Understanding the Difference Between Oral Contraceptive Hormones and Hormone Therapy
Hormones play a critical role in regulating many of the body’s functions, especially in women’s reproductive health. Two common hormone-related therapies are oral contraceptives (commonly known as birth control pills) and menopausal hormone therapy (MHT). While both involve the use of hormones, they serve very different purposes.
In this blog post, we will explain the differences between oral contraceptive hormones and menopausal hormone therapy, how they work, and what conditions they are designed to treat.
What Are Oral Contraceptive Hormones?
Oral contraceptives, or birth control pills, are medications that contain synthetic forms of the hormones estrogen and/or progestin (the synthetic form of progesterone). These hormones work together to prevent pregnancy by affecting the reproductive cycle in several ways:
Preventing Ovulation: The main way oral contraceptives work is by stopping the ovaries from releasing eggs (ovulation). Without an egg to fertilize, pregnancy cannot occur.
Thickening Cervical Mucus: Progestin in birth control pills thickens the cervical mucus, making it more difficult for sperm to swim through the cervix and reach an egg.
Thinning the Uterine Lining: Birth control pills also cause the lining of the uterus to thin, making it less likely that a fertilized egg could implant and grow.
There are different types of oral contraceptives, including combined pills (which contain both estrogen and progestin) and progestin-only pills (also called mini-pills). Women often use oral contraceptives not only for birth control but also for managing menstrual irregularities, heavy periods, acne, and conditions like polycystic ovary syndrome (PCOS).
Key Features of Oral Contraceptive Hormones
Purpose: Primarily used to prevent pregnancy, regulate menstrual cycles, and manage conditions like PCOS or acne.
Age Group: Typically used by women of reproductive age, usually from their teens through their 40s.
Hormones Involved: Contains synthetic forms of estrogen and/or progestin.
Daily Use: Oral contraceptives are taken daily, regardless of sexual activity, to maintain hormone levels and prevent ovulation.
What is Menopausal Hormone Therapy (MHT)?
Menopausal hormone therapy (MHT), also known as hormone therapy (HT), is used to manage the symptoms of perimenopause and menopause due to declining levels of estrogen and progesterone. Perimenopause is the decade leading up to menopause. During this time, the ovaries produce less estrogen, which leads to a range of physical and emotional symptoms. HT helps alleviate these symptoms by supplementing the body with the hormones that decline during this transitional phase.
Key Features of Hormone Therapy
Purpose: Used to relieve the symptoms of menopause and reduce long-term health risks associated with estrogen loss, such as osteoporosis.
Age Group: Typically used by women in perimenopause (the years leading up to menopause) and postmenopause (after menopause is complete).
Hormones Involved: Estrogen, progesterone and testosterone.
Duration: HT is used to manage menopausal symptoms and treatment should be tailored to each individual patient based on various factors (symptoms, personal medical history, family history, and long term goals). The duration should be a shared decision between the patient and the provider.
How Do Oral Contraceptives and MHT Differ?
While both oral contraceptives and hormone therapy involve estrogen and progestin, they have distinct differences in terms of purpose, hormonal content, and how they affect the body:
Purpose and Timing
Oral Contraceptives: The primary goal is to prevent pregnancy and regulate menstrual cycles. They are generally used by women in their reproductive years.
MHT: Used to alleviate menopausal symptoms and manage long-term health risks associated with menopause, such as bone loss. It is typically used by women in perimenopause and postmenopause.
Hormonal Composition
Oral Contraceptives: Usually contain higher doses of synthetic hormones (both estrogen and progestin) compared to HT. These higher doses are needed to consistently prevent ovulation and other processes involved in pregnancy.
MHT: Contains lower doses of hormones, specifically designed to replace the natural decline in estrogen and progesterone during menopause. Estrogen levels are typically much lower than in oral contraceptives because the goal is not to prevent ovulation but to relieve menopausal symptoms. The most common form of estrogen given is estradiol, which his natural to what our body makes. Natural progesterone is in the form of micronized progesterone, which is necessary to take for endometrial protection for women that still have an intact uterus.
Duration of Use
Oral Contraceptives: Taken daily, usually for many years, as long as pregnancy prevention is desired.
MHT: Usually prescribed for short- to medium-term use to manage menopausal symptoms, with the goal of minimizing potential long-term health risks. The length of treatment is individualized based on the woman's symptoms and risk factors.
Health Considerations
Oral Contraceptives
In addition to preventing pregnancy, birth control pills can have side benefits such as reducing the risk of ovarian cysts, improving acne, and regulating heavy or painful periods. However, they may also increase the risk of blood clots, especially in smokers or women over age 35.
MHT
MHT is effective in reducing and/or alleviating the various symptoms of menopause. There are many preventive benefits with MHT depending on the timing of when a woman starts taking the HT. Treatment is individualized to each patient. Personal medical history, lifestyle, and family history all play a role in the decision making when determining the safety and duration of MHT.
Hormone Delivery
Oral Contraceptives: Typically taken in pill form, but there are also options such as hormonal patches, implants or vaginal rings.
MHT: Available in a variety of forms, including pills, patches, gels, creams, and vaginal rings. The method of delivery can be tailored to the woman's needs and symptoms.
Although oral contraceptives and menopausal hormone therapy both involve the use of hormones, they serve very different purposes. Oral contraceptives are primarily designed to prevent pregnancy and manage menstrual cycles during a woman’s reproductive years, while hormone therapy is used to alleviate symptoms of perimenopause and menopause with the decline in estrogen, progesterone, and testosterone.
Understanding the differences between these two therapies can help women make informed decisions about their reproductive health and their approach to managing hormonal changes. Always consult with a healthcare provider to determine which therapy is right for your individual needs and health circumstances.
