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unplanned pregnancy

What You Should Know

Hormonal methods of birth control

Hormonal methods of birth control include combined oral contraceptives (the Pill), progestin-only pills (the mini-pill or POPs), Depo-Provera (the Shot), Implanon (implant), the contraceptive patch (Ortho Evra), contraceptive ring (Nuva Ring), Mirena IUS, and Emergency Contraceptive Pills (ECP or Morning-After Pills). These methods involve hormones which change the way a woman's reproductive system works. These methods primarily work by preventing ovulation and thinning the lining of the uterus to prevent implantation should fertilization occur (see side bar). Typical failure rates for these methods range from 1-13% per year.

Considerations for Teens

Oral contraceptives and Depo-Provera are popular methods for teens due to their ease of use. However, all hormonal methods have many possible side-effects, such as weight gain and skin problems. Some side effects can be quite serious, such as prolonged bleeding with Depo-Provera, which is why you should always let your health care providers (and parents) know if you are using any of these methods. All hormonal methods, especially Depo-Provera, are associated with loss in bone density for teens, which is permament. Additionally none of these methods offers any protection from STDs like the AIDS virus, and can in fact incease your risk.

Considerations for Single Adults

All hormonal methods typically have some unpleasant side-effects, such as weight gain, depression, and loss of sex drive. Older women who smoke should not use combined oral contraceptives due to cardiovascular risks. These methods offer no protection from STDs. Although these are some of the more effective methods of pregnancy prevention, many women do get pregnant despite proper use. Others get pregnant when they forget a pill or take antibiotics (which can compromise the effectiveness of the Pill). Hormonal methods offer no protection from STDs, and can in fact incease your risk of contracting one.

Considerations for Married Couples

After discontinuing combined OCs or Depo-Provera, it may take several months to over a year for normal fertility to return. Keep in mind that with a 1-13% annual failure rate, the odds are that after using many of these methods continuously for several years, you may eventually experience a surprise pregnancy. Talk to your mate about this possibility ahead of time.

How It Works

Pregnancy prevention?

Think "oral contraceptives" prevent conception? Think again. Hormonal methods suppress ovulation much of the time, but scientists recognize that in many cases ovulation continues to occur. Some women who use hormonal methods ovulate every single cycle. So how do hormonal methods prevent conception? That depends on how you define "conception." Although most people think of conception as the joining of egg and sperm to form new life, in some circles the word "conception" has an alternate meaning — the implantation of the embryo into the uterus.

When fertilization is not prevented, hormonal birth control methods commonly cause the expulsion of an embryo prior to implantation by changing the lining of the uterus so that it will not accept an embryo and by changing the way the fertilized ovum travels down the fallopian tube. This action has been termed by some as 'interceptive,' as opposed to contraceptive or abortive. This is an important distinction, because any woman interested in preventing fertilization will want to avoid using these methods. Although there are legitimate medical uses for some of these drugs, clinicians tend not to explain the interceptive effects to their patients, some being unaware themselves. Pharmaceutical companies minimize this mechanism of hormonal methods to prevent women of conscience from rejecting their products, as had occurred with the IUD.