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Combined Hormonal Methods

Birth control methods containing both estrogen and progesterone are called combined hormonal contraceptives. A prescription is needed to obtain these methods. They come in many brands, doses, and forms. Examples of the different kinds of combined hormonal birth control methods are: Birth control pills, the "patch", and the vaginal ring. They all work in the same way to prevent pregnancy:

  • They suppress ovulation, that is, the woman's body does not release an egg;
  • They thicken cervical mucus, which makes it more difficult for the sperm to reach the egg, should one be released, and;
  • They alter the lining of the uterus so that a fertilized egg (zygote) cannot implant.

Current medical science suggests that ovulation suppression is the most important action; however, the other actions also may play a role.

All combined hormonal methods are very effective when used correctly. They are also very safe to use for most women and serious side effects are rare.

Advantages of combined hormonal contraceptives include:

  • More regular and lighter menstrual periods with less cramping.
  • Reduced incidence of iron-deficiency anemia.
  • Long-term reduction in risk of ovarian cancer, uterine cancer, ovarian cysts, and benign breast disease.
  • Fertility returns quickly after stopping these methods.
  • Positive psychological effects such as freedom from worry over possible pregnancy and increased enjoyment of sexual intimacy have been reported.

Possible disadvantages and side effects of combined hormonal contraceptives include:

  • Unexpected bleeding or spotting in between menstrual periods.
  • Mild or temporary breast tenderness.
  • No protection against HIV/AIDS or other sexually transmitted diseases (STDs) like Chlamydia, gonorrhea, syphilis, warts, hepatitis, or human papilloma virus (HPV).
  • Negative psychological effects such as moodiness and decreased sex drive have been reported.

Possible health risks may include:

  • Some specific health conditions may make use of combined hormonal methods unwise. Women who have cardiovascular problems like stroke, heart attack, blood clotting disorders or high blood pressure may be advised not to use these methods. Women who have certain kinds of cancer should not use combined hormonal contraceptives.
  • Women who have certain types of migraines may be cautioned against using combined hormonal methods.
  • Cigarette smoking increases the risk of serious cardiovascular side effects, especially for women over 35.

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