin and that releases a constant quantity of hormones into the body. You replace this patch once a week. After three weeks, there is a week-long break. Menstruation occurs during this week.
2. Methods involving progestogen alone
When a contraceptive method that releases progesterone alone is used, the menstrual cycle is often no longer discernible:
- About 1 in 3 women no longer lose any blood
- 1 in 3 women still have a discernible cycle but with less blood loss
- 1 in 3 women have unpredictable blood loss, which is sometimes troublesome.
The total blood loss with the use of these methods is, however, lower than if no hormones are used. These methods are reliable even if bleeding does not occur.
The minipill is mainly used while breastfeeding or by women who are not allowed to use oestrogen. This method involves taking one pill daily without a break, preferably at the same time. The minipill is used continuously and is just as reliable as the combination methods.
The hormone shot is an injection in the muscle, which is administered once every three months by a doctor or a nurse.
The advantage of this is that you only have to think about contraception four times a year.
The disadvantage of the hormone shot is that after you stop it can sometimes be a long time before the normal cycle returns: a maximum of one year.
If complaints occur due to the hormone shot, the hormone administered cannot be removed and you have to wait until the hormone disappears from your body itself.
The hormone rod is 4 centimetres long and releases a constant quantity of progesterone. It is inserted in the upper arm just beneath the skin by a doctor under a local anaesthetic.
The hormone rod can stay in place for three years. It has to be inserted and removed by a doctor who is familiar with this method.