In this section, we look at the most popular hormone-based birth control methods: oral contraceptives, the vaginal ring, the transdermal patch, injected contraception, and contraceptive implant.

chapter 10

Oral Contraceptives

Oral contraceptives have evolved during 40 years of developing variations in the chemi­cal structure and dosage of hormones, resulting in a wide range of choices. Oral con­traceptives are the most commonly used reversible method of birth control by women younger than 35 in the United States, and 80 % of women have used the pill during their lifetime (Dempsey et al., 2011; Guttmacher Institute, 2008a). More than 100 million women worldwide use the pill (Blackburn et al., 2000). Four basic types of oral contraceptives are currently on the market: the constant-dose combination pill, the triphasic pill, the extended-cycle pill, and the progestin-only pill.

Placebo-controlled studies of oral contraceptives have found no significant dif­ference in side effects such as headache, nausea, breast pain, or weight gain. Bleed­ing irregularity was correlated with the low-estrogen dose pills (Grimes & Schultz, 2011). Taking the pill does not interfere with subsequent ability to become pregnant (Mansour et al., 2011). For most women who use them, oral contraceptives improve overall health (Speroff & Fritz, 2005). However, for about 16% of women, oral con­traceptive use is not advisable (Shortridge & Miller, 2007): This percentage includes women with a history of blood clots, strokes, circulation problems, heart problems, jaundice, cancer of the breast or uterus, and undiagnosed genital bleeding. In addi­tion, a woman who has a liver disease or who suspects or knows that she is pregnant should not take the pill. • Women who smoke cigarettes or have migraine headaches, depression, high blood pressure, epilepsy, diabetes or prediabetes symptoms, asthma, or varicose veins should weigh the potential risks most carefully and use the pill only under close medical supervision. ■ Table 10.3 describes rare but serious side effects of the birth control pill.