Advantages and disadvantages of hormonal birth control

The following table lists the advantages and disadvantages of using hormonal birth control methods.

Deciding about hormonal birth control methods

Consideration	Combination pills, skin patch, or vaginal ring (estrogen plus progestin)	Progestin-only pills, implant, or shot
Advantages	No interruption of foreplay or intercourse Reduced bleeding and cramping with periods, which lowers the risk of anemia Fewer or no periods (with certain types of pill) Reduced pain during ovulation Reduced risk of pelvic inflammatory disease (PID) Reduced fibrocystic breast changes Reduced risk of ectopic pregnancy May reduce acne May reduce ovarian cysts May reduce symptoms of endometriosis May reduce bone density loss May protect against ovarian and endometrial cancer Can be used after an abortion	No interruption of foreplay or intercourse Reduced bleeding and cramping with periods, which lowers the risk of anemia Fewer or no periods (especially with shot or implant) Reduced pain during ovulation Reduced risk of pelvic inflammatory disease (PID) Do not contain estrogen, so can be used by women who cannot take estrogen May be used by women over 35 who are smokers Shot and implant provide extremely effective birth control protection. Shot protects for about 3 months; implant lasts 3 years. Possible protection against endometrial cancer May be used while breast-feeding
Disadvantages	Does not protect against sexually transmitted diseases or HIV May not be as effective when taken with certain medications May delay return of normal cycles Pills must be taken every day. Patches may not fully protect you from pregnancy if they are exposed to direct sun or high heat. This can release a high dose of hormone from the patch, which leaves less for the patch to release later in the week. Patches deliver more estrogen than low-dose birth control pills do. Some research has found that women using the patch are more likely to get dangerous blood clots in the legs and lungs. The risk may be higher if you smoke or have certain health problems. The U.S. Food and Drug Administration (FDA) suggests that you talk to your doctor about your risks before using the patch. If used in early breast-feeding, may reduce milk supply.	Does not protect against sexually transmitted diseases or HIV May not be as effective when taken with certain medications Shot may delay return of normal cycles, but there is no delay with pills or implant. Pills must be taken at the same time each day. Progestin-only pills are less effective than combination pills, but the shot and implant are extremely effective. Make diabetes more likely if you have had gestational diabetes during pregnancy.1, 2 (Combination estrogen-progestin birth control does not appear to increase this diabetes risk.)3 Cause more irregular periods or spotting between periods Implant must be inserted and removed by a trained health professional. Shot causes bone mineral loss, so calcium supplementation is necessary.

Author:	Bets Davis, MFA	Last Updated: May 22, 2008
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology
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