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Alternatives to the pill

by Josephine Andrews
Published: Last Updated on 161 views

There is often uncertainty about contraception. New methods are constantly being added – and the perfect form of contraceptive protection can change depending on your life situation. Read more about the pill and what the alternatives are here.

Every second woman in Germany trusts the pill . It mostly consists of the hormones progestin and estrogen. These suppress ovulation, thicken the mucus in the cervix and prevent sperm from rising up. Depending on the composition, the pill has side effects and additional effects. The decision in favor of a preparation is made after the doctor has weighed up the individual benefits and risks.

pill and PMS

There are ideal hormone combinations for hair loss, deterioration in sugar levels, acne and disorders in blood lipid metabolism. If you have a tendency to water retention, a preparation with a low estrogen content can help. Natural estrogens have proven effective against listlessness and menopausal symptoms. If you suffer from PMS, you can improve your symptoms by taking the pill for a long time. If it is swallowed continuously for several months, there is usually no bleeding – and with it the painful symptoms such as stomach ache and the like.

Pill and risk of thrombosis

Anyone who has a family history of a stroke, is prone to thrombosis, smokes or is very overweight should not use estrogen as a contraceptive. In addition, modern active ingredients such as drospirenone or gestodene are criticized because of the increased risk of thrombosis. When in doubt, doctors therefore recommend a pill that has been on the market for some time.

In contrast to pills with only one active ingredient, combination preparations in particular have an increased risk of thrombosis. A new type of preparation with bioidentical estetrol is said to have fewer side effects than previous pills. However, whether this also reduces the risk of thrombosis remains to be investigated.

Find out more about the pill here .

What hormonal alternatives to the pill are there?

If it is difficult to take the pill regularly (e.g. when working shifts), a hormone patch or a vaginal ring can be used. Both are considered very safe. The patch is applied to the stomach or upper arm three times in a row for seven days each, after which the bleeding is stopped for a week. The ring is inserted into the vagina by the woman at home, remains there for three weeks and is then removed. After the bleeding pause, a new one is inserted.

hormone sticks

If family planning does not include a baby for a long time, the gynecologist can place a hormone stick under the skin of the upper arm. This evenly releases the hormone progestin, remains safe in the event of vomiting or diarrhea, and reduces bleeding. Since ten percent of women have side effects such as bleeding between periods, the active ingredient is tested beforehand by taking a pill with the same hormone.

You can find out more about the hormone stick here .


The temperature method does not interfere with the cycle. However, it requires a lot of discipline and a regular period to be reliable. After all, you have to measure your body temperature at the same time every morning and enter it in a cycle calendar. Based on the rise in temperature after ovulation, the time of the fertile phase is calculated here – and thus when a condom or something similar has to be used as a contraceptive.

Learn more about the temperature method here .

Apps calculate ovulation

The temperature is measured automatically, for example with an “OvulaRing”. It is inserted into the vagina and measures the temperature there every five minutes. It will be renewed after three months at the latest. In between, it is taken out to read the data or, if desired, before sex or during bleeding. The fertile period and ovulation are then calculated using web software or an app.

contraceptive computer

Alternatively, birth control computers tell when it’s time for a condom by measuring temperature or hormones in the urine.

Learn more about birth control computers here .

What are the advantages of the hormone-free copper spiral or chain?

Depending on their size, both are an option for women of all ages and are as safe as the pill. The (mini) copper spiral and the copper chain prevent the implantation of the egg by releasing copper ions and inhibit the mobility of the sperm. They can stay in the womb for three to five years. However, common side effects are increased bleeding and menstrual pain. With the copper chain, however, these are somewhat less pronounced.

You can find out more about the copper spiral here .

Condoms as a contraceptive

Do you rarely have sex? Then the condom is the contraceptive of choice. It does not burden the body and protects against sexually transmitted diseases, which are currently increasing in women over 40 years of age. Safety is high when handled correctly.

You can find out more about condoms here .

Do I have to use contraception while breastfeeding?

Who breastfeeds will not get pregnant? A mistake! If you are not planning a sibling for the baby right away, contraception is the order of the day. Since estrogen-containing pills stop milk production, the mini-pill is suitable in addition to the condom. Your progestin thickens the mucus in the cervix, preventing sperm from entering. Requirement: You always take them at the same time. With a difference of three hours, mini-pills with levonorgestrel reduce the protection, with desogestrel after twelve.

Find out more about contraception while breastfeeding here .

Hormone spiral and hormone rods

A good alternative after completing family planning is the hormonal spiral. It can be inserted into the uterus more easily after birth because the cervix is ​​dilated. The low-dose hormone spiral works locally, i.e. more gently than the pill, and protects against unwanted pregnancy for up to five years. It also reduces bleeding in most women and relieves menstrual pain.

You can find out more about the hormone spiral here .

Contraception despite menopause?

The last period takes place on average around 50. But only when she has been absent for a whole year can one assume that she will no longer be pregnant. Until then, the following applies: prevent as usual.

The “morning after pill”

dr Ines Thonke answers the most important questions about the emergency drug: The newer of two active ingredients has been approved throughout Europe: ulipristal acetate. In Germany, the active ingredient levonorgestrel is also available without a prescription. It is well researched and has been available to women in many countries for years without a prescription for emergency contraception.

How soon do you have to take the morning-after pill?

As quickly as possible. Taken in good time before ovulation, the morning- after pill is highly likely to prevent a possible pregnancy. Levonorgestrel works up to 72 hours, ulipristal acetate up to five days after unprotected intercourse. In both cases, the effectiveness probably decreases when you are significantly overweight. Women with a high BMI should seek advice from their pharmacist/doctor.

Important: There is no contraceptive protection after taking the pill, even if you continue to take the normal pill. Depending on the ‘morning after pill’, it only works again after seven days or the next period. Until then, additional non-hormonal contraception – for example with a condom – is necessary.

How much does the morning-after pill cost?

So far, the preparations cost between 18 and 35 euros. The morning-after pill is free for women under the age of 20 if they go to the doctor.

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