Pill, syringe, vaginal ring – hormonal contraceptives are always an intervention in a generally healthy hormone balance. Therefore, their use should be discussed with the doctor you trust – age, previous illnesses or a later desire to have children play a decisive role in choosing the right preparation. STYLEBOOK introduces the most common methods and explains which is best for whom.
The hormone spiral is inserted directly into the uterus by the gynecologist, from where it releases the hormone levonorgestrel. This ensures that the mucus thickens in the cervix, there is no more for sperm to get through. And if one should do it, the uterine lining, which is too thin, prevents possible implantation.
The amount of hormone released is minimal and therefore well tolerated. Thanks to the effectiveness of three to five years, the user does not have to worry about contraception for a long time. Most of the time there is no bleeding, if it does occur, then only very weak and painless. The spiral is also a very safe contraceptive, the pearl index is 0.16.
As with all hormonal contraceptives, headaches, sexual discomfort, feelings of tension in the breasts or nervous upsets can occur. In a few cases, the body repels the spiral because it is perceived as a foreign body. Cysts and blemishes can occur increasingly, and there are also indications that the risk of developing breast cancer is slightly increased.
Who is it for?
For women who suffer from heavy and very painful bleeding. Not suitable for teenagers.
Between 250 to 400 euros
About the Pearl Index: The lower the value, the safer the method: If the index is 0.1, it means that one in a hundred women who use the same contraceptive method for more than a year will become pregnant. For comparison: the pearl index for condoms is 2 to 12.
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Hormone sticks (Implanon)
The hormone or contraceptive stick is four centimeters long and two millimeters thin. Inserted under the skin on the inside of the upper arm, it offers contraceptive protection for three years. As with the spiral, a continuously released amount of hormone ensures that the cervix cannot be passed through the thickened mucus plug. In addition, natural ovulation is suppressed.
With a pearl index of 0.0 to 08, the hormone stick is one of the safest methods of contraception, application errors are practically excluded. In most cases, the menstrual period does not occur here either.
Often a weight gain of a few pounds, depressive moods and sexual discomfort. Skin blemishes can occur, and the risk of vaginal dryness and thus vaginal infections increases.
Who is it for?
For all those who want safe, long-term contraception and don’t want to think about the pill every day. The hormone stick can also be a useful alternative for women who cannot tolerate the pill or the spiral or who are not allowed to use it for health reasons.
about 300 euros
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Three month syringe
In addition, the three-month injection prevents the ovulation by the hormone medroxprogesterone acetate (MPA) and makes the cervix impermeable to sperm. To do this, the syringe must be administered by a healthcare professional every three months. Protection against contraception begins from the first application.
Very sure, with regular refreshing, the Pearl Index is 0.2 to 0.6 percent. In addition, contraception works without foreign objects such as spirals or chopsticks. There is no bleeding, most women tolerate the three-month injection well.
There may be a temporary decrease in bone density, which will recover after weaning. If you wish to have children, the return to fertility can be delayed by a few months. Side effects such as headache, acne or depressive moods occur comparatively frequently, and an abrupt cessation is not possible.
Who is it for?
Women who are not allowed to take estrogen-containing medication because of intolerance, and improvement can also occur in all those who suffer from mild endometriosis or migraines. In addition, many doctors only recommend the three-month peak when family planning is safely completed. The method is therefore not suitable for teenagers.
30 euros per syringe
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Vaginal ring or contraceptive ring
The vaginal ring is a flexible plastic ring that, like the classic pill, contains the hormones estrogen and progestin. It is pressed together and inserted into the vagina by hand as deep as possible. There it releases hormones for over three weeks until it is taken out again at the beginning of the fourth week. After a seven-day break and the associated poor bleeding, the procedure begins again.
Easy handling, which every woman can do at home, weaning is possible at any time. Practical for frequent changes between time zones. With a pearl index of 0.4, the vaginal ring is considered very safe.
If the ring is wrong, it can be disruptive during sex. Not all users are spared from the known side effects that almost all hormonal contraceptives bring with them.
Who is it for?
For women with gastrointestinal complaints or eating disorders that can affect the effectiveness of the conventional pill.
Between 60 and 90 euros
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The contraceptive patch gradually releases the hormones estrogen and progestogen. The patch is applied to a dry and clean area of skin once a week. The fourth week is paused, there is a weak and painless bleeding.
Very simple use, vomiting and diarrhea have no influence on the effectiveness. Practical for frequent changes between time zones. The Pearl index is 0.9.
The patch is visible and can cause skin irritation, but it can also fall or slip unnoticed. Nausea, dizziness, sexual discomfort, breast tenderness and mood swings are among the most common side effects. Not suitable for overweight women.
Who is it for?
Similar to the vaginal ring, the patch is suitable for women who suffer from gastrointestinal problems or an eating disorder (bulimia).
approx. 40 euros per month
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The mini pill is an estrogen-free pill that is taken consistently – i.e. without a break for bleeding – whenever possible at the same time of day. The preventive effect is carried out exclusively by a yellow body hormone (two different ones are used: desogestrel and drospirenone), which – as with the other preparations – solidifies the mucus in the uterus, suppresses ovulation and makes it impossible for a potentially fertilized egg cell to nest.
The classic side effects that most hormonal contraceptives have are less pronounced with the mini pill. The menstrual period also fails to appear or is only extremely weak. When used correctly, the Pearl Index is 0.3.
An extremely disciplined intake is important because a delay of just a few hours reduces contraceptive protection. The lack of estrogen can promote acne and can also cause vaginal dryness. In the worst case, the latter causes painful to dangerous infections, in which case it is advisable to stop taking the pill or to replace it with another product.
Who is it for?
Women who suffer from extremely severe menstrual cramps. Even breastfeeding women who want to use hormonal contraception can take a mini pill. The mini pill is rather unsuitable for women who travel a lot, work in shifts or for other reasons have no regular daily routine. Caution also with certain allergies or previous illnesses, as always consultation with the doctor is mandatory.
Costs: approx. 15 euros per pack
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All hormonal contraceptive pills that contain ethinyl estradiol and a progestogen in low doses are called micropills (combination pills, approx. 90 preparations on the market). In addition to various gestagens, this pill receives the hormone ethinyl estradiol, but in a lower dose than was the case in the 1960s, which makes the product much better tolerated. Unlike the mini pill, there is a seven-day break after 21 days during which bleeding occurs.
For many women, taking the micropill improves the complexion, the bleeding is weak, usually very regular and almost painless. It also reduces the risk of developing uterine or ovarian cancer. The Pearl index is between 0.1 and 0.9.
Taking the micro pill increases the risk of thrombosis, which favors strokes and heart attacks. Benign cysts in the uterus and breasts can also develop. Smokers, diabetics or women who are prone to high blood pressure should refrain from taking it. Common side effects such as mood swings, slight weight gain, loss of libido or hair loss occur comparatively often. Certain medications, such as antibiotics or sedatives, reduce the effectiveness. Long-term use and very early onset may increase the risk of (HPV-associated) cervical cancer.
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Who is it for?
Healthy women who choose hormonal contraception for the first time. The micro pill is considered a beginner’s preparation and is still the most commonly prescribed contraceptive.
approx. 21 euros per pack
In general, it should be noted: Hormonal contraceptive methods do not offer any protection against sexually transmitted diseases, in this case a condom should always be used during intercourse. The technical advice for this article was provided by Univ. Prof. Dr. Doris Maria Gruber, gynecologist from Vienna.