Searching for the right birth control can feel like a serious quest, and sometimes it takes trial and error to choose the right option for you. However, one type that many people have had success with is progestin-only birth control.
You may have heard the term in your doctor’s office or even with your friends. But it can be hard to keep track of all the different birth control options, and it’s understandable to have questions. Here’s the deal with progestin-only birth control and how to decide if it’s right for you.
What is progestin-only birth control?
Let’s go back for a second: Progestin is a form of progesterone, a hormone involved in your menstrual cycle and pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG).
Progestin in the form of birth control works in a number of ways to prevent pregnancy, ACOG explains. It thickens the mucus in the cervix, making it difficult for sperm to enter the uterus and fertilize an egg; it stops ovulation; and it thins the lining of the uterus.
What Are the Types of Progestin-Only Contraception?
Progestin is also used in several birth control methods. These include:
- The minipill: The minipill is a small progestin-only pill designed to be taken at the same time each day, according to ACOG. With typical use, this pill is 91 percent effective, ACOG says.
- The shot (Depo Provera): The injection contains the hormone depot medroxyprogesterone acetate, which protects against pregnancy for 13 weeks, explains ACOG. (You need four injections a year.) It’s 94 percent effective with typical use, per ACOG.
- Certain intrauterine devices (IUDs): There are different types of IUDs – one that contains copper and others that contain progestin. The progestin-only IUDs are a T-shaped device that is implanted in your uterus, according to ACOG. There, the IUD prevents the fertilization of an egg with sperm. It is 99 percent effective in preventing pregnancy, ACOG says.
- The implant (Nexplanon): The implant is a flexible, matchstick-sized plastic rod that is inserted just under the skin in the upper arm. There, it releases progestin into the body, ACOG explains. Like the progestin IUD, the implant is 99 percent effective in preventing pregnancy.
What are the benefits of choosing progestin-only birth control?
Progestin-only birth control is generally well tolerated and doesn’t typically have many side effects, says Christine Greves, MD, a board-certified ob-gyn at Winnie Palmer Hospital for Women and Babies.
It’s also just a better choice for some people who won’t do well with birth control methods that contain the hormone estrogen, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. Some people may be advised not to take estrogen, such as those who are breastfeeding, says Dr. Minkin. Others with certain types of migraines, such as migraines with aura, should not take combined estrogen and progestin pills, she says.
And then there is personal preference. Some people “just don’t feel good with estrogen-containing pills,” says Dr. Minkin – in which case a progestin-only method is useful.
Who is progestogen-only contraception good for?
There are many options to choose from in this birth control category, Dr. Greves says, often making it a good choice for many people looking for birth control. But there is some variation between each. Here’s who doctors usually recommend looking at each method:
- The minipill“The minipill is good for someone who is breastfeeding and can remember to take a pill every day,” says Dr. Greves. It can also be helpful if you know you want to get pregnant in the near future, says Dr. Minkin. “You decide you want to get pregnant,” she says. “Just stop the pill.”
- The shot (Depo Provera): This may be a good option for those who don’t want to take a pill every day, but also don’t want to have a device implanted, Dr. Greves says. Most people with uteri or assigned female at birth (AFAB) “don’t get periods with this method, but they may experience some spotting,” says Dr. Minkin. “And if you’re thinking about a pregnancy in the near future, you don’t want to use Depo-Provera, because while you might be able to get pregnant three months after your last injection, it could take as long as nine months to get out of your system. “
- Certain intrauterine devices (IUDs): A progestin IUD is good for “someone who isn’t interested in getting pregnant within a year, can’t take estrogen, and finds it hard to take a pill at the same time every day,” says Dr. Greves. It’s also a great “set it and forget it” method of birth control that can last for years, she says.
- The implant (Nexplanon): The implant is good for someone who wants to avoid a daily pill, Dr. Greves says. You may experience irregular bleeding for several months, says Dr. Minkin. “But these are also extremely effective for birth control.”
Side effects of progestogen-only birth control
Side effects of progestin-only birth control can vary by type, whether it’s the minipill, injection, IUD, or implant. Here’s what you might experience from each birth control method, according to ACOG:
- Mini pill: Short cycles of bleeding or spotting, headache, nausea, and breast tenderness
- The shot (Depo Provera): Irregular bleeding, prolonged periods of bleeding or spotting
- Certain intrauterine devices (IUDs): Spotting, headache, nausea, breast tenderness and mood swings
- The implant (Nexplanon): Unpredictable bleeding, digestive problems, headaches, breast pain, weight gain and acne
How to choose the right progestin-only contraception
It’s a good idea to have a conversation with your doctor, Dr. Minkin says. “Always talk to your provider and be upfront about your period, your feelings about getting a period, and how likely you are to remember to take a pill,” she says, noting that you should also discuss whether you want to get pregnant during pregnancy. the near future.
Dr. Greves agrees. “It’s best to talk to your doctor,” she says. “Together you can find out what’s right for you.”