Sexual Health - Hormonal Contraception

Contraception helps prevent pregnancy, when taken correctly. Hormonal contraception does NOT protect against sexually transmitted infections. There are lots of contraceptive options that are available. For those who are interested in using contraception, an assessment of lifestyle, beliefs, concerns and risk factors need to be determined before deciding which method of contraception is best. For hormonal contraceptives that are only available through a prescription, an appointment with a physician or clinician will need to be made first. You will be required to have a pap smear and pelvic exam before hormonal contraception can be prescribed. Please inform the person who schedules your appointment that you are interested in hormonal contraception. The phone number for the appointment desk is (662) 325-7539

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Oral contraceptives are the most familiar form of birth control for women. There are a wide variety of pills that range in the levels of hormones, estrogen and progesterone. Oral contraceptives typically come in packs of 28 pills. For the first 3 weeks it is necessary that 1 pill be taken everyday at the same time. The last 7 pills in a pack are placebo pills, meaning that they do not contain any hormones. If a woman has problems remembering to take her pills everyday, it may be helpful to take these placebo pills so that she can maintain her normal regimen. If one pill is missed it should be taken immediately which could cause you to take two pills in one day or at one time. In this case you do not need to use a backup form of birth control. If you miss two or more pills in a row take them immediately and use a backup form of barrier contraception. The primary way oral contraceptives prevent pregnancy is by preventing ovulation, the release of an egg from the ovaries. Progesterone and estrogen work together to thicken cervical mucus. The thickening of cervical mucus makes it harder for sperm to swim and fertilize an egg. Seasonale is a newer form of oral contraception. Hormone containing pills are taken everyday for 12 weeks straight. During the thirteenth week a woman can elect to take the placebo pills or throw them away. During this thirteenth week she will have a period. With perfect use the pill can be up to 99% effective. Perfect use means taking it everyday at the same time.

There are some factors that can decrease the effectiveness of oral contraceptives:
• Taking antibiotics
• Taking certain medications, including oral vaginal infection medication, certain anti-seizure drugs and certain HIV drugs
• Having diarrhea or vomiting
• Taking St. John's Wort
• Binge Drinking/Excessive Alcohol Use
• There are several benefits of taking the pill other than pregnancy prevention. Some may include:
• More regular periods
• Shorter and lighter periods
• Decrease in acne
• Decrease in menstrual cramps and PMS symptoms

Women who smoke should not take oral contraceptives due to increase risk of heart disease and stroke. These risks increase when the woman is over 35.
Oral Contraceptives DO NOT protect any against sexually transmitted infections, including HIV/AIDS.


The contraceptive patch, Ortho Evra works like the combination birth control pill. Just like the pill, the patch contains the hormones progestin and estrogen which are released directly into the bloodstream through the skin. The patch is changed once a week for three consecutive weeks and on the fourth or patch-free week, menstruation occurs. Each week the patch is rotated to 1 of 4 sites on the body: upper outer arm, upper torso (front and back, excluding the breasts), abdomen, or buttocks. To ensure the effectiveness of ORTHO EVRA, do not place the birth control patch on areas of your skin where makeup, lotions, creams, powders, or other products are or will be applied. In addition, do not place ORTHO EVRA on skin that is red, irritated, or cut. The patch can be worn during all daily activities such as bathing, showering, and swimming, and exercising without interruption.

If a patch falls off : Do not try to reapply a birth control patch if it is no longer sticky; if it has been stuck to itself or another surface; if it has other material stuck to it; or if it has become loose or has fallen off before.

For less than 24 hours: Try to reapply your patch or apply a new patch immediately. No backup contraception is needed and your "Patch Change Day" will remain the same.

For more than 24 hours, or if you are not sure for how long: Start a new 4-week cycle immediately by applying a new patch. You now have a new Day 1 and a new "Patch Change Day". You must use backup contraception, such as a condom, spermicide or a diaphragm, for the first week of your new cycle because you may become pregnant during this time.

Re-apply the Patch by following these instructions: Press down firmly on the Patch with the palm of your hand for 10 seconds, making sure that the edges stick well. Then run your fingers around the edge of the patch. Do not use tapes or wraps to keep the birth control patch in place. If the birth control Patch does not stick well, remove it and then apply a replacement birth control Patch. This Patch should be replaced on the original "Patch Change Day." Single replacement patches are available through your pharmacist. Hormones from patches applied to the skin get into the blood stream and are removed from the body differently than hormones from birth control pills taken by mouth. You will be exposed to about 60% more estrogen if you use ORTHO EVRA® than if you use a typical birth control pill containing 35 micrograms of estrogen. In general, increased estrogen exposure may increase the risk of side effects. However, it is not known if there are differences in the risk of serious side effects based on the differences between ORTHO EVRA® and a birth control pill containing 35 micrograms of estrogen. Talk to your healthcare provider about how this information relates to your use of ORTHO EVRA®.

The Patch does NOT protect against any sexually transmitted infections, including HIV/AIDS.


Depo-Provera is a form of contraception that is injected by a healthcare provider once every three months. The injection provides continuous protection from pregnancy through a synthetic hormone similar to Progesterone that is synthesized naturally by the body. This hormone causes the body to think that an egg has already been released from the ovaries, inhibiting the ovaries from releasing another one. If there is no egg available for fertilization, pregnancy will not occur. This form of hormonal contraception is the only type that does not use estrogen. Therefore, if a women uses tobacco this is the safest form of contraception available by prescription for her. The hormone injection is given in the arm or buttocks. Depo-Provera is more than 99% effective in preventing pregnancy. This is partly due to the way Depo is administered. A woman has to remember her to get her birth control injection every 3 months as opposed to daily or weekly. The first injection should be given within the first five days of a normal menstrual period, within five days after childbirth for non-breastfeeding women, or six weeks after childbirth for women who are breast-feeding. A pregnancy test, recent physical exam and Pap test should be done prior to receiving the first injection. Because even the most sensitive test can't detect pregnancy in the first two weeks, it is important to abstain from sex or only have protected sex two weeks before the first injection.

The most common side effects associated with Depo-Provera:
• menstrual irregularities
• weight gain

In addition, some patients may experience
• headache
• nervousness
• abdominal pain
• dizziness
• weakness or fatigue

The drug should not be used by women who have acute liver disease, unexplained vaginal bleeding, breast cancer or blood clots in the legs, lungs or eyes. Prolonged use of Depo-Provera may result in significant loss of calcium stored in the bones, and the loss is greater the longer the drug is administered. This stored calcium lost may not be completely reversible after discontinuation of the drug. A woman should only use Depo-Provera Contraceptive Injection as a long-term birth control method (for example, longer than two years) if other birth control methods are inadequate for her.

Depo-Provera DOES NOT protect against ANY sexually transmitted infections or diseases, including HIV/AIDS.

CALL your physician IMMEDIATELY IF any of the following occur after an injection of Depo-Provera:

1. Sudden severe headache or vomiting, dizziness or fainting, problem with eyesight or speech, weakness or numbness in an extremity.
2. Unusually heavy vaginal bleeding.
3. Severe calf pain or swelling.
4. Persistent pain, pus, or bleeding at the injection site.
5. Severe pain or tenderness in the lower abdominal area.
6. Sharp chest pain, coughing of blood, or sudden shortness of breath.


The Nuva Ring contains the synthetic hormones estrogen and progestin, the same hormones that are in the birth control pill. The ring works by slowly releasing these hormones into the body. It releases these hormones through the vaginal wall where they enter the bloodstream. The hormones prevent the ovaries from releasing an egg and thicken the cervical mucus, making it more difficult for sperm to swim.
The Nuva Ring NOT protect any against sexually transmitted infections, including HIV/AIDS.