Combined hormonal contraception

Combined hormonal contraception (CHC) refers to birth control methods that contain two types of hormones: estrogen and progestin. These hormones work together to prevent ovulation, thicken cervical mucus to block sperm, and thin the lining of the uterus to prevent a fertilized egg from implanting. CHC is available in several forms, including the oral contraceptive pill (often simply called "the pill"), the patch, and the vaginal ring.

Types of Combined Hormonal Contraception

Oral Contraceptive Pill

The oral contraceptive pill is the most widely used form of CHC. It is typically taken once a day at the same time each day. There are various types of oral contraceptive pills, including monophasic, biphasic, and triphasic pills, which refer to the dosage of hormones in the pills.

Patch

The contraceptive patch is a small, sticky patch that is applied to the skin. It releases estrogen and progestin into the bloodstream through the skin. A new patch is applied once a week for three weeks, followed by a week off.

Vaginal Ring

The vaginal ring is a flexible, plastic ring that is inserted into the vagina. It releases hormones locally, affecting the reproductive system directly. The ring is left in place for three weeks and then removed for one week, during which a withdrawal bleed may occur.

Mechanism of Action

Combined hormonal contraceptives work by:

• Preventing ovulation: The hormones in CHC prevent the ovaries from releasing an egg.
• Thickening cervical mucus: This makes it more difficult for sperm to enter the uterus.
• Thinning the uterine lining: This reduces the likelihood of a fertilized egg implanting in the uterus.

Benefits and Risks

Benefits

• Highly effective when used correctly
• Can regulate menstrual cycles and reduce menstrual cramps
• May reduce the risk of certain types of cancer, such as ovarian and endometrial cancer
• Can improve acne

Risks

• Increased risk of blood clots, especially in smokers and women over 35
• May increase blood pressure
• Possible side effects include nausea, breast tenderness, and mood changes
• Does not protect against sexually transmitted infections (STIs)

Choosing a Method

The choice of CHC method depends on individual preferences, medical history, and lifestyle. It is important to discuss all options with a healthcare provider to determine the best method for each individual.

See Also

• Birth control
• Progestogen-only pill
• Intrauterine device
• Emergency contraception