Hormonal contraception, or birth control as it is more commonly known, refers to any method, medication, or device that contains a small amount of hormones to prevent pregnancies. However, while there has been an increase in prevalence of hormonal contraceptive methods such as the contraceptive pill, the male condom remains the most popular. In a 2019 publication, the United Nations (UN) reported that just 62% of the Singaporean population used contraceptives and that the male condom remained the most prevalent method in the country.
Being equipped with knowledge of the different methods of hormonal contraception, as well as their benefits and effectiveness can help with the decision-making process when determining whether to get started on hormonal or non-hormonal contraceptives. That’s why we created a 101 guide discussing three common methods of hormonal contraceptives, covering everything from how it works, to the level of effectiveness, and possible side effects.
The Combination Pill
The combination pill, also known as the birth control pill, are oral medications that are taken to prevent pregnancies. Combination pills, which contain synthetic forms of the hormones estrogen and progesterone, are the most widely used types of contraceptive pills. The hormones in these combination pills work to prevent pregnancies in three ways; by preventing ovulation, building a layer of thick, sticky mucus at the opening of the cervix to make it harder for sperm to pass through, and by thinning the lining of the uterus to prevent a fertilized egg from attaching and developing.
Birth control pills are prescribed in two different dosing packets, either as 21-day or 28-day packs. With perfect use (i.e. no missed pills), the contraceptive pill is more than 99% effective. However, because some people miss pills, or take them later than usual, they end up typically having an efficacy rate of around 91%.
The contraceptive patch, like most methods of hormonal contraception, contains hormones that prevent pregnancies. It is a thin, sticky patch that looks almost like a large band-aid, except it is beige in color — making it discreet and easy to wear under clothing. The birth control patch is best applied to areas that don't have too much hair, and should be applied onto skin that is clean and completely dry. It is recommended to apply it on the buttocks, arms, abdomen, or upper torso. It should never be applied onto the breasts or chest area.
The birth control patch comes in packs of 3, and is applied once a week for 3 weeks, for a total of 21 days a month. During the 7 patch-free days, you’ll have your period. With perfect usage (i.e. having no missed patches, and patches are applied and changed correctly), the birth control patch is up to 99% effective. With typical use (forgetting to place the patch on time, etc) however, it has an efficacy rate of around 91%.
The Hormonal Intrauterine Device (IUD)
The hormonal IUD is a method of long-acting reversible contraception (LARC) that releases small amounts of progestin into the body over its lifetime – usually either 3 to 5 years depending on the brand. It is a small piece of flexible plastic that is shaped like a ‘T’, and sits inside the uterus — once it is in place, no other methods of contraception are needed until its expiry in 3 to 5 years (depending on the brand). The hormonal IUD is more than 99% effective at preventing pregnancies, and unlike other short-acting reversible methods of contraception, such as the pill and the patch, it does not require daily or weekly changes.
What are the side effects of using hormonal contraception?
The side effects of hormonal contraceptives are something most women are concerned about, and is often why some are dissuaded from using hormonal contraceptives as a method of birth control. It is common that women shy away from using hormonal contraceptives because of the misconception that taking hormones is bad for them or that it could lead to infertility later on in life - even though hormonal contraceptives are the most effective preventative measure for pregnancy as compared to non-hormonal methods such as condoms.
While side effects vary across different hormonal contraceptives, not all users will experience them. In fact, side effects tend to disappear on their own after 2-3 months of continued use as the body adjusts to the hormonal changes. Educating people about the common side effects of hormonal contraceptives can help to establish realistic expectations and remove the misconceptions many still have about hormonal contraceptives today. Click here to learn more about the common side effects of hormonal contraceptives.
What else can I use hormonal contraception for?
Beyond pregnancy prevention, hormonal contraception can be used to regulate menstruation cycles, and help manage conditions such as painful menstruation cramps, and acne. Hormonal contraception can also be prescribed to alleviate symptoms of polycystic ovarian syndrome (PCOS) which includes irregular menstruation cycles, unwanted hair growth, and acne.
How do I know which method of hormonal contraception is suitable for me?
With different methods of hormonal contraception available, and the extensive information available on the internet, it can be overwhelming to make a decision. Different hormonal contraception methods are suitable for different needs, and as such the consideration of multiple factors such as lifestyle, health status, and specific preferences (like wanting to skip periods or preventing acne breakouts with the hormones in the contraceptive method) will all contribute to the decision making process.
If it is your first time taking hormonal contraceptives, it is recommended that you make an appointment to consult with a doctor — as they can better advise you on which method of contraception will work best for you based on your medical history, and also answer any other concerns you might have.
Gan, E. and Chia, E., 2017. Birth control methods that work. The Straits Times.
Gaither, K. (2018, December 26). Birth Control: Benefits Beyond Pregnancy Prevention. Retrieved from https://www.webmd.com/sex/birth-control/other-benefits-birth-control
Hatcher RA, Trussell J, Nelson A, Cates W, Kowal D, Policar M. Contraceptive technology. 20th ed. Ardent Media; 2012.
Pazol K, Kramer MR, Hogue CJ. Condoms for Dual Protection: Patterns of Use with Highly Effective Contraceptive Methods. Public Health Reports. 2010;125(2):208–17.
United Nations, Department of Economic and Social Affairs, Population Division (2019). World Contraceptive Use 2019 (POP/DB/CP/Rev2019).