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Birth Control: Pros and Cons of Hormonal Methods - Topic Overview

Progestin-only pills, implant, or shot

ProsCons
  • No interruption of foreplay or intercourse
  • Fewer or no periods (especially with shot or implant)
  • Reduced cramps and pain during ovulation
  • Reduced bleeding and cramping with periods, which lowers the risk of anemia
  • Reduced risk of pelvic inflammatory disease (PID)
  • Does not contain estrogen, so can be used by women who cannot take estrogen
  • May be used by women over 35 who are smokers
  • May be used while breast-feeding
  • Reduces risk of ectopic pregnancy
  • Possible protection against endometrial and ovarian cancer
  • Implant gives rapid return to fertility following removal.
  • Shot and implant provide extremely effective birth control protection.
  • Shot protects for about 3 months; implant lasts 3 years.
  • Shot reduces symptoms of endometriosis.
  • Shot reduces frequency of seizures in women who have a seizure disorder.
  • Shot reduces number of sickle cell crises in women who have sickle cell disease.
  • Does not protect against sexually transmitted infections or HIV
  • Causes more irregular periods or spotting between periods
  • May not be as effective when taken with certain medicines
  • Makes diabetes more likely if you have had gestational diabetes during pregnancy1
  • Progestin-only pills are less effective than combination pills, but the shot and implant are extremely effective.
  • Pills must be taken at the same time each day.
  • Implant may cause menstrual periods to stop or be very light.
  • Implant must be inserted and removed by a trained health professional.
  • Implant may cause headaches.
  • Shot may delay return of normal cycles for 6 to 8 months after the medicine is stopped, but there is no delay with pills or implant.
  • Shot may increase the risk of chlamydia or gonorrhea infection among women who are sexually exposed to these bacteria.2
  • Shot causes slight weight gain.
  • Shot may decrease levels of HDL ("good") cholesterol.
  • Shot causes bone mineral loss, so calcium supplementation is necessary.
  • Using the shot for 2 or more years can cause bone loss, which may not be fully reversible after stopping the medicine. This concern may be greatest during the teen years, when young women should be building bone mass.3
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